Epididymal abscess
Last revised by Mostafa Elfeky on 15 Jan 2023
Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Elfeky M, Saber M, et al. Epididymal abscess. Reference article, Radiopaedia.org (Accessed on 27 Apr 2024) https://doi.org/10.53347/rID-23148
Permalink:
rID:
23148
Article created:
25 May 2013,
Yuranga Weerakkody ◉
Disclosures:
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosures
Last revised:
15 Jan 2023,
Mostafa Elfeky ◉
Disclosures:
At the time the article was last revised Mostafa Elfeky had no financial relationships to ineligible companies to disclose.
View Mostafa Elfeky's current disclosures
Revisions:
10 times, by
7 contributors -
see full revision history and disclosures
Systems:
Tags:
Synonyms:
- Epididymal abscesses
- Pyogenic epididymal abscess
- Pyogenic epididymal abscesses
An epididymal abscess is an uncommon complication of epididymitis.
On this page:
Pathology
Causative organisms are the same that cause epididymitis:
- older individuals
- Escherichia coli
- Proteus mirabills
- younger individuals
- Chlamydia trachomatis
- Neisseria gonorrhoeae
- Other rare etiological agents
- Streptococcus faecalls
- Ureaplasma urealyticum
- viral, spirochete infections
- Mycobacterium tuberculosis (tuberculous epididymitis)
Radiographic features
Ultrasound
Sonographic findings include
- scrotal wall thickening
- hyperemic enlargement of the epididymis
- focal regions of decreased or mixed echogenicity
- nonvascular hypoechoic area surrounded with hypervascular epididymis
Tuberculous epididymal abscesses tend to be larger in size while the degree of blood flow in the peripheral portion of the abscess can be comparatively lower.
Treatment and prognosis
Complications
Further possible complications from an epididymal abscess
- rupture with focal testicular ischemia or infarction
- inflammatory ulceration of the efferent ductules or the ductus epididymis
- may allow sperm to extravasate into the surrounding interstitium, inciting an intense inflammatory response that leads to sperm granuloma formation.
References
- 1. Konicki P, Baumgartner J, Kulstad E. Epididymal Abscess. Am J Emerg Med. 2004;22(6):505-6. doi:10.1016/j.ajem.2004.07.013 - Pubmed
- 2. Seçil M, Göktay AY, Dicle O et-al. Bilateral epididymal Candida abscesses: sonographic findings and sonographically guided fine-needle aspiration. J Clin Ultrasound. 1998;26 (8): 413-5. Pubmed citation
- 3. Slanetz PA, Whitman GJ, Chew FS. Epididymal abscess. AJR Am J Roentgenol. 1995;164 (2): 376. doi:10.2214/ajr.164.2.7839972 - Pubmed citation
- 4. Yang DM, Kim SH, Kim HN et-al. Differential diagnosis of focal epididymal lesions with gray scale sonographic, color Doppler sonographic, and clinical features. J Ultrasound Med. 2003;22 (2): 135-42. J Ultrasound Med (full text) - Pubmed citation
- 5. Yang DM, Yoon MH, Kim HS et-al. Comparison of tuberculous and pyogenic epididymal abscesses: clinical, gray-scale sonographic, and color Doppler sonographic features. AJR Am J Roentgenol. 2001;177 (5): 1131-5. doi:10.2214/ajr.177.5.1771131 - Pubmed citation
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