Bell D, Glick Y, Bickle I, et al. Global testicular infarction. Reference article, Radiopaedia.org (Accessed on 28 Mar 2024) https://doi.org/10.53347/rID-69383
Global testicular infarction is fortunately rare, and is most commonly seen in the context of testicular torsion. However rarely it can occur secondary to other causes.
Doppler ultrasound is the mainstay for assessing testicular blood flow and diagnosing ischemia 1. Hyperemia and increased Doppler flow suggest infection (e.g. epididymo-orchitis), whereas reduced flow indicate testicular ischemia. Spermatic cord torsion identified on ultrasound is the most specific finding in testicular ischemia 2 . In pediatric cases where testes are smaller and color Doppler may be suboptimal, contrast enhanced ultrasound (CEUS) may be utilized to demonstrate reduced/absent testicular blood flow 3.
Ultrasound in isolation is insufficient for diagnosis. Exploratory surgery is the gold standard in the assessment of testicular ischemia.
1. Alkhori N & Barth R. Pediatric Scrotal Ultrasound: Review and Update. Pediatr Radiol. 2017;47(9):1125-33. doi:10.1007/s00247-017-3923-9 - Pubmedhttps://radiopaedia.org/articles/global-testicular-infarction/edit?lang=gb#
2. Ramjit A, Shin C, Hayim M. Complete Testicular Infarction Secondary to Epididymoorchitis and Pyocele. Radiology Case Reports. 2020;15(4):420-3. doi:10.1016/j.radcr.2020.01.001 - Pubmed
3. Cokkinos D, Antypa E, Kalogeropoulos I et al. Contrast-Enhanced Ultrasound Performed Under Urgent Conditions. Indications, Review of the Technique, Clinical Examples and Limitations. Insights Imaging. 2012;4(2):185-98. doi:10.1007/s13244-012-0209-5 - Pubmed
4. Fehily SR, Trubiano JA, McLean C et-al. Testicular loss following bacterial epididymo-orchitis: Case report and literature review. (2015) Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 9 (3-4): E148-51. doi:10.5489/cuaj.2174 - Pubmed
5. Rhudd A, Moghul M, Reid G. Epididymo-orchitis causing testicular infarction: a serious complication of a common disorder. (2017) Journal of surgical case reports. 2017 (10): rjx207. doi:10.1093/jscr/rjx207 - Pubmed
6. Chang CD, Lin JW, Lee CC et-al. Acute Epididymo-orchitis-Related Global Testicular Infarction: Clinical and Ultrasound Findings With an Emphasis on the Juxta-epididymal String-of-Bead Sign. (2016) Ultrasound quarterly. 32 (3): 283-9. doi:10.1097/RUQ.0000000000000225 - Pubmed
7. Farber NJ, Slater RC, Maranchie JK. Multidrug resistant epididymitis progressing to testicular infarct and orchiectomy. (2013) Case reports in urology. 2013: 645787. doi:10.1155/2013/645787 - Pubmed
8. Alsulmi HA. Testicular infarction in a patient with sickle cell anemia: A case report. (2018) International journal of health sciences. 12 (5): 100-102. Pubmed
9. Toushan M, Atodaria A, Lynch SD et-al. Bilateral Testicular Infarction from IgA Vasculitis of the Spermatic Cords. (2017) Case reports in nephrology. 2017: 9437965. doi:10.1155/2017/9437965 - Pubmed
10. Kim MH, Kim CG, Park SA et-al. Usefulness of Tc-99m Pertechnetate SPECT/CT in the Diagnosis of Testicular Infarction After Inguinal Herniorrhaphy. (2017) Nuclear medicine and molecular imaging. 51 (4): 357-359. doi:10.1007/s13139-016-0469-y - Pubmed
11. Pathmarajah T, Abdelhamid M, Tenna AS et-al. Acute Global Testicular Infarction Post-EVAR from Cholesterol Embolisation can be Mistaken for Torsion. (2017) EJVES short reports. 35: 11-15. doi:10.1016/j.ejvssr.2017.03.002 - Pubmed
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