Discontinuity of the tunica albuginea with mild contour irregularity of left testis , localized hypoechoic echotextuter with loss vascularity noted involving the superior pole of the left testis
Left epidydimis paper enlarged and hetero echoic
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Hematocele occurs where there is blood between the layers of a sac that surrounds each testicle. Traumatic injury, such as a direct blow to the testicles, is the most likely cause.
Initial conservative treatment for patients with minor trauma in which the testes are unequivocally spared and the scrotum has not been violated. The usual treatment consists of scrotal support, nonsteroidal anti-inflammatory medications, ice packs, and bed rest for 24-48 hours.
Scrotal support decreases scrotal mobility and the likelihood of aggravating the injury. Anti-inflammatory medications decrease scrotal edema and provide nonsedating analgesia. Ice packs applied to the groin at least every 3-4 hours decrease swelling in the acute phase.
Failure of medical management after an appropriate period of observation warrants imaging of the scrotum with ultrasonography and Doppler studies.
In the case of testicular dislocation, manual reduction has been used successfully in 15% of cases. Future elective orchiopexy should still be performed to minimize the risk of torsion.