IS Case 123: Bilateral epididymo-orchitis
Imaging Sciences URMC 2008
Publication Date: 2009-05-20
Scrotal inflammatory disease usually involves the epididymis initially and spreads to the testis, scrotal sac and scrotal wall. Orchitis develops in 40% of patients with epididymitis. Isolated orchitis is less common and generally is viral (i.e. mumps).
Color Doppler findings: Increased vascularity and increased concentration of the vessels within testis and epididymis. Hyperemia is the distinguishing characteristic of this disease, but normal blood flow can be seen in the epididymis with high frequency transducer sonography; therefore, comparison with the other side is important.
All patients with heterogeneous appearance of the testis should be followed up to demonstrate sonographic resolution after antibiotic treatment to exclude the possibility of tumor. Complications of epididymo-orchitis include abscess, pyocele, infarction, infertility, atrophy and gangrene.
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