A Series of Unfortunate Events: Epididymo-orchitis Complicated by Testicular Abscess, Necrosis and Rupture.

Emily Pratt, Radiography and Diagnostic Imaging, School of Medicine, University College Dublin


Acute epididymo-orchitis is the inflammation of both the epididymis and the testis and is a common cause of acute scrotum in adults (Suciu et al. 2017). It can be of infectious or non-infectious aetiology. These include sexually transmitted infections and urinary tract pathogens (Chia et al. 2016).

Epididymo-orchitis is typically established based on clinical symptoms and physical examination. However, it should be differentiated from testicular torsion which is considered a urological emergency (Suciu et al. 2017).

Testicular infections are usually treated with oral antibiotics resulting in little to no morbidity (Rhudd et al. 2017). However, progression to further complications occurs in 3-5% of patients and can lead to abscess formation, testicular infarct and
possible testicular loss (Rhudd et al. 2017).

The use of ultrasound (US) imaging is essential in equivocal cases or in severe persistent cases when adequate palpation is hindered by pain or induration (Cek et al. 2017). US has proved to be a reliable modality in assessing a broad range of timesensitive scrotal pathologies and in guiding surgical decisions (Holliday et al. 2017).

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