Segmental Testicular Infarction Research Articles

Contrast-enhanced US of Segmental Testicular Infarction.

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Segmental testicular infarction in a 17-year-old teenager

EDITORIAL COMMENT. According to clinical data, segmental testicular infarction occurred due to transient testicular torsion with impaired arterial blood supply. Thus, in the presented clinical case, segmental testicular infarction should not be considered as a complication of varicocele.Introduction. Segmental testicular infarction in children and adolescents is a rare case that is mostly met as a complication of andrological or other diseases. This pathology is extremely difficult to diagnose. At the same time, in order to increase the chance for favorable outcomes, decision on the proper way of care must be taken as soon as possible.Purpose. To demonstrate a case of successful diagnostics and treatment of segmental testicular infarction in a teenager with varicocele.Material and methods. The patient was admitted with a picture of acute scrotum syndrome three hours later after the onset of the disease with preliminary diagnosis "testicular torsion and thrombosis of testicular veins in a patient with varicocele". Four days before, the patient consulted a urologist about pain in the left testicle. Varicocele grade III on the left without orchopathy was diagnosed. The pain syndrome was relieved by non-steroidal anti-inflammatory drugs. Previously, this pathology had not been diagnosed in this patient, and he did not suspect it. Examination of organs: no marked changes; locally, on the left, there is expansion of testicular veins of degree III; testicle on the left is painful, dense. Ultrasound examination and dopplerography of the scrotum organs were urgently made. Findings of radial examinations revealed segmental thrombosis in the middle part of the testicle; however, because of low occurrence of segmental thrombosis and greater focus on the testicular torsion the surgeons were not sure of absolute accuracy of the obtained additional findings. An emergency revision of the scrotum was performed at which the diagnosis of segmental thrombosis was confirmed. Three month later, at a follow-up examination partial restoration of blood flow in the infarction zone without pronounced signs of testicular atrophy was seen.Conclusion. Segmental testicular infarction is an extremely rare complication of varicocele in children and adolescents. A proper assessment of the clinical picture and ultrasound imaging allow to put the well-timed and correct diagnosis of segmental testicular infarction. Not in all cases, segmental testicular infarction should be considered as an irreversible condition that leads to sclerosis in its outcome.

A case report of acute testicular pain secondary to segmental testicular infarction

BackgroundSegmental testicular infarction is a rare condition that often occurs in the upper pole of the left testicle and usually presents with acute onset of scrotal pain. Contrast-enhanced ultrasound and MR are essential for diagnosing and differentiating segmental testicular infarction in clinical practice, and conservative treatment can only be adopted after a definitive diagnosis. In the present case, after conservative treatment, the infarct volume was reduced, the blood flow around the infarct was increased, and blood flow signals appeared in the infarct. We performed a correlation analysis to investigate the causes of these changes.Case presentationA 33-year-old male, without any specific disease history, was admitted to the hospital with a 5-day history of left testicular pain, and the imaging showed focal necrosis of the left testicle with hemorrhage. He was diagnosed with segmental testicular infarction after differentiating and excluding it from malignant tumors. Conservative medical treatment was given, and the symptoms of testicular pain were relieved after treatment. After discharge, regular reexamination at follow-ups showed that the infarct’s size was reduced, the blood flow around the infarct was increased, and blood flow signals appeared in the infarct.ConclusionConservative treatment has become the standard treatment currently adopted after confirming the diagnosis of segmental testicular infarction through contrast-enhanced ultrasound and MR. The blood flow changes in and around the focus of testicular infarction can be related to various factors. At present, relevant conclusions of the underlying mechanisms were mainly deduced from infarction studies of other related organs such as the heart and brain; thus, the specific pathological mechanism needs further experimental verification.

Various Intratesticular Hypoechoic Lesions on Scrotal Sonography.

Sonography with a high-frequency transducer is the modality of choice for imaging the scrotum. Most intratesticular lesions are hypoechoic. Differentiation of intratesticular hypoechoic lesions as either malignant or benign is important because the treatment of these lesions vary. In this paper, we review the sonographic features of different types of intratesticular hypoechoic lesions, such as testicular cysts, testicular tumors, testicular inflammatory lesions, segmental testicular infarction, and testicular trauma.

