Presentation
Acute left Hemi-scrotal pain and swelling. Negative trauma.History of multiple left scrotal surgeries.
Patient Data
Scrotal ultrasound confirmed tubular ectasia of the left epididymal head and body. There is no associated left spermatocele. There is a mild left-sided varicocele (extratesticular) typically accentuated on Valsalva. The testes demonstrated mild inhomogeneous echo appearance however no torsion or testicular abscesses. There are no hydroceles or inguinoscrotal hernias. There is reactive, bilateral, benign inguinal lymph adenopathy.
Sonographer: Ms Senamile Luthuli
Annotated and zoomed image of the left epididymal head demonstrating the speckled sonographic appearance typical for tubular ectasia.
Case Discussion
Features consistent with left-sided epididymal head and body tubular ectasia which is well demonstrated by the typical speckled sonographic appearance. In this instance, intra and extratesticular causes likely contributed to this finding. The patient confirmed prior left inguinal hernia repair, and multiple previous scrotal surgical interventions for unknown causes (possibly for complicated sepsis/ varicocele surgical management). He confirmed the absence of prior vasectomy.