Emergency Ultrasound > Top 10 Pathology > Fournier's Gangrene

Fournier's Gangrene

Defined as an undescended testicle, cryptorchidism is more commonly found in premature babies and if uncorrected it carries significant risk of malignant transformation (more than 40 times increase) and also infertility. Ultrasound helps detect up to 80% of undescended testicles in the inguinal canal region. MRI may be needed for other anatomic locations. Treatment is with orchiopexy within one year of age if the testicle has not spontaneously descended. Recent Urology literature recommends surgical treatment as early as 6 months of age since most testes that spontaneously descend, do it so by this age. The latest recommendations by the National Guidelines Clearinghouse states:

In cryptorchidism, if a testis has not descended by the age of 1 year, there is no benefit in waiting for a spontaneous descent. To prevent histological deterioration, treatment should be carried out and finished before 12-18 months of age. Medical treatment with hCG or GnRH can have a beneficial effect on increasing the patient's fertility index when given before or after surgical orchidolysis and orchidopexy.

Sonographic findings include an oval 1 cm mass similar to the descended contralateral testicle (Fig 13). The differential diagnosis is that of a lymph node, which would contain a central fatty hilum.


Fig 13. Cryptorchidism.

A good example of a testis in the inguinal canal with an empty scrotum is found in ULTRASOUND Q., Volume 20(4).December 2004.181-200.

11a ULTRASOUND Q., Volume 20(4).December 2004.181-200.jpg

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