Clinical case: segmental testicular infarction as a complication of varicocele in a 17-year-old teenager

Introduction. Segmental testicular infarction in childhood and adolescent practice is a rare condition that develops most often as a complication of other andrological or other diseases. This pathology is extremely difficult to diagnose. At the same time, in order to increase the probability of a favorable outcome, it requires a decision to carry out appropriate therapeutic measures as soon as possible.

Description of the observation. The patient was admitted with a picture of acute scrotum syndrome 3 hours after the onset of the disease with suspected testicular torsion? Testicular vein thrombosis on the background of varicocele? Previously, I had not been observed about varicocele, I did not know about the disease.

By organs without gross changes. In the local status, there is an expansion of the testicular veins on the left to the III degree.  The testicle on the left is painful, dense, taut. Ultrasound examination and dopplerography of the scrotum organs were performed on an emergency basis. According to the radiation methods, segmental thrombosis was detected in the middle part of the testicle, however, the low frequency of segmental thrombosis and a greater focus on testicular torsion did not allow us to be sure of the absolute accuracy of these additional methods. An emergency revision of the scrotum was performed, in which the diagnosis of segmental thrombosis was confirmed. Subsequently, during the examination after 3 months, a partial restoration of blood flow in the infarction zone was noted without pronounced signs of testicular atrophy.

Conclusion. Segmental testicular infarction is an extremely rare complication of varicocele in childhood and adolescence. An adequate assessment of the clinical situation and the use of ultrasound imaging methods make it possible to establish the true diagnosis of segmental testicular infarction.  Not in all cases, segmental testicular infarction should be considered as an irreversible condition that leads to sclerosis in its outcome.