EVALUATION OF ACUTE SCROTAL PAIN BY COLOR-CODED DUPLEX SONOGRAPHY

In light of the high sensitivity of color-coded duplex sonography (CCD S), we analyzed a group of patients with acute scrotal pain to evaluat e the use of CCDS in routine clinical examination. During March 1988 t hrough April 1991, CCDS was used in 31 patients with acute scrotal pai n before they underwent surgery in our department. In 15 patients, the structural and perfusion changes of the scrotal contents were such th at a definitive diagnosis was possible. In the rest of the patients, t he pathologic changes seen with CCDS were more complex, and the correc t interpretation needed more expertise; this was especially true in pa tients with partial torsion, posttorsion status, and torsion of hydati ds. CCDS with the simultaneous display of anatomic scrotal structures and blood flow over the entire scan field is an excellent method for e valuating patients with acute scrotal pain. However, apart from the cl assical case of no perfusion (as in testicular torsion) and increased perfusion (as in inflammation), more complex changes are more difficul t to interpret. The correct diagnosis in the latter cases requires con siderable experience and evaluation of all facts, including clinical h istory, results of palpation, and structural and perfusion changes of the scrotal contents.