Scrotal abscess

Case contributed by Dr Henry Knipe

Presentation

Perineal pain.

Patient Data

Age: 83
Gender: Male
CT

Centred on the left scrotum is a 4.7 x 6.2 x 6.8cm cystic lesion with peripheral contrast enhancement. There is fat stranding associated with the remainder of the scrotum extending posteriorly in the subcutaneous tissues to towards the anus and superiorly towards the base of the penis. No associated gas. The spermatic cords on both sides are thickened and are hyperdense (~50HU) and this more likely represents venous engorgement rather than infection.

Prostatomegaly. Centred on the right bladder is a lobulated, enhancing mass that indents into the bladder. The bladder itself is collapse. Colonic faecal loading. No enlarged lymph nodes. No suspicious bone lesions.

Conclusion:

  1. Superficial Scrotal abscess. Fat stranding indicative of associated cellulitis.
  2. Mass lesion projecting into the left inferior bladder likely arises from an enlarged prostate. Cystoscopy could help clarify this.

Case Discussion

Clinically, this case presented as Fournier gangrene but subsequent investigation demonstrated a superficial scrotal abscess. Ultrasound (not shown) demonstrated normal testicular Doppler flow and this abscess separate to the testes. 

PlayAdd to Share

Case information

rID: 30162
Case created: 22nd Jul 2014
Last edited: 6th Sep 2015
System: Urogenital
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.