Isolated thrombosis of right spermatic vein with underlying Factor V Leiden mutation

Bolat, Deniz; Günlüsoy, Bülent; Yarımoğlu, Serkan; Ozsinan, F.; Solmaz, Şerife; İmamoğlu, Fatma Gül

doi:10.5489/cuaj.3208

Cited by 13 publications

(8 citation statements)

References 10 publications

(14 reference statements)

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“…Summation of all the reports make us come to a conclusion that medical therapy may be successful if only a single superficial spermatic vein is involved, while in cases like ours where the majority of pampiniform plexus is thrombosed, surgical management will have a better outcome. This conclusion is similar to the one by Bolat et al who opined that treatment can be started conservatively, with surgical intervention reserved for failed cases on an emergent basis [ 5 ]. Similarly Isenberg et al advice that though venography, Doppler can be diagnostic, surgery should not be delayed in doubtful cases [ 9 ].…”

Section: Discussionsupporting

confidence: 86%

“…Varicocele thromboses can occur post operatively (5 cases) or spontaneously (5 cases) [ 2 – 4 ]. Spontaneous thrombosis can occur due to trauma or in patients with coagulation abnormalities [ 5 ]. Kayes et al had reported that vigorous sexual or sporting activity, infections, trauma, long hour flights and drugs could cause this condition [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Thrombosed varicocele - a rare cause for acute scrotal pain: a case report

2018

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BackgroundAcute scrotal pain has various causes. Testicular torsion, torsion of appendages and Epididymo-orchitis are common causes, while varicocele thromboses are a rare cause. Varicocele thromboses can occur post operatively or spontaneously. Five cases of post-operative and five cases of spontaneous thromboses have been described till date. The traditional advice in the management of thrombosed varicocele has been to manage it conservatively in all patients by drugs and scrotal support with little description of the surgical treatment. Herein, we present an unusual sixth case of spontaneous thromboses of varicocele and discuss its presentation and surgical management. We would also like to highlight the differentiating points between spontaneous thrombosis and post operative in vitro clot formation in the varicoceles, as these two entities can often be confused for each other.Case presentationA 68 year-old man presented with excruciating scrotal pain of one week duration. Doppler study of scrotum revealed left varicocele with no evidence of Epididymo-orchitis. He was treated with intravenous antibiotics, analgesics and scrotal elevation. He had no relief and continued to have severe pain. Clinical examination was normal. Patient underwent exploratory surgery on a semi- emergent basis. Exploration revealed normal testis with thrombosed varicoceles. Patient underwent Varicocelectomy. Postoperatively patient had immediate pain relief. Histopathology revealed prominent thrombosed varicocele. A varicocelectomy specimen (done for primary infertility) was used for comparison. The differentiating points between the two entities were noted.ConclusionSpontaneous thrombosis of varicocele is a rare cause of acute scrotal pain. Pain out of proportion to clinical features is characteristic. Patients not responding to medical therapy may need varicocelectomy. Varicocelectomy may give immediate relief. Histopathology is useful in this disorder.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Thrombosed varicocele - a rare cause for acute scrotal pain: a case report

2018

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“…The present case is relevant because it is the third of its kind reported on the right side worldwide (1,9) and because a favorable outcome and an acceptable follow-up were achieved. The limitations of this report include the fact that no specific etiology was found to explain the onset of the disease.…”

Section: Discussionmentioning

confidence: 80%

Trombosis de la vena espermática derecha. Primer caso clínico reportado en Colombia

et al. 2021

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Introducción. La trombosis de la vena espermática (TVE) es una entidad muy poco frecuente de la cual no se tienen datos epidemiológicos específicos. Su presentación es de predominio izquierdo, en la mayoría de los casos su causa es desconocida y su diagnóstico suele realizarse por exclusión en el estudio del escroto agudo. A continuación, se presenta el primer caso documentado de TVE en Colombia y uno de los pocos de lateralidad derecha en el mundo. Presentación del caso. Hombre de 21 años quien consultó al servicio de urgencias de una institución de tercer nivel de atención de Bogotá, Colombia, por un cuadro clínico de una semana de evolución consistente en dolor en región inguinoescrotal derecha que aumentó progresivamente de intensidad y estuvo acompañado de un pico febril no cuantificado; el paciente indicó como único antecedente médico un trauma craneoencefálico leve sin secuelas a los 20 años. Se realizó estudio con ecografía Doppler testicular en donde se observó trombosis del cordón espermático derecho. Se inició manejó con antibioticoterapia, heparinas de bajo peso molecular y cumarínicos, con lo cual se obtuvo una adecuada respuesta y la resolución del cuadro. Conclusión. La TVE representa un reto diagnóstico, por lo que se requiere de una alta sospecha clínica, la cual se genera teniendo conocimiento de la entidad e incluyéndola en el diagnóstico diferencial del escroto agudo. La ecografía Doppler es una herramienta fundamental para diagnosticar TVE, además permite iniciar un tratamiento conservador oportuno, seguro y eficaz que evite desenlaces desfavorables para el paciente, lo que resulta ser costo-efectivo.

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“…Bilateral pampiniform plexus thrombosis reported by Kamel et al was caused by protein C deficiency, whereas Bakshi described an idiopathic case mimicking incarcerated hernia [1,2]. The literature has described several etiologies for spermatic vein thrombosis, which include protein C deficiency, factor V Leiden mutation, underlying cancer, cardiac catheterization complications, inguinal region injury, and after suspected coronavirus disease 2019 (COVID-19) infection [1][2][3][4][5][6][7]. The nutcracker syndrome where there is compression of the left renal vein in the aortomesenteric space is also complicated by spermatic vein thrombosis in one study [8].…”

Section: Discussionmentioning

confidence: 99%

“…The low blood flow in the left testicular vein as it joins the left renal vein is the cause of left dominance of spermatic vein thrombosis, and any cause of decreased flow in the testicular vein such as genitourinary malignancy or conditions like nutcracker syndrome might lead to spermatic cord thrombosis [ 4 ]. Isolated right spermatic vein thrombosis reported in one study was associated with underlying factor V Leiden mutation [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Bilateral Spermatic Vein Thrombosis: A Rare Clinical Presentation

Kolleri¹,

Abdirahman²,

Mahmood³

et al. 2021

Cureus

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Cases of acute scrotum presenting to the emergency department are usually due to testicular torsion, complicated hernia, or epididymo-orchitis. Thrombosis of the spermatic vein is an uncommon entity and most of the cases reported to date are of unilateral involvement. Here, we present an extremely rare case of spontaneous bilateral spermatic vein thrombosis, which was diagnosed by a Doppler ultrasound of the testes. This article highlights its clinical presentation, radiological imaging, etiology, and management.

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Isolated thrombosis of right spermatic vein with underlying Factor V Leiden mutation

Cited by 13 publications

References 10 publications

Thrombosed varicocele - a rare cause for acute scrotal pain: a case report

Thrombosed varicocele - a rare cause for acute scrotal pain: a case report

Trombosis de la vena espermática derecha. Primer caso clínico reportado en Colombia

Spontaneous Bilateral Spermatic Vein Thrombosis: A Rare Clinical Presentation

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