Segmental testicular infarction: a case report

Abstract

BackgroundSegmental testicular infarction is a very rare condition, which can mimic a testicular torsion or testicular cancer. Correct diagnosis is difficult but it is important to avoid unnecessary radical treatment.Case presentationWe report a clinical case of a 36-year-old white man who presented at our emergency department with subacute testicular pain. A urine analysis, Doppler ultrasound, surgical exploration, blood analysis, and magnetic resonance imaging were performed to diagnose his condition, to exclude a testicular torsion, and to raise confidence in its non-malignancy. He was treated conservatively. At follow-up, a few months after the incident, he no longer had complaints. Ultrasonography showed remaining hypo-echogenicity of the left upper pole, indicating a sequel of ischemia.ConclusionsSegmental testicular infarction is a rare condition which can be easily confused with a testicular torsion or a testicular tumor. This case report can be helpful in recognizing and diagnosing this condition. Making the right diagnosis is important since it can prevent an unnecessary radical treatment.

Idiophatic Asynchronous Bilateral Segmental Testicular Infarction and Anticoagulant Therapy: A Case Report

“…The pathogenesis is still not well known and is usually idiopathic 8 . Reduced or interrupted blood flow, insufficient collateral blood supply, and thrombus formation is one of proposed mechanisms [9][10][11] . Epididymo-orchitis is a one of the well-known underlying causes 12 .…”

Sonographic Discovery of Segmental Testicular Infarction

“…Color Doppler will show reduced or absent flow within the area of infarction. 5 There is a broad spectrum of testicular pathologies that share similar clinical symptoms making segmental testicular infarction difficult to distinguish from other findings. Because the sonographic presentation of testicular masses or testicular torsion are similar, these are the two most common differential diagnoses.…”

“…Patients usually clinically present with acute scrotal pain and swelling; however, some studies have found that these symptoms may be variable or absent. 5 Physical examinations of the testis are typically normal without a palpable mass. Sonography of the testicles using color and pulsed wave Doppler is important for making a diagnosis of segmental infarctions.…”

Etiology of testicular pain 2019: Classification into ten logical subgroups

“…Initial onset can be similar to that of testicular torsion, with a sudden and lacerating pain, but it is also described in patients with falciform anemia or septic embolus during bacterial endocarditis. (37) with panic attacks. (41,42)…”