Scrotal trauma: follow the tunica

Question 1What is the key structure to follow after scrotal trauma?

1. aThe spermatic cord only
2. bThe scrotal skin
3. cThe epididymis only
4. dThe tunica albuginea, the bright line around the testis

Question 2Which finding suggests testicular rupture?

1. aNormal flow and texture
2. bA break in the tunica with an irregular outline
3. cA thin, even layer of fluid around a normal testis
4. dA smooth tunica with a small dark area inside

Question 3Does a mixed-texture area inside an intact tunica prove rupture?

1. aOnly in children
2. bYes, always
3. cNo, it can be a contusion or haematoma
4. dYes, if it is dark

Question 4Why does early diagnosis of rupture matter?

1. aIt does not matter
2. bIt changes only the analgesia
3. cEarly surgical repair usually saves the testis
4. dRupture always heals on its own

Question 5The scan is difficult because of a large haematocele. What next?

1. aAspirate the haematocele in the emergency department
2. bDischarge and rescan next week
3. cUrgent urology review: a difficult scan must not delay it
4. dReassure the patient