Testicular infarction secondary to epididymo-orchitis

Case contributed by Dr Muhammad Yousaf

Presentation

Worsening testicular pain.

Patient Data

Age: 30 years
Gender: Male

Ultrasound images show enlarged right epididymis, testis, and thickened inflamed cord. The right testis is enlarged, heterogeneous, and shows no internal vascularity. The right epididymis and left testis show normal to increased vascularity. Mild right hydrocele.

Orchiectomy was performed after confirming the testis to be non viable.

Case Discussion

This case shows testicular ischemia/infarction as a complication of epididymo-orchitis. The patient was admitted with epididymo-orchitis three days prior to this ultrasound (day 1 USG images not available) and was put on a double antibiotic cover but his pain kept increasing. On day 3rd, again ultrasound was done to look for any abscess/collection. There was no evidence of any abscess formation but a lack of testicular vascularity.

Upon surgical exploration, testis was non viable. There was no evidence of torsion. An orchiectomy was then performed. 

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