to illustrate the imaging anatomy of the venous drainage of the human testis to review the clinical presentation and radiological findings of internal spermatic vein thrombosis as well as demonstrate potential mimickers of this condition to discuss the possible etiologies and optimal management and treatment

Patients presenting with acute scrotal pain (ASP) to the emergency department require a timely diagnosis. Frequently encountered causes of ASP include testicular torsion, complicated hernia, epididymo-orchitis or testicular trauma. Testicular (or internal spermatic) vein thrombosis (TVT) is a rare entity, most often involving the left side. Diagnosis solely based on the clinical presentation can be challenging and TVT can be easily misdiagnosed as an incarcerated inguinal hernia, epididymo-orchitis or spermatocele which may result in wrong treatment pathway and possibly unnecessary surgical intervention. The exact etiology...

Due to the high variability and low specificity of the symptoms of TVT, a high suspicion rate is required in order to accurately diagnose the condition. Doppler ultrasound is the gold standard imaging technique due to its high sensitivity and specificity while it can also be used to differentiate between other causes of ASP. Ultrasound imaging findings include a non-compressible hypoechoic tubular structure located in the spermatic cord and possible extending within the pelvic cavity, with absence of flow in the Colour Doppler ultrasound [Fig...

TVT is rarely observed and its clinical presentation may overlap with other common causes of ASP making the diagnosis of the condition a challenge.Doppler ultrasound is the preferred imaging method to confirm the diagnosis.Conservative management with anticoagulants and anti-inflammatory medicine has been suggested by most studies as the preferred treatment pathway.

c. aslanidi: Nothing to disclose S. Athanasiou: Nothing to disclose Z. Papoutsou: Nothing to disclose V. Mamalis: Nothing to disclose S. Mylona: Nothing to disclose A. Tsanis: Nothing to disclose

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