Epididimo-orşit ve skrotal enfeksiyon BT bulguları

Özet

Epididimo-orşit epididimden başlayıp testise ve skrotal yumuşak dokulara yayılabilen enfeksiyondur. Tanıda ve perfüzyon değerlendirmesinde ilk tercih ultrasonografidir; BT daha çok karın-pelvis incelemesinde skrotum görüntü alanına girmişse veya komplike üriner enfeksiyon araştırılırken çevre inflamasyonu fark edilirse katkı sağlar. Kontrastlı BT enfeksiyonlu yumuşak dokularda anormal kontrastlanma, çevre yağ dokusunda inflamatuvar değişiklikler ve apse benzeri koleksiyonları gösterebilir. Fournier gangreni, hızla ilerleyebilen nekrotizan bir yumuşak doku enfeksiyonudur ve BT'de gazlı enfeksiyonun skrotumdan pelvis, karın duvarı ve retroperitona uzanımı görülebilir.

Faz ve pencere

Portal: Skrotum kesitlerinde enfekte epididim/testiste anormal kontrastlanma, çevre yağ dokusunda inflamatuvar çizgilenme ve apse benzeri koleksiyonlar değerlendirilir. Santral düşük dansiteli, çevresi kontrastlanan koleksiyon apse lehinedir; perfüzyon değerlendirmesi için renk Doppler ultrasonografi tercih edilir.

Önerilen pencereler: Yumuşak doku (G 400 / M 40), Batın (G 400 / M 50).

BT bulguları

Skrotal enfeksiyonda skrotal duvar kalınlaşması ve büyümesi görülebilir.
Epididimit ile septalı hidrosel birlikte görülebilir.
Epididimal ve testiküler apseler epididimo-orşitin nadir komplikasyonlarıdır.
Yumuşak dokuda gaz odakları ve yaygın fasya kalınlaşması; Fournier gangreni yönünden acil bulgu

Normalde

Normal BT kesitlerinde epididim ve testisler homojen görünür, belirgin periviskeral yağ değişikliği veya patolojik sıvı birikimi izlenmez. Sağ ve sol epididim-testis kompleksleri karşılaştırılarak boyut, kontrastlanma ve çevre yumuşak doku asimetrisi değerlendirilir.

Normal BT ile kıyasla

Aynı bölgenin, kaynak veri setinde patoloji içermediği belirtilen bir BT incelemesini kesit kesit kaydırın; organ sınırlarını açarak anatomiyi hasta görüntüsüyle karşılaştırın. Küçük rastlantısal bulgular tümüyle dışlanmamıştır.

Kaynak: TotalSegmentator v2.01 veri seti (Wasserthal ve ark., Radiology: Artificial Intelligence 2023), CC BY 4.0, vaka s1256; organ sınırları veri setinin otomatik segmentasyonundan, birleştirilerek sadeleştirildi. Görüntüler 2,5 mm kesit aralığına yeniden örneklendi.

Ayırıcı tanı

Testis torsiyonu, akut skrotumda acil tanı ve müdahale gerektiren bir ayırıcı tanıdır.
Testis tümörü epididimo-orşit benzeri bulgularla ortaya çıkabilir; kalıcı veya tedaviye yanıtsız testiküler kitlede neoplazi ayırıcı tanıda düşünülmelidir.
Epididimal veya testiküler apse, epididimo-orşitin nadir bir komplikasyonudur.
Fournier gangreninde gaz oluşturan enfeksiyon skrotumdan pelvise, karın duvarına veya retroperitoneal yapılara uzanabilir.

Tuzaklar

Belirgin kontrastlanma inflamasyonu destekler ama Doppler hiperemisiyle eşdeğer değildir; BT ile torsiyonu veya infarktı dışlama.
Epididimit ile septalı hidrosel birlikte görülebilir.
BT’de skrotumu etkileyen enfeksiyon düşündüren bulgular saptanırsa tanısal doğrulama için ek renk Doppler ultrasonografi endikedir.

