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2 wk later the patient returns in the emergency room
Diffuse thickening of the scrotal wall. Diffusely increased echogenicity of the fat planes is observed in the right inguinal canal region, with some foci of higher echogenicity associated with acoustic shadowing suggestive of gas dissection.
The right testicle has increased dimensions and is heterogeneous echotexture, with two circumscribed nodular lesions which has heterogeneous hypoechoic content and no doppler flow, measuring 4.0 ml and 4.2 ml (abscess).
Hydrocele with heterogeneous hypoechoic content compatible with the hypothesis of pyocele.