A Rare Case of Testicular Vein Thrombosis in an 18-Year-Old Male

Testicular vein thrombosis is a rare cause of acute scrotal pain and swelling, with very few cases reported in adolescents. We present a case of an 18-year-old male with a 24 h history of sudden-onset left scrotal pain and swelling, without prior trauma, infection, or surgery. Physical examination revealed mild tenderness along the spermatic cord, and Doppler ultrasound demonstrated a non-compressible thrombus in the left testicular vein extending into the abdomen, confirming the diagnosis. The patient was treated with a short four-week course of apixaban on hematology advice, along with activity restriction and scrotal support. Follow-up imaging showed partial recanalization and complete symptomatic improvement. This case underscores the importance of early recognition, Doppler imaging, and conservative anticoagulation therapy in achieving favorable outcomes while avoiding unnecessary surgical exploration.