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Pelvis » Scrotum And Testicles
Orchitis with abscess formation and hydrocele
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Author(s) :
Rafay Ahmed, MD  |  Ross Wank, MD
Presentation 54 year old male with scrotal pain and swelling.
Caption: Transverse View of Testes
Description: The right testis is enlarged and exhibits multiple heterogeneous predominantly hypoechoic mass-like areas. There is also thickening of the scrotal skin, suggestive of inflammation. The left testicle is normal in size and echotexture.
Caption: Transverse View of Testes at Lower Pole
Description: In this view the mass-like area contains multiple reflective echogenic foci, most likely bubbles of gas, from gas forming organisms.
Caption: Transeverse View with Color Doppler
Description: Color Doppler shows flow around the hypoechoic masses within the right testicle, but no flow within the hypoechoic masses. There is normal flow in the adjacent normal left testicle.
Caption: Transverse Above Upper Pole of Right Testis
Description: The hydrocele is septated, exhibiting multiple internal membranes.
Caption: Transverse View of Right Testicle
Description: Within the right testicle two mass-like areas are seen at this level. One contains several highly reflective echogenic foci with comet tails.
Caption: Longitudinal View of Right Testicle
Description: Longitudinal view shows multiple heterogenous, predominantly hypoechic masses. There is also a hydrocele.
Caption: Longitudinal View with Color Doppler
Description: Longitudinal view with color Doppler shows no flow within the masses, with increased flow surrounding the masses.
Differential Diagnosis

Testicular Torsion

Final Diagnosis Orchitis in right testis with abscess formation due to gas-forming organisms. There is associated hydrocele and inflammation of adjacent scrotal tissue.
Discussion This case illustrates a typical appearance of abscess formation within the testicle and the appearance of small bubbles within the abscess cavity due to gas forming organisms.
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