Testicular trauma can be classified aetiologically as blunt or penetrative. Bicycles and motorbikes are considered high risk for road traffic accidents accounting for 9-17% % of all blunt trauma. We present a case of assessment and management of isolated blunt testicular trauma in a tertiary care hospital. A 36-year-old gentleman presented to the accident and emergency department with testicular pain after a road traffic accident while riding a motorcycle. On arrival, he was fully conscious and denied any other injuries. On examination, he had bruising and gross swelling of the right hemiscrotum. Ultrasound of the scrotum revealed testicular rupture and emergency exploration was undertaken which confirmed the diagnosis. Testis was non-salvageable therefore orchidectomy was done. The patient had unremarkable post-operative recovery. A majority of testicular ruptures are secondary to blunt trauma mainly caused by sport-related injuries and road traffic accidents. Ultrasonography remains a non-invasive modality to investigate testicular injuries with a sensitivity of 100%. When not available in an emergency setting, scrotal exploration should be undertaken for both diagnostic and therapeutic purposes. Surgical repair done within 72 hours yields a 90% salvage rate after which the salvage rate is reduced significantly. Tumor markers should be checked in patients managed conservatively. Early assessment and diagnosis are crucial in the management of acute testicular rupture. Early intervention can salvage injured testes and an orchidectomy can be avoided.

Primary testicular lymphoma is the common testicular neoplasm in patients aged more than 65 years. It accounts for a small number of cases of adult testicular malignancies. Though the metastasis to bone marrow, liver, and central nervous system are well known, metastasis to adrenal glands is a very rare entity. It can be mistaken as a germ cell tumor or a dual malignancy. To rule out other causes, a multidisciplinary approach is required. Here, we present a rare case of primary testicular Non-Hodgkin\'s lymphoma with bilateral adrenal metastasis.

Traumatic injuries to the scrotum are uncommon but, when they do occur, frequently lead to serious complications. Early complications include testicular infarction, necrosis and abscess formation; in the longer-term trauma may result in testicular atrophy and subfertility. Early surgical intervention in patients with testicular rupture can significantly improve the clinical outcome and reduce the need for delayed orchidectomy. However, clinical examination of the scrotum following trauma is difficult and frequently inaccurate; this may result in incorrect triage of patients for surgical exploration. Scrotal ultrasound can reliably assess scrotal injuries and diagnose testicular rupture with a high level of accuracy. Additionally, ultrasound can provide important information regarding testicular perfusion, which can further inform decisions on surgical management. This article reviews the sonographic findings that may be encountered in patients with scrotal trauma, with an emphasis on blunt trauma. It describes the pivotal role that ultrasound can play in the accurate triage of these patients to surgical or conservative management.