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spermatocele question

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A 55 yr old patient, 6'3" tall 175 pounds; was in an auto accident a little over a yr ago. He had left lap belt/groin pain and left sided sciatica with lumbar and sacral sprains. Left big toe fractured causing altered gait for over 4 months. He continued to work as a grocery produce stocker with increasing pain, until he couldn't take it any longer. The ER doc put him back to work after 2 weeks off. He didn't see me until 11 months post auto accident. The low back pain resolved by about 85%. The left sciatica continues daily. The left groin pain became so persistent and intense that I sent him to a urologist who found (with palpation and ultrasound) a spermatocele 3.3 X 3.3 X 1.7 cm and offered the following statement:

"There is absolutely no way to prove or disprove this was caused by trauma; as a spermatocele almost without excpetion occurs in indivuduals with no history of trauma. ALthough there is some 'theory' that trauma may cause on to form."

The case is ready to go to arbitration. Anyone have any experience with this sequella following trauma in any of your patients?

thanks.

Minga Guerrero DC

abowoman@...

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I believe that it doesn't matter if he had it before the accident. If the

accident made him symptomatic then it is related?

s. fuchs dc

>

>

> A 55 yr old patient, 6'3 " tall 175 pounds; was in an auto accident a little

over a yr ago. He had left lap belt/groin pain and left sided sciatica with

lumbar and sacral sprains. Left big toe fractured causing altered gait for over

4 months. He continued to work as a grocery produce stocker with increasing

pain, until he couldn't take it any longer. The ER doc put him back to work

after 2 weeks off. He didn't see me until 11 months post auto accident. The low

back pain resolved by about 85%. The left sciatica continues daily. The left

groin pain became so persistent and intense that I sent him to a urologist who

found (with palpation and ultrasound) a spermatocele 3.3 X 3.3 X 1.7 cm and

offered the following statement:

>

> " There is absolutely no way to prove or disprove this was caused by trauma; as

a spermatocele almost without excpetion occurs in indivuduals with no history of

trauma. ALthough there is some 'theory' that trauma may cause on to form. "

>

> The case is ready to go to arbitration. Anyone have any experience with this

sequella following trauma in any of your patients?

> thanks.

>

>

> Minga Guerrero DC

> abowoman@...

>

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