Kendini dene

Skrotum veya perine tutulumu düşündüren akut skrotum vakalarında tanıyı netleştirmek için ilk tercih edilen görüntüleme yöntemi hangisidir?
Cevabı göster
Renk Doppler ultrasonografi. Skrotum ve perine tutulumu şüphesinde yüksek çözünürlüklü problarla renk Doppler ultrasonografi önerilir. MRI, sonografik bulgular belirsiz olduğunda problem çözücü inceleme olarak kullanılabilir; BT ise komplike üriner enfeksiyonların değerlendirilmesine katkı sağlar.
Epididimo-orşit sırasında gelişebilen nadir komplikasyon hangisidir?
Cevabı göster
İntratestiküler pürülan koleksiyon. Epididimo-orşit epididimal veya testiküler apseyle komplike olabilir; apse bu enfeksiyonun seyrek komplikasyonlarındandır.

İlgili konular

Kaynaklar

Bu sayfadaki 29 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 22 cümle bu karşılaştırmada düzeltildi (2026-10-09).

Cross-sectional imaging of complicated urinary infections affecting the lower tract and male genital organspmc.ncbi.nlm.nih.gov
Insights Into Urogenital Tuberculosis: Impact of Microbiological Diagnosis.pubmed.ncbi.nlm.nih.gov
Testicular Ischaemia Following Diverticulitis Complicated by Colovesical Fistula: A Case Report.pubmed.ncbi.nlm.nih.gov
Masked invaders: A case series on uncommon manifestations of extrapulmonary tuberculosis.pubmed.ncbi.nlm.nih.gov
Lupus Enteritis With Concomitant Genitourinary Involvement as the Initial Presentation of Juvenile-Onset Systemic Lupus Erythematosus.pubmed.ncbi.nlm.nih.gov
Right sided testicular pain as the sole presenting symptom of an abdominal aortic aneurysm: A case report.pubmed.ncbi.nlm.nih.gov
Iopromide CT peritoneography for diagnosis and management of dialysate scrotal leakage in continuous ambulatory peritoneal dialysis.pubmed.ncbi.nlm.nih.gov
Imaging Findings of Testicular Tuberculosis: A Case Report and Pictorial Review.pubmed.ncbi.nlm.nih.gov
Guillain-Barré syndrome involving reproductive system revealed on <sup>18</sup>F-FDG PET/CT: a case report.pubmed.ncbi.nlm.nih.gov
Hidden in plain sight: Extrapulmonary manifestations of tuberculosis in Asia.pubmed.ncbi.nlm.nih.gov
Emphysematous conditions of the abdomen and pelvis: pearls and pitfalls.pubmed.ncbi.nlm.nih.gov
Imaging findings in inflammatory disease of the genital organs.pubmed.ncbi.nlm.nih.gov
Ultrasound innovations in abdominal radiology: techniques and clinical applications in pediatric imaging.pubmed.ncbi.nlm.nih.gov
Non-traumatic lower abdominal pain: ultrasonographic and clinical differential diagnosis.pubmed.ncbi.nlm.nih.gov
Computed Tomographic Features of Intra-Abdominal Testicular Torsion in Cryptorchid Dogs.pubmed.ncbi.nlm.nih.gov
Paratesticular Embryonal Rhabdomyosarcoma Masquerading as Epididymitis: A Diagnostic Challenge in Adolescents.pubmed.ncbi.nlm.nih.gov
Clinical Management of Testicular Tumors in Dogs.pubmed.ncbi.nlm.nih.gov
The challenges in diagnosing isolated epididymal tuberculosis (TB) in an adolescent male: a case report.pubmed.ncbi.nlm.nih.gov
Identifying the deceiver: the non-neoplastic mimickers of genital system neoplasms.pubmed.ncbi.nlm.nih.gov
Pediatric gonadal torsion in radiology: A comprehensive literature and pictorial review using surgically proven cases.pubmed.ncbi.nlm.nih.gov
Acute idiopathic scrotal edema in the adult: A case report.pubmed.ncbi.nlm.nih.gov
Adult Acute Scrotal Edema - When Radiologists Can Help to Avoid Unnecessary Surgical Treatment.pubmed.ncbi.nlm.nih.gov
Abscess Adjacent to the Vas Deferens Mimicking Recurrent Inguinal Hernia: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
A rare guest in the hernia sac: Preoperatively diagnosed Amyand's hernia with gangrenous appendicitis.pubmed.ncbi.nlm.nih.gov
