What is beyond testicular torsion and epididymitis? Rare differential diagnoses of acute scrotal pain in adults: A systematic review

Sieger, Nadine; Quilio, Francesca Di; Stolzenburg, Jens‐Uwe

doi:10.1016/j.amsu.2020.05.031

Cited by 8 publications

(19 citation statements)

References 73 publications

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“…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.…”

Section: Discussionmentioning

confidence: 53%

“…In addition, compression of the left renal vein by the superior mesenteric artery can cause reduced blood flow and predisposition to stasis (8). The presence of varicocele, protein C deficiency or activated protein C resistance, infective status, drug abuse, and prolonged immobility have been suggested as predisposing factors for spermatic vein thrombosis (6). In addition, sexual intercourse or excessive sportive activity, prolonged flights, and prolonged sitting can also cause this condition (9).…”

Section: Discussionmentioning

confidence: 99%

“…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).…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatment is the first option as a testicular sparing approach. Surgical excision of the thrombosed segment has also been reported in cases that do not respond to treatment (6).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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Acute scrotal pain due to testicular vein thrombosis is a rare condition. Thrombosis is defined as clot formation within the blood vessels and as a result, it interrupts the blood supply of the peripheral organs. In routine urology practice, the incidence of thromboembolic diseases is <1%, and it is mostly encountered in patients at the postoperative period. Nevertheless, testicular vein thrombosis should also be remembered in the differential diagnosis of patients admitted to the emergency department due to acute scrotum. In general, conservative treatment is the first choice in treatment management, but surgical intervention may also be required in some cases. Since the available data on this subject are based on the information obtained from case reports, a standard treatment approach should be developed by examining the current treatment methods. We aim to present the case report of testicular vein thrombosis in the light of the literature, which is one of the rarely seen emergencies of urology. Keywords: acute pain; color doppler ultrasonography; venous thrombosis; testicular diseases

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…Because it is difficult to obtain tissue culture from all patients with epididymitis, it may be necessary to consider the escalation of antimicrobial agents when the clinical course deteriorates rather than relying solely on the results of urine culture. The diagnosis is often based on the ultrasonographic evaluation of blood flow, as in this case, but it is necessary to differentiate between scrotal abscesses and testicular infarction in the hypoechoic areas of the scrotum [12] . When the diagnosis is difficult, contrast-enhanced MRI is used as an adjunct for diagnosis [10] , [11] , but MRI is difficult to perform in facilities that do not have access to imaging.…”

Section: Discussionmentioning

confidence: 99%

Testicular infarction as a rare complication of pyogenic epididymoorchitis due to Pseudomonas aeruginosa: A case report and systematic literature review

Ishikawa¹,

Matsuo²,

Nakamura³

et al. 2021

IDCases

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Background Testicular infarction is a known serious complication associated with epididymitis. It is known to be idiopathic in 70% of cases but the frequency, risk factors, and management are yet to be elucidated. This paper aims to report a case of testicular infarction secondary to pyogenic epididymoorchitis caused by Pseudomonas aeruginosa. Case presentation A 64-year-old male with a past medical history of benign prostate hypertrophy using intermittent self-catheterization and a recent history of culture-negative pyogenic epididymoorchitis treated with oral cefpodoxime was admitted to our hospital due to a 4-week history of fever, right scrotal pain, and swelling. Scrotal ultrasonography showed a hypoechoic testis without testicular torsion. He was diagnosed with testicular infarction and a scrotal abscess due to Pseudomonas aeruginosa , and was treated with cefepime along with transcutaneous drainage. Despite the antimicrobial treatment, he experienced testicular loss with necrotic tissue. Because little is known about the risk factors, clinical characteristics, management, and prognosis of testicular infarction secondary to epididymitis, we performed a systematic review of the literature. Conclusion This is a case of testicular necrosis during the treatment of epididymitis with negative urine culture and detection of Pseudomonas aeruginosa in tissue culture. Clinicians should perform frequent blood flow evaluation to the testis for early urologic intervention.

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High risk and low prevalence diseases: Testicular torsion

Lacy¹,

Smith²,

Koyfman³

et al. 2023

The American Journal of Emergency Medicine

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What is beyond testicular torsion and epididymitis? Rare differential diagnoses of acute scrotal pain in adults: A systematic review

Cited by 8 publications

References 73 publications

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

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

Testicular infarction as a rare complication of pyogenic epididymoorchitis due to Pseudomonas aeruginosa: A case report and systematic literature review

High risk and low prevalence diseases: Testicular torsion

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