Presentation
Eight-day history of testicular swelling with associated mild tenderness.
Patient Data
Unilateral globular enlargement of the left testicle and the ipsilateral left epididymis (double the size of their normal right contralateral counterparts) with diffusely augmented vasculature on both color and power Doppler flow mapping (scrotal inferno) is noted. Conspicuously flared-up and echoic fats (f) is noted at the paramedian and the lateral left epididymal caput and there is attendant scrotal sac hydroceles displaying low level internal echoes bilaterally (infected). Grade one left scrotal venous varicoceles was chanced as well with the serpiginous vascular structures measuring up to 1. 8 mm in diameters.
Case Discussion
Unilateral epididymitis concurring simultaneously with ipsilateral orchitis is quite common and presents sonographically with diffuse scrotal inferno primarily attributable to the augmented vascularity and hyperemia of the affected structures. The testis and the epididymis may appear edematous and increased in size with or without an altered echopattern. Coexisting reactive hydroceles (most often non-communicating) and/or with engorgement of the veins of the pampiniform plexus, are always the hallmark sonographic features of such an acute infective process.
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