July 2010

Abnormal scrotal wall

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Clinical information

Painful red swollen scrotum and fever

Ultrasound Images & Clips

Abnormal scrotal wall

There is a massively swollen scrotal wall with highly reflective structures causing acoustic shadowing

Another image of the swollen scrotal wall with highly reflective structures causing acoustic shadowing, that is caused by the presence of air in the scrotal wall.

Detail of another part of the scrotal wall showing massive edema

The scrotal wall shows increased vascularity

There is also increased vascularity around the air in the scrotal wall

Longitudinal image of the left testis. The testis and peritesicular structures are normal

Transverse image of both normal testicles

Axial CT scan image of the scrotal wall showing air in the wall

Coronal CT scan image of the scrotal wall showing air in the wall

Conclusion

Fournier's gangrene is a type of necrotizing infection or gangrene usually affecting the perineum.
It was first described by Baurienne in 1764 and is named after a French venereologist, Jean-Alfred Fournier following five cases he presented in clinical lectures in 1883
Most cases are caused by an infection with both aerobic and anaerobic bacteria.
The presence of air in the soft tissues of the scrotal wall is one of the characteristics of Fournier's gangrene.
In this case the treatment was a wide surgical drainage procedure and treatment with antibiotics. The patient responded well to this treatment.
Fournier's gangrene is an urological emergency that when it is untreated can lead to sepsis and eventually death

Details

Sex: Male
Age: 046

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Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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