Liposarcoma With Extensive Necrosis Obscuring the Diagnosis in an HIV-Positive Patient: A Potential Diagnostic Pitfall.pubmed.ncbi.nlm.nih.gov
Epididymal and testicular abscesses: A case report and review of the literature.pubmed.ncbi.nlm.nih.gov
Ultrasonographic Evaluation of Acute Scrotal Emergencies: A Comprehensive Case Series.pubmed.ncbi.nlm.nih.gov
Immune-modulating medications: the masquerading culprit of epididymo-orchitis.pubmed.ncbi.nlm.nih.gov
Case Report: A case of intrahepatic papillary neoplasm of the bile duct with invasive carcinoma in a young patient and review of the literature.pubmed.ncbi.nlm.nih.gov
Multiparametric Ultrasound for Diagnosing Testicular Lesions: Everything You Need to Know in Daily Clinical Practice.pubmed.ncbi.nlm.nih.gov
Contrast-enhanced ultrasound as a valuable imaging modality for characterizing testicular lesions.pubmed.ncbi.nlm.nih.gov
Case Report: Fournier's gangrene occurring in the setting of intestinal obstruction complicated by suspected intra-abdominal infection, successfully managed with repeated surgical debridement.pubmed.ncbi.nlm.nih.gov
Fournier's Gangrene and Extensive Abdominal Necrotizing Fasciitis Secondary to Perforated Appendicitis Within an Inguinoscrotal Hernia: A Rare Case Report.pubmed.ncbi.nlm.nih.gov
The role of nutritional status in prognosis of Fournier gangrene: a single-center experience.pubmed.ncbi.nlm.nih.gov
Research progress on testicular torsion secondary to inguinal cryptorchidism.pubmed.ncbi.nlm.nih.gov
Evaluation of Scrotal Pathologies by Ultrasound and Color Doppler.pubmed.ncbi.nlm.nih.gov
A review of varicocele repair for pain.pubmed.ncbi.nlm.nih.gov
International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Non-proliferative and Proliferative Lesions of the Non-human Primate ( M. fascicularis ).pubmed.ncbi.nlm.nih.gov
Yolk sac tumor after post-detorsion changes in a torsed undescended testis: a case report.pubmed.ncbi.nlm.nih.gov
Computed tomography of testicular torsion in a juvenile dog with unilateral cryptorchidism.pubmed.ncbi.nlm.nih.gov
Epidemiology, Etiopathogenesis, Diagnosis, and Treatment of Male Infertility-Current Trends and Future Directions: A Narrative Review.pubmed.ncbi.nlm.nih.gov
A Unique Case of Extramedullary Relapse in Acute Lymphoblastic Leukemia: Testicular to Ocular, Cardiac, and Colonic Involvement and the Role of Sperm Phenotyping in Diagnosis-Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
Testicular Plasmacytoma Masking as Epididymo-orchitis in a Known Multiple Myeloma Patient.pubmed.ncbi.nlm.nih.gov
Management of Fournier's gangrene in a newborn: A rare case report and literature review.pubmed.ncbi.nlm.nih.gov
Multiple skip incision skin-sparing debridement for perianal necrotizing fasciitis: a retrospective study.pubmed.ncbi.nlm.nih.gov
A Case of Necrotizing Fasciitis Mimicking a Burn in an Elderly Patient.pubmed.ncbi.nlm.nih.gov
A Rare Extramedullary Presentation of Acute Myeloid Leukemia: Myeloid Sarcoma Presenting as a Hard Scrotal Swelling.pubmed.ncbi.nlm.nih.gov
Pediatric Spigelian Hernia and Spigelian-Cryptorchidism Syndrome: An Integrative Review.pubmed.ncbi.nlm.nih.gov
Extratesticular leiomyoma arising from the epididymis: Diagnostic challenges in a chronic scrotal mass.pubmed.ncbi.nlm.nih.gov
Isolated Testicular Tuberculosis Mimicking a Testicular Tumor: A Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
Expanding Role of Contrast-Enhanced Ultrasound and Elastography in the Evaluation of Abdominal Pathologies in Children.pubmed.ncbi.nlm.nih.gov
Clinical Characteristics, Microbiological Spectrum, Biomarkers, and Imaging Insights in Acute Pyelonephritis and Its Complicated Forms-A Systematic Review.pubmed.ncbi.nlm.nih.gov
