Global testicular infarction

Case contributed by Dr Mostafa El-Feky

Presentation

Recent postoperative status for left varicocele.

Patient Data

Age: 40 years
Gender: Male
Ultrasound

Both testes are average in size (~13 cc in volume). 

The left testis is markedly hypoechoic with absent parenchymal vascularity. The left epididymis and spermatic cord are enlarged with heterogeneous hyperechoic texture and decreased vascularity, suggestive of ischemia.

The right testis shows preserved echogenicity and parenchymal vascularity.

Case Discussion

The patient presented with pain with recent history of varicocelectomy on the left side few days ago. There is marked discrepancy in appearance between both testes, although having the same size. The marked hypoechoic texture and absent vascularity are in keeping with testicular infarction. There are associated ischemic changes of the epididymis and spermatic cord.

Global testicular infarction is one of the uncommon complications of varicocelectomy. It is believed to be due to soft tissue edema at inguinal canal that compressed testicular vessels leading to ischemia.

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