Necrotising epididymo-orchitis with scrotal abscess

Muttarak, M; Chiangmai, Wittanee Na; Kitirattrakarn, Pruit

doi:10.2349/biij.1.2.e11

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…Although there are several case reports where orchiectomy has been performed for testicular abscess, it is rare to salvage a testis in this situation 2 3Learning points

Long-term indwelling urethral catheters should be avoided.

Even in cases of testicular abscess and necrosis it may be possible to salvage the testis.

While performing debridement for testicular abscess, a staged closure may be performed to confirm the viability and to ensure that further necrosis has not taken place.

…”

Section: Discussionmentioning

confidence: 99%

Salvaging a solitary necrotic testis in a quadriparetic

Chaudhary

Singh²,

Jain³

et al. 2014

BMJ Case Reports

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“…Although there are several case reports where orchiectomy has been performed for testicular abscess, it is rare to salvage a testis in this situation 2 3Learning points

Long-term indwelling urethral catheters should be avoided.

Even in cases of testicular abscess and necrosis it may be possible to salvage the testis.

While performing debridement for testicular abscess, a staged closure may be performed to confirm the viability and to ensure that further necrosis has not taken place.

…”

Section: Discussionmentioning

confidence: 99%

Salvaging a solitary necrotic testis in a quadriparetic

Chaudhary

Singh²,

Jain³

et al. 2014

BMJ Case Reports

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“…Typically, pain associated with epididymoorchitis improves when the testicle is elevated above the level of the pubic symphysis (the Prehn sign); such improvement does not occur in testicular torsion. Testicular edema may compromise testicular venous outflow, leading to necrosis ( Fig 5) (20). Late or incomplete treatment of epididymoorchitis may be complicated by pyocele or testicular abscess formation (Figs 5, 6) (21).…”

Section: Scrotal Emergenciesmentioning

confidence: 99%

Imaging of Penile and Scrotal Emergencies

Avery¹,

Scheinfeld²

2013

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131

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Penile and scrotal emergencies are uncommon, but when they do occur, urgent or emergent diagnosis and treatment are necessary. Emergent conditions of the male genitalia are primarily infectious, traumatic, or vascular. Infectious conditions, such as epididymitis and epididymo-orchitis, are well evaluated at ultrasonography (US), and their key findings include heterogeneity and hyperemia. Pyocele and abscess may also be seen at US. Fournier gangrene is best evaluated at computed tomography, which depicts subcutaneous gas. Vascular conditions, such as testicular torsion, infarction, penile Mondor disease, and priapism, are well evaluated at duplex Doppler US. The key imaging finding of testicular torsion and infarction is a lack of blood flow in the testicle or a portion of the testicle. Penile Mondor disease is characterized by a lack of flow to and noncompressibility of the superficial dorsal vein of the penis. Clinical examination and history are usually adequate for diagnosis of priapism, but Doppler US may help confirm the diagnosis. Traumatic injuries of the penis and scrotum are initially imaged with US, which depicts whether the penile corpora and testicular seminiferous tubules are contained by the tunicae albuginea; herniation of contents and discontinuity of the tunica albuginea indicate rupture. In some cases, magnetic resonance imaging may be performed because of its ability to directly depict discontinuity of the tunica albuginea. Radiologists must closely collaborate with emergency physicians, surgeons, and urologists to quickly and efficiently diagnose or rule out emergent conditions of the male genitalia to facilitate prompt and appropriate treatment.

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“…В острой стадии АЯ может протекать под маской острых заболеваний пахово-мошоночной области, объединённых общим термином «острая мошонка» (acute scrotum), принятым в англоязычной медицинской литературе, таких как острый банальный эпидидимоорхит, перекрут семенного канатика, гематома мошонки, ущемлённая пахово-мошоночная грыжа, опухоль яичка с распадом [6,15,24,32,34,39].…”

unclassified

“…Приблизительно у четверти пациентов заболевание характеризуется стёртым клиниколабораторным течением, симулируя опухоль яичка или туберкулёзный орхит [6,24,39,53,54]. Описаны случаи АЯ, в которых начало заболевания проявлялось клинической картиной острого живота по типу острого аппендицита, ущемлённой пахово-мошоночной грыжи, заворота толстой кишки [18,34,49,51].…”

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Testicular abscess

Prokhorov¹

2016

Kazan Med J

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In the present literature review modern view on the etiopathogenesis, clinical course, diagnosis, treatment and prognosis of testicular abscess, which is a rare disease, are described. Testicular abscess develops most often as a result of acute epididymo-orchitis (more than 80% of all cases), much rarer due to testicular inversion and injury. The etiological agent is often E. coli. The disease occurs at any age, especially in immunocompromised patients. Clinical and laboratory picture of testicular abscess has symptomatic nature and consists of local and general signs of purulent inflammation. There are no pathognomonic clinical symptoms. Testicular abscess may occur under the guise of acute inguinal and scrotal area diseases, in a quarter of patients it is characterized by inapparent clinical and laboratory course, simulating testicular tumor or tuberculous orchitis. Diagnostic difficulties are caused by nonspecific clinical and laboratory characteristics and radiation patterns, disease infrequency and a lack of awareness among physicians. Suspicion of testicular abscess arise in ineffectiveness of antibiotic therapy for acute epididymo-orchitis during the first 5-7 days of disease and makes physician to perform necessary X-ray studies. The method of choice for the testicular abscess diagnosis is ultrasound examination. The diagnostic capabilities of other radiation techniques have currently been studying. Ultrasound picture of testicular abscess depending on the disease stage is varying and does not differ from the ultrasound picture of abscess of other localization. The most difficult is differential diagnosis of abscess and testicular tumors. In diagnostically ambiguous cases, ultrasound-guided percutaneous testicle biopsy or exploratory surgery are performed. Choice of treatment method is determined by the disease stage. A variety of conservative and surgical treatment methods of the testicular abscess are applied, such as antibiotic therapy, percutaneous puncture and ultrasound-guided abscess aspiration, abscessotomy and orchiectomy. Prognosis for life is favorable with timely treatment of disease.

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Necrotising epididymo-orchitis with scrotal abscess

Cited by 4 publications

References 3 publications

Salvaging a solitary necrotic testis in a quadriparetic

Salvaging a solitary necrotic testis in a quadriparetic

Imaging of Penile and Scrotal Emergencies

Testicular abscess

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