Imaging Evaluation and Management of Breast Symptoms in the Pediatric Population.pubmed.ncbi.nlm.nih.gov
Atypical Presentation of Chronic Appendicitis With Concurrent Epididymo-Orchitis in a 71-Year-Old Patient: A Case Report and Clinical Implications.pubmed.ncbi.nlm.nih.gov
Imaging of the scrotum: beyond sonography.pubmed.ncbi.nlm.nih.gov
Cross-sectional imaging of complicated urinary infections affecting the lower tract and male genital organs.pubmed.ncbi.nlm.nih.gov
Pediatric emergency medicine point-of-care ultrasound: summary of the evidence.pubmed.ncbi.nlm.nih.gov
Microscopic ligation combined with shunt procedure versus microsurgical varicocelectomy for nutcracker syndrome and left varicocele: a randomized controlled trial.pubmed.ncbi.nlm.nih.gov
Loss of WNT4 in the gubernaculum causes unilateral cryptorchidism and fertility defects.pubmed.ncbi.nlm.nih.gov
Analysis of genome-wide knockout mouse database identifies candidate ciliopathy genes.pubmed.ncbi.nlm.nih.gov
A Hidden Neighbor: A Rare Benign Paratesticular Mass Presenting as a Testicular Tumor.pubmed.ncbi.nlm.nih.gov
Single Epididymis Metastasis 12 Years After Radical Prostatectomy: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
Clinical and radiological features of severe mpox: a case series of 16 patients in Beijing, China.pubmed.ncbi.nlm.nih.gov
Radiological insights into diverticulitis: Clinical manifestations, complications, and differential diagnosis.pubmed.ncbi.nlm.nih.gov
Computed tomography imaging analysis of hematogenous disseminated pulmonary tuberculosis cases combined with prostate tuberculosis.pubmed.ncbi.nlm.nih.gov
Malignant mesothelioma of the tunica vaginalis testis: A case report.pubmed.ncbi.nlm.nih.gov
Primary scrotal diffuse large B-cell lymphoma with skip metastasis to the mediastinum: a case report and literature review.pubmed.ncbi.nlm.nih.gov
First description of an orthotopically located spontaneously ruptured non-seminomatous, metastatic germ cell tumor and review of literature.pubmed.ncbi.nlm.nih.gov
Case Report: Atypical presentations of neonatal and infantile hemophilia B.pubmed.ncbi.nlm.nih.gov
Thyroglossal Duct Cyst Infection Caused by Neisseria gonorrhoeae: An Unusual Complication of Pharyngeal Gonorrhea.pubmed.ncbi.nlm.nih.gov
A rare case of disseminated genitourinary tract tuberculosis complicated by emphysematous prostatitis and seminal vesicle abscess.pubmed.ncbi.nlm.nih.gov
POCUS in Differentiating Etiology of Acute Scrotum.pubmed.ncbi.nlm.nih.gov
Malignant mesothelioma of the tunica vaginalis testis initially misdiagnosed as a benign testicular hydrocele: a case report.pubmed.ncbi.nlm.nih.gov
Testicular histiocytic sarcoma: a case report and literature review of an uncommon histological type of urogenital malignancy.pubmed.ncbi.nlm.nih.gov
A Comprehensive Review of SURGICEL®: Efficacy, Applications, and Radiological Insights in Surgery.pubmed.ncbi.nlm.nih.gov
Qualitative and quantitative spermatic cord abnormalities at CT predict symptomatic scrotal pathology.pubmed.ncbi.nlm.nih.gov
Adrenal hemorrhage and hemorrhagic masses; diagnostic workup and imaging findings.pubmed.ncbi.nlm.nih.gov
Acute Scrotal Involvement in Kawasaki Disease: A Potential Clinical Clue to Persistent Disease Activity.pubmed.ncbi.nlm.nih.gov
Idiopathic Scrotal Elephantiasis: Case Report of a Rare Occurrence.pubmed.ncbi.nlm.nih.gov
Role of High-Resolution Ultrasonography With Colour and Duplex Doppler in the Evaluation of Acute Scrotal Diseases.pubmed.ncbi.nlm.nih.gov
Xanthogranulomatous epididymo-orchitis: A single-institutional case series and systematic review.pubmed.ncbi.nlm.nih.gov
