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  • Left testicular venous infarction secondary to large spontaneous retroperitoneal haematoma compressing left testicular vein: a case report

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Case Reports: Unusual association of diseases/symptoms
Left testicular venous infarction secondary to large spontaneous retroperitoneal haematoma compressing left testicular vein: a case report
  1. Thomas Vu1,
  2. Sivaneswaran Lechmiannandan2,
  3. Sarah Birks1 and
  4. Jeremy Grummet2
  1. 1Department of General Surgery, Alfred Health, Melbourne, Victoria, Australia
  2. 2Department of Medicine at Alfred Medical Research and Education Precinct, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Thomas Vu; tomvu90{at}gmail.com

Abstract

A man in his early 50s presented with a spontaneous large left-sided retroperitoneal haematoma (RPH), on a background of therapeutic anticoagulation with warfarin for homozygous factor V Leiden. His international normalised ratio was found to be supra-therapeutic at 9.0 on presentation. He was treated non-operatively with prompt reversal of the coagulopathy and close monitoring. On day 4 of the admission, the patient reported scrotal pain and swelling. An urgent scrotal ultrasound revealed infarction of the left testis and the patient was taken to an emergency scrotal exploration. Intraoperatively, the left testis was found to be no longer viable with the left spermatic vein and venules completely thrombosed with extensive clots, while the left testicular artery remained intact. Consequently, a left orchidectomy was performed. Therapeutic anticoagulation was recommenced on day 3 postoperatively. It is thought that the large RPH caused extrinsic compression of the left testicular vein, in addition to the patient’s pre-existing factor V Leiden, which resulted in thrombosis of the blood vessel.

  • Urology
  • Urological surgery
  • General surgery

http://dx.doi.org/10.1136/bcr-2022-249913

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    Footnotes

    • Contributors TV is a general surgery registrar responsible for the patient’s care, the primary and corresponding author, and contributed to the writing, editing and submission of the manuscript. SL is a urology fellow responsible for the reviewing and editing of the manuscript. SB is a general surgery consultant and the lead clinician of the patient’s care, and contributed to the reviewing and editing of the manuscript. JG is a urology consultant who contributed to the reviewing and editing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.