Epididymo-orchitis Presenting as Painful Hemiscrotal Swelling Clinical History A 25-year old man presented with symptoms of swelling and pain in the left hemiscrotum. The patient was referred to have an inpatient ultrasound on the same day. Case Description Ultrasound revealed a bulky and heterogeneous left epididymis (epididymo-orchitis). The left testis and epididymis both showed evidence of a significantly increased vascularity within them. There was also some reactive hydrocoele in the left hemiscrotum with a heterogeneous collection adjacent to the left epididymis. Diagnosis/ Discussion/ Treatment/ Follow up The patient’s symptoms resolved after completing antibiotic therapy. A subsequent ultrasound post-treatment confirmed the resolution of symptoms. Sonograms A panoramic image of the left hemiscrotum, in B-mode, showing an inflamed left epididymis B-mode image of the inflamed left testis and left epididymis Heterogeneous (complex) fluid collection in the left hemiscrotum adjacent to the left epididymis. No internal vascularity seen in the collection, as it is not a lesion B-mode left hemiscrotum showing the bulky and inflamed left epididymis Colour Doppler imaging showing hypervascularity of the left testis and epididymis in a ‘christmas tree’ fashion Published on: September 25, 2024
