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DOI: 10.4103/ijmbs.ijmbs_90_20
Direct gunshot wound to the testicular artery: A rare case report
Gunshot wounds (GSWs) to male genitalia are rare. They have mainly been described in the military and urban trauma settings, such as in sports activities or violent interactions. Male genitalia can be injured in an isolated way or in association with other genitourinary traumatism. GSWs can also determine vascular injuries which can be life-threatening. We report a rare case of direct GSW of the testicular artery and a scrotal hematoma without a primary injury of the testis. We present the case of a 29-year-old man with a direct GSW to the testicular artery. The patient underwent a surgical left inguinal exploration and orchiectomy. Intraoperative findings showed an actively bleeding from the left testicular artery at the level of the superficial inguinal ring. Dartos fascia and tunica vaginalis were thickened and testis was ischemic but not directly injured by GSW. After the surgery, cessation of bleeding and clinical stabilization occurred. The patient was discharged after 5 days. The pathology report showed an extensive ischemic infarction, heavy infiltration by acute inflammatory cells, excessive tissue edema, and congested blood vessels. Surgical exploration should be performed in all cases except for the most insignificant and superficial wound. All patients with a GSW to the external genitalia should be evaluated with an index of suspicion for other associated lesions. In this context, fertility and sexuality can be negatively impacted. Moreover, people with violence-related disabilities manifest a complex array of psychosocial and relational problems.
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Publikationsverlauf
Eingereicht: 17. Juli 2020
Angenommen: 21. September 2020
Artikel online veröffentlicht:
14. Juli 2022
© 2020. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Hudak SJ, Hakim S. Operative management of wartime genitourinary injuries at Balad Air Force Theater Hospital, 2005 to 2008. J Urol 2009;182:180-3.
- 2 Randhawa H, Blankstein U, Davies T. Scrotal trauma: A case report and review of the literature. Can Urol Assoc J 2019;13:S67-S71.
- 3 Maraqa TI, Shin JJ, Diallo I, Sachwani-Daswani GR, Mercer LC. Penetrating obturator artery injury after gunshot wounds: A successful multidisciplinary trauma team approach to a potentially lethal injury. Cureus 2017;9:e1857.
- 4 Mc Dougal W, Wein A, Kavoussi L, Partin A, Peters C. Campbell-Walsh Urology. 11th ed. US: Elsevier; 2016. p. 4176.
- 5 Cass AS, Luxenberg M. Testicular injuries. Urology 1991;37:528-30.
- 6 Cavalcanti AG, Krambeck R, Araujo A, Manes CH, Favorito LA. Penile lesion from gunshot wound: A 43-case experience. Int Braz J Urol 2006;32:56-60.
- 7 Simhan J, Rothman J, Canter D, Reyes JM, Jaffe WI, Pontari MA,et al. Gunshot wounds to the scrotum: a large single-institutional 20-year experience. BJU Int 2012;109:1704-7.
- 8 Ferguson GG, Brandes SB. Gunshot wound injury of the testis: The use of tunica vaginalis and polytetrafluoroethylene grafts for reconstruction. J Urol 2007;178:2462-5.
- 9 Mirenda F, Baccellieri D, Carmignani A, La Spada M, Benedetto F, Spinelli F. [Gunshot injury of superficial femoral artery. Surgical treatment without preoperative angiography: A case report]. Chir Ital 2006;58:117-20.
- 10 Mehra BL, Skandhan KP, Prasad BS, Pawankumar G, Singh G, Jaya V. Male infertility rate: A retrospective study. Urologia 2018;85:22-4.