[Acute orchiepididymitis: assessment with high-resolution ultrasonography in 52 cases]

The present study describes our experience in ultrasound diagnosis of acute orchiepididymitis, with special reference to the most common US patterns and complications of this disease entity.

In acute scrotum suspected as having an inflammatory origin, high resolution ultrasonography is performed in the acute phase in addition to routine blood and urine analyses. Treatment and subsequent US control evaluation vary according to each case.

The sonographic findings in 52 cases with a clinical suspicion of acute orchiepididymitis are presented. All examinations were performed in the acute phase. Subsequent sonographic control evaluation was performed 2-4 months after treatment. Seven cases had a negative ultrasound; in 4 cases ultrasound disclosed a different pathology (2 tumors, 1 testicular torsion and 1 hydatid torsion); 12 had both testicular and epididymal involvement; one had testicular and 28 had epididymal involvement alone. Complications were observed in 21 cases (hydrocele, abscess, pyocele, infarct...). Sonographic evaluation after treatment showed complete resolution in 26 cases whereas 15 cases showed postinflammatory sequelae (atrophy, changes in testicular ultrasound pattern, calcifications, chronic hydrocele...). The ultrasound findings indicated surgery in 2 cases.

High resolution ultrasonography is currently the diagnostic method of choice in scrotal inflammation. It permits determining the extent of the lesion (orchitis, epididymitis, orchiepididymitis), complications (hydrocele, hematocele, pyocele, abscess, infarct...) and the result of therapy.