Global testicular infarction

Last revised by Yaïr Glick on 27 Aug 2022

Global testicular infarction is fortunately rare, and is most commonly seen in the context of testicular torsion. However rarely it can occur secondary to other causes. 

Doppler ultrasound is the mainstay for assessing testicular blood flow and diagnosing ischemia 1. Hyperemia and increased Doppler flow suggest infection (e.g. epididymo-orchitis), whereas reduced flow indicate testicular ischemia. Spermatic cord torsion identified on ultrasound is the most specific finding in testicular ischemia 2 . In pediatric cases where testes are smaller and color Doppler may be suboptimal, contrast enhanced ultrasound (CEUS) may be utilized to demonstrate reduced/absent testicular blood flow 3

Ultrasound in isolation is insufficient for diagnosis. Exploratory surgery is the gold standard in the assessment of testicular ischemia.

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