Thrombosis of the pampiniform plexus and spermatic vein can present as an acute scrotum.
Clinical features:
(1) inguinal and/or scrotal pain
(2) swelling of the hemiscrotum
(3) hematuria
Scrotal Doppler ultrasound shows decreases blood flow with dilation of veins.
Risk factors for thrombosis:
(1) hereditary hypercoagulable state
(2) acquired hypercoagulable state (systemic inflammatory disorder, drugs, etc)
(3) prolonged exercise with increased intra-abdominal pressure
(4) surgery on the inguinal region or scrotum
