Testicular infarction and spontaneous scrotal rupture secondary to acute epididymo-orchitis

Abstract

Epididymo-orchitis is a common cause of acute unilateral testicular pain. Both infectious or non-infectious causes have been proposed and, rarely, testicular abscess formation and even infarction can occur as a severe complication. We present here a case of acute epididymo-orchitis leading to testicular abscess formation, infarction and spontaneous rupture through the scrotal wall despite appropriate antibiotic treatments. Orchidectomy and partial scrotectomy were performed during surgical exploration for management of the non-viable testis and associated scrotal sinus. Clinical vigilance is important to prevent this complication by close clinical follow up with ultrasonography and even early surgical decompression to prevent testicular loss.

Multimodal ultrasound diagnosis of epididymo‐orchitis with secondary testicular infarction: A case report

“…5 Severely inflamed and enlarged testes may be more susceptible to torsion, especially if there are congenital pendulum malformations. 6 Another cause may be endothelial damage caused by endotoxins released by bacteria, potentially leading to thrombosis within the epididymal and spermatic veins, further compromising blood flow. 7 Ultrasound remains the most useful imaging method for diagnosing testicular ischemia.…”

“…When EO continues to develop, it can gradually cause circulatory disorders in the epididymis testis blood flow, resulting in ischemia and hypoxia in the epididymis and testis, causing minimally invasive injury and ultimately leading to testicular ischemic necrosis 5 . Severely inflamed and enlarged testes may be more susceptible to torsion, especially if there are congenital pendulum malformations 6 . Another cause may be endothelial damage caused by endotoxins released by bacteria, potentially leading to thrombosis within the epididymal and spermatic veins, further compromising blood flow 7 …”