Testicular infarction secondary to epididymo-orchitis

Case contributed by Khalid Alhusseiny
Diagnosis certain

Presentation

Insidious onset of right side scrotal pain and swelling.

Patient Data

Age: 40 years
Gender: Male

At presentation

ultrasound

The right epididymis is enlarged with increased vascularity denoting epididymitis.

The right testis is enlarged with absent diastolic flow denoting increased flow resistance.

Left testis and epididymis are of average size and homogeneous echopattern with average perfusion.

On follow-up

ultrasound

On follow-up 5 days after presentation; the right testis became hypoechoic and heterogenous with absent blood flow.

Case Discussion

The case represents testicular venous infarction as a complication of epididymo-orchitis that cause testicular edema and compromised blood flow.

On Doppler evaluation there will be absence of the diastolic flow followed by reversed diastolic flow and eventually loss of systolic flow.

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