Paul Singh Sidhu MD, Presenter: Nothing to Disclose

Praveen Bilagi MBBS, Abstract Co-Author: Nothing to Disclose

Seshadri Sriprasad MD, Abstract Co-Author: Nothing to Disclose

Jane L Clarke MS, Abstract Co-Author: Nothing to Disclose

Gordon H Muir MD, Abstract Co-Author: Nothing to Disclose

Acute segmental testicular infarction (ASTI) is an uncommon condition, caused by infection, trauma but may be 'idiopathic'. The objective was to analyse the clinical features and to establish the US appearances of ASTI.

All patients attending for a scrotal US with symptoms of testicular pain were included. Selected patients with any intra-testicular abnormality were re-examined by a single experienced operator. Patients were examined with a 15MHz linear array transducer, using colour Doppler imaging on a Sequoia US machine (Acuson, Siemens, Mountain View, CA). An area thought to be segmental infarction was defined as follows; focal area of altered reflectivity, with or without focal enlargement with no or markedly diminished colour Doppler flow and no posterior acoustic enhancement. The US findings were correlated with presenting clinical symptoms and signs, age and any follow-up procedures (surgery, repeat US and clinical examination) likely to establish the diagnosis of ASTI.

Over a five-year period a total of 16 patients were diagnosed with ASTI on the US appearances described above (mean age 44.9 yrs, range17-50 yrs). All patients presented with sudden onset of acute pain with scrotal swelling, but the testis was mobile. On follow-up procedures, five patients had exploration, histology demonstrated focal necrosis and atrophy without evidence of malignancy. The remaining eleven patients had follow up clinical andUS examinations at 3 and 6 months intervals with resolution of symptoms, but with evidence of continuing absence of colour Doppler flow, and progressive atrophy of the focal abnormality.

ASTI may be recognised as an entity that affects an older patient group than spermatic cord torsion. Awareness of the condition based on specific US features allows a confident diagnosis, enabling appropriate conservative or testis sparing procedures.

Sidhu, P, Bilagi, P, Sriprasad, S, Clarke, J, Muir, G, Segmental Infarction of Testes as an Unusual Cause for the Acute Scrotum: Five-year Experience from a Single Centre.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416702.html