Recurrent Necrotizing Fasciitis: A Case Report of Fulminant and Sub-Acute Necrotizing Fasciitis in a Diabetic Patient.pubmed.ncbi.nlm.nih.gov
Fatal lymphatic-dominant progression in metastatic prostate cancer initially presenting with a clinically suspected inguinal node metastasis: a case report.pubmed.ncbi.nlm.nih.gov
Scrotal hematoma: a rare complication of transfemoral percutaneous coronary intervention.pubmed.ncbi.nlm.nih.gov
Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings.pubmed.ncbi.nlm.nih.gov
Galectin-3 restrains T cell-driven inflammation in the testis and epididymis.pubmed.ncbi.nlm.nih.gov
Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.pubmed.ncbi.nlm.nih.gov
Management of spermatic cord tumors: a rare urologic malignancy.pubmed.ncbi.nlm.nih.gov
Metastasis of Castration-Resistant Prostate Adenocarcinoma to the Lacrimal Gland: A Case Report.pubmed.ncbi.nlm.nih.gov
A Comprehensive Overview of <i>Klebsiella Pneumoniae</i>: Resistance Dynamics, Clinical Manifestations, and Therapeutic Options.pubmed.ncbi.nlm.nih.gov
Case Report: Acute Testicular Pain as the Initial Manifestation of a Ruptured Common Iliac Artery Aneurysm.pubmed.ncbi.nlm.nih.gov
Tissue infarction secondary to brucellosis: a systematic review of case reports and case series.pubmed.ncbi.nlm.nih.gov
Case Report: Multifocal plexiform neurofibromas presenting as a paratesticular "string-of-beads" mass in a 7-year-old boy with neurofibromatosis type 1.pubmed.ncbi.nlm.nih.gov
Are We Going to Give Up Imaging in Cryptorchidism Management?pubmed.ncbi.nlm.nih.gov
Necrotizing (Abscessing) Lymphadenopathy and the Diagnostic Value of Contrast-Enhanced Ultrasound (CEUS): A Review with Clinical Vignettes.pubmed.ncbi.nlm.nih.gov
Multiparametric Abdominal Ultrasound as a Source of Imaging Biomarkers in Predictive and Personalized Medicine: A Narrative Review.pubmed.ncbi.nlm.nih.gov
Unveiling the Microvasculature: The Index of Microcirculatory Resistance and Its Expanding Role in Cardiovascular Care.pubmed.ncbi.nlm.nih.gov
Contrast-enhanced ultrasound of the small organs in children.pubmed.ncbi.nlm.nih.gov
2012 CUA Abstracts.pubmed.ncbi.nlm.nih.gov
Unilateral testicular tuberculosis in a kidney transplant recipient: a case report.pubmed.ncbi.nlm.nih.gov
Incidental finding of probable epididymal adenomatoid tumor and tubulocystic renal cell carcinoma in a patient with epididymo-orchitis: a case report.pubmed.ncbi.nlm.nih.gov
A review of multiparametric ultrasound imaging in the clinical setting: scrotal contents.pubmed.ncbi.nlm.nih.gov
Computed Tomographic Features in a Case of Bilateral Neoplastic Cryptorchidism with Suspected Torsion in a Dog.pubmed.ncbi.nlm.nih.gov
Total laparoscopic radical hysterectomy for cervical cancer in prolapsed uterus.pubmed.ncbi.nlm.nih.gov
Differential diagnosis of testicular embryonal rhabdomyosarcoma and testicular seminoma with enhanced CT: a retrospective study.pubmed.ncbi.nlm.nih.gov
Concurrent inferior vena cava syndrome and spontaneous retroperitoneal hemorrhage secondary to inferior vena cava filter thrombosis, treated with large bore mechanical thrombectomy: a case report.pubmed.ncbi.nlm.nih.gov
A case report of primary para-testicular spindle cell rhabdomyosarcoma.pubmed.ncbi.nlm.nih.gov
Epididymal segment-specific miRNA and mRNA regulatory network at the single cell level.pubmed.ncbi.nlm.nih.gov
Fournier's Gangrene: Current Practices.pubmed.ncbi.nlm.nih.gov
A novel case of testicular metastasis from prostate cancer mimicking epididymo-orchitis despite suppressed PSA.pubmed.ncbi.nlm.nih.gov
Acute Scrotum Masquerading as Testicular Torsion: Spontaneous Intratesticular Hematoma in a Patient With Congenital Afibrinogenemia.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.