Presentation
Pain and swelling of the scrotum.
Patient Data
Mild diffuse thickening of the skin of the scrotum, nonspecific. Testes are symmetrical with no signs of focal lesions. Absence of hydrocele.
Antibiotic therapy was initiated.
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.
Case Discussion
After the initial diagnosis of orchitis, the patient was lost to follow-up treatment. He returned in 2 weeks with a clinical complication characterized on ultrasound as testicular abscesses, pyocele and panniculitis toward the right inguinal canal.
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