Acute scrotal pain with a twist (original) (raw)
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Segmental testicular infarction in a young man simulating a testicular tumor
Pediatric Radiology, 2009
A 19-year-old boy presented with a 48-hour history of acute onset severe right scrotal pain with minimal scrotal swelling. High-frequency US including color Doppler demonstrated a wedge-shaped, heterogeneous, avascular testicular mass diagnosed preoperatively as a segmental testicular infarction (STI). This was proved at surgery and subsequent histology. The preoperative diagnosis of STI was suggested based on the young man's presentation of severe pain and the sonographic appearance of the mass. Entertaining the preoperative diagnosis of STI from a testicular tumor is important for testis-sparing surgery even though STI in the pediatric age group is extremely rare.
Segmental Testicular Infarction Mimicking Testicular Seminoma
Urology & Nephrology Open Access Journal
Segmental testicular infarction could present as a hypoechoic well-rounded mass, with or without vascular flow and negative tumor markers mimicking testicular seminoma. We aim to present a case of segmental testicular infarction of the upper pole of the testis, the microscopic pathological assessment and a state of the art of the current management and diagnosis of this rare entity.
American Journal of Roentgenology, 2011
A cute segmental testicular infarction is an uncommon clinical situation. The etiologic mechanism is largely considered idiopathic, but cases have been associated with hypercoagulability disorders, vasculitis, torsion, trauma, infection [1], and iatrogenic vascular injury [2-4]. Segmental testicular infarction usually presents with acute scrotal pain and may resemble epididymoorchitis or torsion. Although surgery once was recommended, imaging has improved and increases confidence in assessment in many cases. If a firm diagnosis of segmental testicular infarction is reached on the basis of imaging features and negative tumor marker results, follow-up is advocated [1, 5]. Orchiectomy is not performed if symptoms subside and the lesion remains stable or shrinks. The appearance of acute segmental testicular infarction at gray-scale and color Dop
Segmental Ischemia in Testicular Torsion
Baylor University Medical Center Proceedings, 2016
Testicular torsion is a rare but important entity in the discipline of urology, as urgent action is required to save the testicle anatomically and functionally. Occurring mainly in the young prepubertal or pubertal male, testicular torsion is also seen in young adults. The annual incidence has been estimated to be 4.5 cases per 100,000 male subjects. The outcome of testicular torsion, in cases of unsuccessful emergent intervention, is total or partial infarction of the testicular tissue. We present a case of partial testicular ischemia due to testicular torsion.
Journal of X-ray Science and Technology, 2020
INTRODUCTION: Testicular infarction is a rare complication of prolonged epididymitis and may be misdiagnosed as testicular torsion. In this study, we present three cases of testicular infarction and discuss their clinical characteristics, imaging features and clinical management. PATIENTS AND METHODS: Three adult males with prolonged epididymitis presented with chronic unilateral testicular pain, tenderness, and palpable swelling, including left varicocele in one case and hydrocele in the other two cases. Patient's symptoms were not relieved after antibiotic therapy. We analyzed the diagnosis, management, and outcome of these three cases of testicular infarction resulting from prolonged epididymitis. This includes the clinical characteristics, features of color doppler ultrasound imaging for diagnosis, and treatment strategy for testicular infarction from prolonged epididymitis. RESULTS: Complete blood count (CBC) indicated a small leukocytosis (10.6 ± 0.4 × 10 9 /L; normal arrange 3.5-9.5 WBC × 10 9 /L). Color doppler images demonstrated appropriate blood flow to areas of interest at patient's initial visit. At follow up visit several months later, the increased blood flow was detected at the edges of the involved testes with no blood flow to the center. The sizes of the involved testis (27 ± 4 ml) was significantly larger compared to the non affected side (17 ± 2 ml) (p < 0.05). Unilateral simple orchiectomy was performed on the involved testis in all three cases. Grossly, abscess cavities with caseous necrosis were found at the center of the testicle and epididymis in two patients. Histopathologic examination showed chronic inflammation with lymphocytic and macrophage infiltration of the involved testicle in two cases. The third case stained positive for acid fast bacteria. Left varicocele disappeared postoperatively in one patient. No pain, wound infection or other discomfort were noted 12 months after surgery.
An Unusual Cause of Acute Scrotum in a 65-Year-Old Man
UroToday International Journal, 2011
Testicular pain has several etiologies, including torsion, trauma, inflammation, and malignancy. Testicular torsion is a rare cause of scrotal pain in adult men. Few reports have commented on testicular torsion in the geriatric population. It is more common in young adults, and it usually develops as a consequence of certain congenital abnormalities in pediatric and adolescent patients. We report a case of a 65-year-old man who presented with left testicular pain and bilateral groin swelling for 5 days. Surgical exploration was performed and showed left testicular torsion with a right inguinal hernia. In conclusion, testicular torsion should be considered in the differential diagnosis of an acute scrotum regardless of the patient's age. Our case report of testicular torsion in the elderly patient offers a contribution to literature regarding the presentation and management of adult onset testicular torsion.
Acute scrotum — Etiology and management
Indian Journal of Pediatrics, 2005
Objective: Acute scrotal pain is a common urological emergency. Urgent exploration is the standard means of management, since no investigation can confidently exclude torsion of testis from the differential diagnosis.Methods: A review of all boys presenting with acute scrotal pain who underwent emergency scrotal exploration between January 1983 and March 2003 was performed.Results: 195 boys were included in this study. They were divided into 3 groups: group 1–73 with epididymo-orchitis, group 2–63 with torsion of testicular appendages and group 3–57 with spermatic cord torsion. The patients in group 2 were older than group 1, also patients in group 1 were older than group 3. During neonatal period the most common pathology was spermatic cord torsion, whereas in prepubertal period torsion of appendages was more common. In all boys, mean duration of pain at presentation was 2.11 days. Epididymo-orchitis was diagnosed in 37% of patients, with torsion of the appendages being the next most common entity. Testicular torsion was diagnosed in 29% of patients. In the group with testicular torsion salvage rate of testis was 37% because of late admission. The perioperative morbidity and mortality was not seen in any of the groups.Conclusion: We believe that any boy with acute scrotal pain and any suspicion of testicular torsion in physical examination must be applied routine surgical exploration.