Deep Vein Thrombosis: A Rare Cause of Acute Testicular Pain. Case Report: Literature Review

Abstract

Introduction: Thrombosis is defined as the formation of a clot in a blood vessel that obstructs the flow of blood to the peripheral tissues. The incidence of thromboembolic disease ranges from 0.7 to 1.2% within urology. Case Report: A 40-year-old warehouse worker male presented to the emergency department with worsening of a month’s lasting scrotal pain. Physical examination showed the presence of an enlarged and painful left testicle with no other findings. Right testicle, penis and abdominal examination showed no abnormalities whatsoever. Bilateral varicocele with a partial thrombosis of the left one associated with left inguinal hernia was diagnosed by performing an urgent testicular ultrasound test. Conservative treatment was first given. However, since pain was not relieved, surgery was indicated with left varicocelectomy and a left inguinal hernia repair procedure leading to complete symptoms control and normal testicular flow in the control Doppler ultrasound study 2 months after the surgery. Conclusion: Spontaneous thrombosis of the pampiniform plexus is a rare entity where the management remains controversial. The clinical case we report here shows that surgery may be considered an effective option.

Acute testicular vein thrombosis in a young patient with a solitary testicle: a rare urological emergency

“…Typically, in testicular vein thrombosis, a hypoechoic thrombus and endoluminal filling defect that restricts blood flow can be observed on scrotal color doppler ultrasonography (2,6,(12)(13)(14). In our case, the diameter of the intrascrotal segment of the left testicular vein increased in the cranial segment, and intraluminal hypoechogenic material was observed.…”

“…In the treatment of acute testicular vein thrombosis, antibiotics, anti-inflammatory drugs, and anticoagulants can be used as conservative treatment options, and scrotal elevation may also be recommended (6,(13)(14)(15). Cases in which the thrombosed venous segment was excised have also been reported in patients, who did not respond to conservative treatments or underwent a surgical exploration for diagnostic purposes (2,12,16,17).…”

“…Apart from this, kidneys are the most common source of thrombosis among urological organs, and renal infarction may develop as a result of thrombosis in renal vessels. Other urological causes of thromboembolism are Mondor's disease, called superficial vein thrombophlebitis of the penis and thrombosis of the panpiniform plexus that develops in patients with significant varicocele (2).…”

Rare cause of acute scrotal swelling and pain in adult- a case report on spontaneous pampiniform plexus thrombosis and literature review

“…Vicrow's triad is responsible for the pathology of thrombus formation and raised intraabdominal pressure might reduce the gonadal vein blood flow; therefore, creating an environment of stasis and thrombosis. Other etiologies such as retroperitoneal tumours, incompetent valves, compression of renal vein by superior mesenteric arteries were among the rare causes of thrombosis 4 , 5 . Medical condition like hypercoagulable state ought to be considered as well.…”

Case – Spontaneous thrombosis of varix in childhood

“…No guidelines exist for management of this diagnosis, but some case reports have shown effective management with conservative and/or surgical approaches. [8][9][10][11] In this report, we describe a case of unilateral thrombosed varicocele in a child managed conservatively.…”