FREQUENCY OF DIFFERENT ULTRASONOGRAPHIC PATTERNS IN PATIENTS PRESENTING WITH ACUTE SCROTUM

Murli Manohar, Amjad Sattar, Sohail Ahmed Khan, Hatem Adel

Abstract


Background: Acute scrotum is sudden onset of swelling and pain in the scrotum or its contents, accompanied by local signs or general symptoms and is commonly due to testicular torsion, epididymitis, orchitis or epididymo-orchitis. The difficulty arises due to the similarities between the presentations. It is important to recognize sonograpic patterns of acute scrotum to reduce the need of exploratory surgery.

Objective: To determine the frequency of different ultrasonographic patterns in patients presenting with acute scrotum.

Methods: A cross-sectional study was conducted at Dow Institute of Radiology, Dow University of Health Sciences from 20th April 2016 till 20th October 2016. Male patients aged 16-45 years presenting with acute scrotum within 24 hours underwent scrotal ultrasound with color doppler imaging. Comparative axial and sagittal views of each scrotum were obtained. Images were interpreted by two radiologists in terms of echotexture, echogenicity, size of testes, hydrocele and blood flow of testes and epididymis by color doppler study.

Results: Mean age of the patients was 31.82 ±10.86 years. There were majority 89 (37.7%) of the patients with ≤30 years of age. Heterogenous echotexture of testes was found in 127 (53.8%), epididymal enlargement in 205 (39.4%), hydrocele 166 (70.3%), increased degree of blood flow in testes 172 (72.9%) and increased degree of blood flow in epididymis was observed in 173 (73.3%) patients.

Conclusion: Heterogeneous echotexture of the testes, the presence of epididymal enlargement, hydrocele, increased blood flow within the testes and epididymis were frequently observed sonographic patterns in patients with acute scrotum. 


Full Text:

PDF

References


Davis JE, Silverman M. Scrotal emergencies. Emerg Med Clin North Am. 2011; 29:469-484.

Boettcher M, Bergholz R, Krebs TF, Wenke K, Aronson DC. Clinical predictors of testicular torsion in children. Urology. 2012; 79:670-674.

Beni-Israel T, Goldman M, Bar Chaim S, Kozer E. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010; 28:786-789.

Mellick LB. Torsion of the testicle: it is time to stop tossing the dice. PediatrEmerg Care. 2012; 28:80-86.

Lopez RN, Beasley SW. Testicular torsion: potential pitfalls in its diagnosis and management. J Paediatr Child Health. 2012; 48:E30-32.

Kapoor S. Testicular torsion: a race against time. Int J ClinPract 2008; 62:821-827.

Tracy, C.R., Steers, W.D., Costabile, R. Diagnosis and management of epididymitis. Urol Clin N Am. 2008; 35:101-108.

Opio J, Byanyima RK, Kiguli-Malwadde E, Kaggwa S, Kawooya M. The sonographic pattern of diseases presenting with scrotal pain at Mulago Hospital, Kampala, Uganda. East and Central African Journal of Surgery 2008; 13:68-74.

Kaye JD, Shapiro EY, Levitt SB, Friedman SC, Gitlin J, Freyle J, et al. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration. J Urol. 2008; 180:1733-1736.

Becker D, Burst M, Wehler M, Tauschek D, Herold C, Hahn EG. [Differential diagnosis of acute testicular pain using color-coded duplex ultrasonography: difference between testicular torsion and epididymitis]. Dtsch Med Wochenschr. 1997; 122:1405-1409.

Becker D, Burst M, Wehler M, Tauschek D, Herold C, Hahn EG. [Differential diagnosis of acute testicular pain using color-coded duplex ultrasonography: difference between testicular torsion and epididymitis]. Dtsch Med Wochenschr. 1997; 122:1405-1409.

Lemini R, Guanà R, Tommasoni N, Mussa A, Di Rosa G, Schleef J. Predictivity of Clinical Findings and Doppler Ultrasound in Pediatric Acute Scrotum. Urology Journal. 2016; 13:2779-2783.

Mohammed WM, Davis NF, O’Connor KM, Kiely EA. Re-evaluating the role of Doppler ultrasonography in patients presenting with scrotal pain. Irish Journal of Medical Science (1971-). 2016; 185:705-709.

Pogorelić Z, Mrklić I, Jurić I. Do not forget to include testicular torsion in differential diagnosis of lower acute abdominal pain in young males. Journal of pediatric urology. 2013; 9:1161-1165.

Kühn AL, Scortegagna E, Nowitzki KM, Kim YH. Ultrasonography of the scrotum in adults. Ultrasonography. 2016; 35:180.

Liang T, Metcalfe P, Sevcik W, Noga M. Retrospective review of diagnosis and treatment in children presenting to the pediatric department with acute scrotum. American Journal of Roentgenology. 2013; 200:W444-459.


Refbacks

  • There are currently no refbacks.


© Copyright PJR 2008-