Epididymo-orchitis

[edit] Discussion of Epididymo-orchitis

Epididymo-orchitis, which is mainly of infectious origin, is an uncommon cause of acute scrotum in children.
The infection usually originates in the bladder or prostate gland, spreads through the vas deferens and the lymphatics of the spermatic cord to the epididymis, and finally reaches the testis, causing epididymo-orchitis.
Isolated orchitis is very rare.
The clinical spectrum ranges from mild tenderness to a severe febrile process.
There are two peaks of prevalence: under 2 years of age and over 6 years of age.
Complications of epididymo-orchitis include vascular compromise, testicular ischemia, infarction, and abscess.

The epididymal head is the most affected region, and reactive hydrocele and wall thickening are frequently present.
Increased size and, depending on the time of evolution, decreased, increased, or heterogeneous echogenicity of the affected organ are usually observed.
The inflammation produces increased blood flow within the epididymis, testis, or both.
Analysis of the epididymal waveform may reveal a low-resistance pattern as compared with the normal pattern.