Spermatic vein thrombosis:a report of two cases and literature review
Objective To discuss and summarize clinical features of spermatic vein thrombosis for improving the level of diagnosis and treatment.Methods Clinical data of two cases of spermatic vein thrombosis,diagnosed and treated in our hospital recently,were summarized and analyzed combining with the related literature review for obtaining the main points of diagnosis and treatment.Results Two patients with of spermatic vein thrombosis,aged 23 and 37 years,came to the emergency of our hospital for left scrotal acute pain.Physical examination showed no swelling or tenderness in both testicles and epididymis.One patient had palpable cord-like material above the left testicle,with mild tenderness.The other patient had no abnormalities in the scrotum.Emergency ultrasound showed no swelling of the epididymis and normal testicular blood flow.The patients received antibacterial treatment,but no significant improvement was found.Two or three days later,the patients were diagnosed as left varicocele with thrombosis using ultrasound examination.Serum coagulation indexes were all normal.The patients received conservative treatment including NSAIDs,pancreatic kininogenase enteric-coated tablets and aescuven forte.After 2 weeks,their symptoms were basically improved.After 2-3 months,ultrasound examination revealed the disappearance of spermatic vein thrombosis.Conclusion Spermatic vein thrombosis is rare with clinical manifestations of acute scrotal pain ( mostly on the left side) .However,during physical examination,there is no obvious swelling or tenderness of the testis or epididymis,and sometimes a cord-like substance can be palpated within the scrotum.Ultrasound of the scrotum/spermatic vein is the diagnostic standard,and conservative treatment is the first choice.If conservative treatment is not effective for 7-10 days,surgical exploration and removal of the thrombotic vein should be performed.
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