Segmental haemorrhagic infarction of the testis in a paediatric patient: a rare aftermath of epididymitis

Abstract

Testicular infarction is an uncommon finding in paediatric age and is usually due to testicular torsion or trauma causing venous rupture with thrombosis and/or arteriolar obstruction. Other causes of segmental infarction of the testes are represented by polyarteritis nodosa, thromboangioiitis obliterans and hypersensitivity angiitis. A few cases of testicular infarction due to epididymitis have been described in the literature related mainly to adult patients. Epididymitis is usually treated in the outpatient setting with close follow-up, but according to our present experience, and reviewing the literature, there may be some cases in which, surgical exploration is mandatory in order to avoid testicular damage.

Conservative management of pubertal segmental testicular infarction associated with epididymitis

“…The subsequent edema causes lymphatic and venous compression followed by arterial occlusion and/or thrombosis. 5 Anatomically, the testis is nourished by the testicular, anterior and posterior epididymal, and deferens arteries. 2 In this case because STI occupied most of the area other than the cranial and ventral sides, it was considered that blood flow was impaired in the extensive area nourished by arteries other than the anterior epididymal artery.…”

Segmental Testicular Infarction Associated to Torsion: First Case Report in Childhood

“…STI is an extremely rare pediatric condition, being reported only twice in the literature: in an 18-month-old infant with acute onset of epididymitis 6 and in a newborn with STI and complete infarction in the contralateral testicle due to birth trauma. 7 To the best of our knowledge, our case of STI associated with testicular torsion is the first described in the literature.…”

Testicular necrosis due to complicated epididymitis and ruptured sperm granuloma in a 13-year-old boy

“…Most textbooks state that epididymitis is the result of an infection ascending from the bladder or urethra and should be treated with a course of antibiotics effective against usual urinary pathogens. However, there are few data to support a bacterial cause of epididymitis in children, and these treatment recommendations are not evidence-based [1–3].…”

“…Testicular infarction is an uncommon finding in pediatric age and is usually due to testicular torsion or trauma causing venous rupture with thrombosis and/or arteriolar obstruction. Other causes of segmental infarction of the testes are represented by polyarteritis nodosa, thromboangiitis obliterans and hypersensitivity angiitis [1].…”