Global testicular infarction

Last revised by Yaïr Glick on 27 Aug 2022

Citation, DOI, disclosures and article data

Citation:

Bell D, Glick Y, Bickle I, et al. Global testicular infarction. Reference article, Radiopaedia.org (Accessed on 27 Apr 2024) https://doi.org/10.53347/rID-69383

DOI:

https://doi.org/10.53347/rID-69383

Permalink:

https://radiopaedia.org/articles/69383

rID:

69383

Article created:

9 Jul 2019, Daniel J Bell ◉

Disclosures:

At the time the article was created Daniel J Bell had no recorded disclosures.

View Daniel J Bell's current disclosures

Last revised:

27 Aug 2022, Yaïr Glick ◉

Disclosures:

At the time the article was last revised Yaïr Glick had no financial relationships to ineligible companies to disclose.

View Yaïr Glick's current disclosures

Revisions:

13 times, by 9 contributors - see full revision history and disclosures

Systems:

Urogenital, Paediatrics

Tags:

cases

Synonyms:

Complete testicular infarction
Acute testicular infarction

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 ischaemia ¹. Hyperaemia and increased Doppler flow suggest infection (e.g. epididymo-orchitis), whereas reduced flow indicate testicular ischaemia. Spermatic cord torsion identified on ultrasound is the most specific finding in testicular ischaemia ². In paediatric cases where testes are smaller and colour Doppler may be suboptimal, contrast enhanced ultrasound (CEUS) may be utilised 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 ischaemia.

Pathology

Aetiology

testicular torsion
epididymo-orchitis ^4-7
iatrogenic
- surgery, e.g. inguinal hernia repair ¹⁰
- post-EVAR due to cholesterol embolisation ¹¹
trauma
vasculitis, e.g. Henoch-Schönlein purpura ⁹
sickle cell disease: very rare, 6 cases reported globally, as of 2018 ⁸

Quiz questions

References

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8. Alsulmi HA. Testicular infarction in a patient with sickle cell anemia: A case report. (2018) International journal of health sciences. 12 (5): 100-102. Pubmed
9. Toushan M, Atodaria A, Lynch SD et-al. Bilateral Testicular Infarction from IgA Vasculitis of the Spermatic Cords. (2017) Case reports in nephrology. 2017: 9437965. doi:10.1155/2017/9437965 - Pubmed
10. Kim MH, Kim CG, Park SA et-al. Usefulness of Tc-99m Pertechnetate SPECT/CT in the Diagnosis of Testicular Infarction After Inguinal Herniorrhaphy. (2017) Nuclear medicine and molecular imaging. 51 (4): 357-359. doi:10.1007/s13139-016-0469-y - Pubmed
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