Differential Diagnosis for Testicular Bleeding

• Single most likely diagnosis
  • Testicular torsion: This is the most likely diagnosis because testicular torsion is a medical emergency that can cause severe pain and bleeding due to the twisting of the spermatic cord, cutting off the blood supply to the testicle.
• Other Likely diagnoses
  • Testicular trauma: Direct injury to the testicles can cause bleeding, and this is a common scenario in cases of testicular bleeding.
  • Epididymitis: Inflammation of the epididymis, usually due to infection, can cause pain and potentially bleeding in the testicular area.
  • Varicocele: Enlargement of the veins within the scrotum can sometimes cause bleeding, although this is less common.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Testicular cancer with hemorrhage: Although rare, testicular cancer can cause bleeding, and missing this diagnosis could have severe consequences.
  • Spermatic cord thrombosis: A blood clot in the spermatic cord can cause testicular ischemia and potentially bleeding, which is a serious condition.
• Rare diagnoses
  • Henoch-Schönlein purpura (HSP): A systemic vasculitis that can cause testicular pain and bleeding, although this is an uncommon presentation.
  • Polyarteritis nodosa (PAN): A rare autoimmune disorder that can affect various arteries, including those supplying the testicles, potentially leading to bleeding.