Delayed presentation of blunt scrotal trauma, an avoidable cause of testicular necrosis in an adolescent: a case report

Introduction and clinical importance: Testicular trauma is a rare cause of acute scrotum, mainly affecting adolescents. It frequently occurs during sporting activities, and ultrasound enables the diagnosis of testicular lesions and the selection of appropriate treatment. Case presentation: We report the case of a 15-year-old admitted 2 weeks after a left blunt scrotal trauma. Preoperative scrotal ultrasound diagnosed a hematocele with blood flow interruption. The surgical exploration found an intratesticular hematoma with necrosis of the entire left testis. Prophylactic right testicular orchidopexy was performed, along with high-ligation left orchidectomy. The postoperative outcome was unremarkable 4 months after surgery. Clinical discussion: When testicular trauma occurs, diagnosis should be made in the early stages, as surgical management before 72 hours has a lower risk for orchidectomy. But hidden trauma and financial constraints may result in delayed diagnosis with subsequent darkening functional prognosis. Conclusion: Despite a theoretically good prognosis of intratesticular hematoma, delayed diagnosis due to socioeconomic factors may lead to testicular necrosis and subsequent avoidable orchidectomy.