Presentation
Severe left scrotal pain with a swelling, tender palpable mass, and fever.
Patient Data
Relatively increased testicular vascularity on the left side compared to the right one.
The head of the left epididymis is enlarged, heterogeneously hypoechoic with echogenic foci. Markedly hyperemic margins of the epididymis head yet the center is anechoic/ hypoechoic with fluid leveling, and completely avascular on color doppler interrogation, demonstrating increased through- transmission indicative of complex fluid collection.
Mild to moderate left hydrocele with clear aspect likely reactive.
Thickened left scrotal skin and subcutaneous tissue.
Case Discussion
The sonographic and doppler findings are compatible with left epididymo-orchitis with complicated epididymal head abscess formation.
Left moderate hydrocele represents a post-inflammatory reaction.