Penetrating injury to the scrotum is uncommon. Usually not serious in
itself it may be associated with other more serious conditions. A 15-y
ear-old boy was involved in a tobogganing accident, and a shard of woo
d penetrated the left scrotum, the anterior abdominal wall and the rec
tus sheath one-third of the way from umbilicus to xiphisternum. There
was also a liver laceration. Removal of the piece of wood and closure
df the wounds with drainage resulted in successful recovery. A 45-pear
-old man, sustained a penetrating straddle-type injury from a broom ha
ndle. The handle penetrated Dartos fascia but there was no testicular
injury. It also perforated the rectus sheath 6 cm inferior to the cost
al margin, and both anterior and posterior gastric malls. The tract of
the handle extended along the base of the transverse mesocolon and po
sterior to the pancreas. The perforations were debrided and repaired.
The patient received a 5-day course of broad-spectrum antibiotics and
recovered fully. As a result of their experience with these two patien
ts the authors recommend that when there is penetration of Dartos fasc
ia, the testicle and cord should be inspected, lavage and debridement
should be carried out, and any foreign bodies should be removed and th
e injuries repaired. Antibiotics should be given perioperatively. In a
ll cases the entire tract should be explored to its terminus to search
for other injuries. Even upper abdominal injuries can occur with pene
trating scrotal injuries.