Acute Global Testicular Infarction Post-EVAR from Cholesterol Embolisation can be Mistaken for Torsion

T Pathmarajah; M Abdelhamid; A S Tenna; D J W Paton; J A Hockley; S Jansen

doi:10.1016/j.ejvssr.2017.03.002

Acute Global Testicular Infarction Post-EVAR from Cholesterol Embolisation can be Mistaken for Torsion

EJVES Short Rep. 2017 Apr 4:35:11-15. doi: 10.1016/j.ejvssr.2017.03.002. eCollection 2017.

Authors

T Pathmarajah¹, M Abdelhamid¹, A S Tenna¹, D J W Paton², J A Hockley¹, S Jansen^{1

3

4

5}

Affiliations

¹ Department of Vascular and Endovascular Surgery, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.
² Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, Perth, WA, Australia.
³ Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.
⁴ Centre for Population and Health Research, Curtin University, Perth, Australia.
⁵ Heart Research Institute, Harry Perkins Institute of Medical Research, Perth, WA, Australia.

Abstract

Introduction: Endovascular aneurysm repair (EVAR) is the most commonly used approach for treatment of abdominal aortic aneurysms (AAA). Testicular infarction is a rare complication of EVAR. A novel case of acute global testicular infarction post-EVAR from cholesterol embolisation mimicking torsion is presented.

Report: A 75 year old man developed acute right testicular ischaemia requiring orchidectomy following EVAR of an infrarenal aortic aneurysm. The patient was initially diagnosed with testicular torsion as the aetiology of the infarction; however, on re-analysis of histopathology it was found to be secondary to cholesterol emboli.

Discussion: In patients complaining of groin/scrotal pain following EVAR, it is worth considering testicular ischaemia whether secondary to cholesterol embolisation or gonadal occlusion. Clinicians should be aware that clinical and radiological findings can mimic torsion as this affects management and outcome.

Keywords: Aorta; Cholesterol; EVAR; Embolism; Ischaemia; Testis.

Publication types

Case Reports