Epididymitis leading to testicular infarction

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Left hemiscrotal pain and swelling for the last few days.

Patient Data

Age: 40 years
Gender: Male

The left epididymis is enlarged, mildly hypoechoic with the presence of hypervascularity. The left testis reveals normal size, normal echopattern with mild hypervascularity. There is no focal lesion in the epididymis or the testis. There is no hydrocele. The left hemiscrotal wall is edematous.

The right epididymis and testis are normal. The right hemiscrotal wall thickness is normal.

10 days FU study was done...

ultrasound

10 days FU study was done to persistant pain even with Rx.

The left testis is enlarged, heterogeneous, hypoechoic without flow signals. Left epididymis shows enlargement and hypervascularity. There is a rim of fluid in the left tunica vaginalis. The left hemiscrotal wall is edematous. There was no twisted spermatic cord.

The right epididymis and testis are normal. The right hemiscrotal wall thickness is normal.

Case Discussion

The case shows epidiymo-orchitis in at the time of presentation. In spite of treatment, the pain persisted and a second study was done 10 days later which revealed testicular infarction.

Surgery revealed testicular infarction and pyocele.

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