Diagnostic ultrasound ( PDFDrive )

CHAPTER 22 The Scrotum 847
A
B
D
C
FIG. 22.31 Epididymo-orchitis, Epididymitis, and Orchitis: Spectrum of Appearances. (A) and (B) Acute epididymitis. Longitudinal gray-scale
and color Doppler images show enlargement and a heterogeneous echotexture of tail of the epididymis, with greatly increased low in tail of the
epididymis and minimally increased low in the adjacent testis. (C) Acute epididymo-orchitis. Longitudinal color Doppler scan shows increased
low in the epididymis and testis. (D) and (E) Acute orchitis. Longitudinal dual-image gray-scale and color Doppler images show that right testis
is hypoechoic and has greatly increased low.
E
chronic alcoholism, and steroid therapy. 152 Multiple organisms
are usually involved, including Klebsiella, Streptococcus, Proteus,
and Staphylococcus. Surgical debridement of devitalized tissue
is usually required, and morbidity and mortality are high without
prompt treatment. Ultrasound is helpful in diagnosis by demonstrating
scrotal wall thickening containing gas with accompanying
shadowing.
TRAUMA
When evaluating testicular integrity in the setting of acute trauma,
the primary role of sonography is to assess for the continuity of
the tunica albuginea: this determines clinical management.
Disruption of the tunica albuginea indicates testicular rupture.
Prompt diagnosis of a ruptured testis is crucial because of the