Penetrating Scrotal Trauma: A Case Report and Brief Management with Literature Review

Mehul S Patel Stephen H Culp

doi:10.4172/2167-1222.1000205

Abstract

Penetrating scrotal trauma is an uncommon injury that is often secondary to civilian or combat violence. Much of the literature on the topic is from case reports, small retrospective series from civilian trauma centers, and reports from combat zones. In this manuscript, a case report involving self-inflicted penetrating scrotal trauma from our institution is presented. Following the case report, accepted management strategies and recent literature on the topic of penetrating scrotal trauma are reviewed. Briefly, current management strategies for penetrating scrotal injuries involve initial resuscitation and stabilization of the patient, followed by operative exploration, with the primary operative goals of hemostasis, debridement, and testicular salvage. Recent case series of penetrating scrotal trauma have shown rates of testicular salvage that vary between institutions, mechanism of injury, and setting (civilian vs military/combat).

Highlights

IntroductionA 29-year-old male with chronic testicular pain and significant psychiatric and substance abuse history presented intoxicated to our emergency department with a self-inflicted scrotal laceration
Rare, penetrating scrotal trauma represents a medical emergency that emergency room physicians, traumatologists, and urologists must be able to assess and manage in a rapid and efficient manner
The patient immediately received urologic evaluation and the patient was emergently taken to the operating room for surgical exploration and management of his scrotal injury

Summary

Introduction

A 29-year-old male with chronic testicular pain and significant psychiatric and substance abuse history presented intoxicated to our emergency department with a self-inflicted scrotal laceration. He had been noncompliant with his prescribed psychiatric medications. There was a large laceration on the base of his penis extending to his scrotum His testicles were neither visualized nor palpable, and were not brought in by the patient. The patient immediately received urologic evaluation and the patient was emergently taken to the operating room for surgical exploration and management of his scrotal injury Preoperatively, his vitals remained relatively stable and were BP 120/64, HR 96, and RR 18; he was still afebrile. He was observed overnight and admitted to the psychiatric service the following morning

Discussion

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Conclusion