A case of epididymoorchitis without testicular infarction presenting with reversal of diastolic testicular flow on Doppler ultrasonography

An acute scrotum is a common clinical scenario prompting urologic involvement. Scrotal ultrasonography with Doppler is the main imaging modality utilized for the evaluation of an acute scrotum and can help distinguish testicular torsion from epididymoorchitis, two common causes of testicular pain. Testicular infarction is a rare but potential complication of epididymoorchitis. We report a case of epididymoorchitis presenting with reversal of testicular diastolic flow concerning for impending testicular infarction but with a non-ischemic testis on scrotal exploration and repeat scrotal ultrasonography post-operatively.
Highlights • Doppler ultrasonography is used to characterize epididymal and testicular flow. • Reversal of testicular diastolic flow does not always lead to testicular infarction. • Epididymoorchitis may present as reversal of testicular diastolic flow. • Scrotal exploration is recommended for reversal of testicular diastolic flow.