Acute Segmental Testicular Infarction caused by COVID-19 Disease: A Case Report and Current Literature Review

Acute Segmental Testicular Infarction caused by COVID-19 Disease: A Case Report and Current Literature Review

Sonographic Discovery of Segmental Testicular Infarction

The prevalence of segmental testicular infarction is extremely uncommon and very few cases have been reported in literature. Clinical and sonographic presentation of this condition can mimic testicular neoplasms or testicular torsion. Therefore, accurate diagnosis of segmental testicular infarction is imperative in the treatment process. This case study presents the sonographic diagnosis of testicular infarction in a 49-year-old man who reported mild testicular tenderness. A conservative treatment approach was used, saving the patient unnecessary surgical intervention.

AB157. SOH21AS133. A case of segmental testicular infarction masquerading as a testicular neoplasm

Background: Testicular infarction is rarely encountered, with fewer than 70 case reports in the literature. Complete infarction of the testis is mainly associated with testicular torsion. However, segmental testicular infarction is infrequently seen and is idiopathic in up to 70% of cases. Other aetiologies of segmental infarction include trauma, iatrogenic insult and co-morbid hypercoagulable disease states such as sickle cell disease and vasculitis.

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

Testicular torsion in children is not uncommon emergency problem which occur due to twist in the spermatic cord leading to ischemia or infarction to testicle. Hemorrhagic infarction can occur following testicular torsion is globally; however, in extremely rare situation, such infarction can be segmental. Segmental testicular infarction (STI) was reported in an infant due to epididymitis and a newborn with STI in 1 testicle with complete infarction in the contralateral testicle due to birth trauma. To best of our knowledge, our case of STI in a child associated with testicular torsion is the first described in the literature.

Two cases report of segmental testicular infarction

The segmental testicular infarction rate is extremely low, usually showing acute testicular pain, which needs to be distinguished from testicular tumor, testicular torsion, etc. Only a few cases were reported. In this study, two cases were presented. Case one, a 13-year-old boy, was admitted to hospital due to right testicular swelling and pain for 3 days. Presenting with vomiting once on May 5, 2017.He underwent right scrotum exploration and testicular fixation. Testicular pain was disappeared and discharged on the five days operation. There was no obvious abnormality in color doppler ultrasound after one year after operation. Another patient, a 26-year-old man, was admitted to hospital due to left testicular swelling and pain for 6 on March 15, 2018. He was treated with Xue Saitong, natra heparin calcium and Maizhiling tablets. After seven days of treatment, the testicular pain improved and were discharged. One month after discharge, the patient had no pain or discomfort, and the color Doppler ultrasound showed that the left subtesticular polar-like low-isoecho, and a small amount of star-like blood flow signal around. Key words: Testicular diseases; Segmental testicular infarction; Color Doppler; Scrotal ultrasound

Case Report: Segmental Testicular Infarction

Segmental testicular infarction is a rare condition that presents with acute testicular pain. The diagnosis can be clinically challenging and include important differential diagnoses such as testicular torsion, testicular tumour and infection. This case report describes a 27-year-old male presenting to a regional Australian hospital with acute left testicular pain. The diagnosis was made intra-operatively during surgical exploration and on histopathologic assessment after the patient underwent a partial orchidectomy. While segmental testicular infarction is a rare condition, it should be considered in the differential diagnosis for acute testicular pain as awareness may help to avoid unnecessary radical surgery.

Imaging of the acute scrotum: keys to a rapid diagnosis of acute scrotal disorders.

Imaging of the scrotum in the setting of acute symptoms such as pain or swelling is commonly performed emergently to differentiate between patients who require immediate surgery and those that do not. Acute scrotal symptoms are generally caused by infectious, traumatic or vascular etiologies. Rapid diagnosis and initiation of treatment is vital for testicular salvage in cases of acute testicular torsion, testicular rupture, and Fournier gangrene. Epididymitis, epididymo-orchitis, torsed testicular appendage, segmental testicular infarction, scrotal hematomas, testicular neoplasms, and acute idiopathic scrotal edema can have similar clinical presentations, but these conditions do not require immediate surgery. Ultrasound is the well-established first-line imaging modality for the acute scrotum. Contrast-enhanced ultrasound and magnetic resonance imaging can be useful as problem-solving tools when ultrasound studies are inconclusive or equivocal. This review describes normal scrotal anatomy and a wide range acute scrotal disorders, with emphasis on the imaging and clinical features that can minimize the risk of misdiagnosis.

Segmental testicular infarction. Report of two clinical cases and literature review

Segmental testicular infarction is rare. To the best of our knowledge forty cases are reported in literature. We present two cases of segmental testicular infarction with different etiology. The first case was observed after herniorrhaphy and varicocelectomy. The second one occurred after acute epididymitis. Both cases have been treated without radical orchiectomy. We have also reviewed the pertinent literature in terms of differential diagnosis, etiology and management, with particular regard to testicular sparing.

