Bilateral testicular infarction caused by epididymitis.

Eisner, David; Goldman, S M; Petronis, John D.; Millmond, S H

doi:10.2214/ajr.157.3.1872237

Cited by 47 publications

(22 citation statements)

References 7 publications

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“…This may reflect the underlying mechanism of the vascular insult to the testis. Global testicular infarction may occur as a result of severe epididymo-orchitis [9,24,25]. Segmental infarction will also occur with epididymo-orchitis with speculation that the predominant vascular insult in a round-shaped lesion is compromise to venous drainage and a wedge-shaped lesion is secondary to arterial compromise.…”

Section: Discussionmentioning

confidence: 99%

Clinical and ultrasound features of segmental testicular infarction: Six-year experience from a single centre

et al. 2007

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The purpose was to analyse the aetiology and ultrasound appearances of segmental testicular infarction. Patients with focal testicular lesions underwent colour Doppler high frequency ultrasound. Segmental testicular infarction was defined as any focal area of altered reflectivity, with or without focal enlargement with absent or diminished colour Doppler flow, proven on histology or on follow-up exclusion of lesion progression. Patients were reviewed to document lesion shape, position, border definition, reflectivity and vascularity and correlated to presenting clinical symptoms and signs. Over a 6-year period 24 patients were defined as having segmental testicular infarction; median age was 37 years (range 16-82 years). All presented with a sudden onset of testicular pain. Of the patients, 14/24 (58.3%) had scrotal inflammatory disease, 5/24 (20.8%) had evidence of spermatic cord torsion, and three patients were termed idiopathic; 12/24 (50.0%) were of low reflectivity, 11/24 (45.8%) of mixed reflectivity, one of high reflectivity, 11/24 (45.8%) were wedge shaped, and 13/24 (54.2%) were round shaped. Of the patients, 8/24 (33.3%) demonstrated a mass effect, all with round-shaped lesions and with underlying epididymo-orchitis in seven. Absent colour Doppler flow was demonstrated in 20/24 (83.3%). Histology confirmed infarction in 8/24 (33.3%), and 12/24 (50.0%) had follow-up examinations without progression of the lesions. Segmental testicular infarction has characteristic ultrasound features, not always wedge-shaped, with reduced or absent vascularity of key importance. Awareness of the ultrasound features will allow for conservative management and avoid unnecessary orchidectomy.

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Section: Discussionmentioning

confidence: 99%

Clinical and ultrasound features of segmental testicular infarction: Six-year experience from a single centre

et al. 2007

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“…An uncommon complication is testicular infarction which may be segmental [3,23] or rarely global [24], with absence of colour Doppler signal as the hallmark. Contrast-enhanced ultrasound may be useful in identifying nonviable testicular parenchyma or abscess formation [25].…”

Section: Epididymitismentioning

confidence: 99%

A review of ultrasound imaging in scrotal emergencies

Yusuf

Sidhu

2013

J Ultrasound

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Scrotal emergencies represent a small proportion of admissions to the emergency department; however, the intimate nature and potential for serious outcome often cause great anxiety. Rapid assessment is required to exclude fertility-threatening conditions and expedite surgical management. Ultrasound is an essential tool in acute scrotal assessment as it allows rapid, radiation-free, highresolution imaging and, importantly, assessment of vascularity with colour Doppler imaging. In the presentation of the acute scrotum, the ''on-call'' practitioner will frequently be asked to exclude pathology requiring surgical management, in particular torsion of the spermatic cord. To provide an accurate evaluation the individual is required to have an understanding of scrotal anatomy, sonographic technique and recognition of pathology. This review article will familiarise the reader with the sonographic findings of common acute scrotal pathology.Sommario Le emergenze scrotali rappresentano una piccola percentuale di accessi al pronto soccorso, ma la natura intima e la possibilità di esiti seri sono spesso causa di grande ansia. E' necessaria una valutazione rapida, al fine di escludere condizioni di pericolo per la fertilità e accelerare il trattamento chirurgico. L'ecografia è uno strumento essenziale per la valutazione dello scroto acuto in quanto rapida, esente da radiazione, ad alta risoluzione e, soprattutto, permette la valutazione della vascolarizzazione con colour Doppler. Nello scroto acuto l'ecografista spesso verrà chiamato a escludere patologie che richiedono un trattamento chirurgico, in particolare la torsione del funicolo spermatico. Al fine di fornire una valutazione precisa è tenuto ad avere una conoscenza dell'anatomia scrotale, della tecnica ecografica e a conoscere le varie patologie. Questo articolo di revisione ha lo scopo di familiarizzare il lettore con gli aspetti ecografici della patologia scrotale acuta più frequente.

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“…6 Our case suggests that testicular Doppler analysis of patients with large and/or painful hydroceles may be a useful adjunct to physical examination because occult vascular compromise may be present which, if undetected, could lead to testicular ischemia.…”

Section: Discussionmentioning

confidence: 84%

“…2 Venous infarction of the testis has been seen after epididymitis. 6 Although a hydrocele can accompany epididymitis and testicular torsion, it has not been directly implicated as a cause of testicular ischemia. Our case demonstrated a resistive index of 1.0 within a testicular capsular artery, without evidence of torsion, epididymitis, or a history of trauma.…”

Section: Discussionmentioning

confidence: 99%