Image of the Day 22: Laceration Wound of Scrotum

12 year old boy alleged fall while he wanted to jump into a river from a floating log. He eventually smashed his testes to the log surface. He sustained pain at the testicular region and noted some bleeding which stop upon compression. No loss of consciousness, no abdominal pain and no passing out of bloody urine.

Examination of the testis reveals laceration wound of testis exposing the external spermatic fascia. He was lucky that no damage to the testis occur and no skin loss.

IV line was inserted and he was given pain killer. The exposed wound was irrigated with normal saline and the testis was covered with wet gauze before he was sent for emergency wound exploration followed by wound toilet and suturing.

Revision: Layer of Testis

1. Scrotum

Skin

Superficial fascia with dartos muscle

2. External spermatic fascia (from external obliques muscle)

3. Cremaster muscle

4. Internal Spermatic Fascia (from transversus abdominis muscle)

5. Tunica vaginalis parietal (from peritoneum)

6. Tunica vaginalis visceral

7. Tunica albuginea and testis.