Segmental Testicular Infarction Mimicking Testicular Seminoma

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.

Segmental testicular infarction: a case report

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.

Segmental Testicular Infarction, an Underdiagnosed Entity: Case Report with Histopathologic Correlation and Review of the Diagnostic Features.

A 30-year-old male presented with a 1-day history of left scrotal pain and a tender left testicle and epididymis on physical exam. Scrotal ultrasound showed an avascular, heterogeneous, hypoechoic lesion in the superior left testis suggestive of infarction or neoplasm. The patient was managed conservatively; however, his pain continued and follow-up ultrasound 6 days later showed interval increase in the size of the mass. Left radical orchiectomy was done and pathology result showed segmental infarction of the left testis.

Segmental Testicular Infarction: A Clinical Dilemma

Segmental Testicular Infarction: A Clinical Dilemma Segmental testicular infarction is an uncommon entity often diagnosed during scrotal imaging for acute scrotum. It is due to a partial ischemic process resulting in hyalinization and fibrosis of the infarcted area. Various factors have been implicated for this entity such as infection, trauma, hematological disorders and microangiopathy. It frequently presents as acute scrotum and sonographically simulates a small intra-testicular neoplasm. Hence it is of paramount importance to distinguish segmental testicular infarction from intra-testicular neoplasm. Although high resolution scrotal ultrasonography can identify such lesions, scrotal MR imaging can accurately differentiate segmental testicular infarction from testicular tumor, thus preventing unnecessary orchiectomy in most of the cases.

Testicular Infarction in the Presence of Epididymitis: An Anatomo Clinical Continuum?

Testicular Infarction in the Presence of Epididymitis: An Anatomo Clinical Continuum? Epididymitis is an inflammation limited to the epididymis, common cause of acute scrotal pain and usually responsive to antibiotics, non-steroidal and anti-inflammatory drugs. Nevertheless complications such as orchitis and abscess may occur; a testicular infarction is less frequent. We are going to discuss two cases of segmental testicular infarction both associated with epididymitis. The first one developed in a massive hemorrhagic infarction after performing a not responsive homolateral epididymitis to conservative therapy and subsequent orchiectomy was performed. The second one was treated with successful medical therapy and complete restoration of testis. We reviewed the pertinent literature in terms of differential diagnosis, etiology with particular interest in physiopathological mechanisms of testicular infarction giving an original etiologic hypothesis.

Segmental testicular infarction: A case report.

The incidence of segmental testicular infarction is extremely low. The condition usually presents with acute scrotal pain and may be confused clinically and radiologically with a testicular tumor or torsion. To the best of our knowledge, only a few cases have been reported in the English literature. In this study, we present a case of segmental testis infarction in a 23-year-old male with an acute onset of testicular pain. The diagnosis of testicular infarction was considered following sonography examination. Hemorrhagic infarction of the testis was confirmed by surgical exploration and pathological examination. Partial orchiectomy was performed. Although it is uncommon, segmental testicular infarction should be taken into consideration when acute scrotal pain is encountered, since the therapeutic strategy could be conservative.

Metachronous bilateral segmental testicular infarction: multi-parametric ultrasound imaging with grey-scale ultrasound, Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE).

Segmental testicular infarction is a rare cause of acute scrotal pain. The appearances on grey-scale sonography are often indistinguishable from that of a testicular tumour, resulting in unnecessary orchiectomy. We report a case of acute bilateral testicular infarction, of unknown etiology, which was conservatively managed to resolution following a confident diagnosis achieved with the aid of contrast-enhanced ultrasound (CEUS) and real-time tissue elastography (RTE) along with conventional grey-scale and Doppler sonography. The evolving appearances on each of the sonographic modalities are described. We discuss the importance of complementing conventional sonography with CEUS and RTE in order to make a confident diagnosis and avoid unnecessary surgical intervention.

Segmental Testicular Infarction Due to Minocycline-induced Antineutrophil Cytoplasmic Antibody–positive Vasculitis

Segmental testicular infarction is an uncommon clinical entity marked by acute scrotal pain and swelling. Classically, these appear as wedge-shaped, avascular, hypoechoic lesions on a testicular ultrasound. We present a unique case of testicular infarct caused by an antineutrophil cytoplasmic antibody-positive vasculitis secondary to the use of the antibiotic minocycline. The patient's symptoms resolved with cessation of minocycline. We suggest that patients who present with otherwise unexplained testicular infarction undergo a careful review of medications to uncover a potential cause.