Pampiniform plexus vein thrombosis presenting as acute scrotal pain

Thrombosis of the pampiniform plexus is a rare cause of acute scrotal pain and may mimic common surgical emergencies. We report the case of a 62-year-old man who presented with left inguinal and testi-cular pain, normal abdominal ultrasonography and computed tomography findings, and localized ten-derness without swelling. Scrotal color Doppler ultrasonography demonstrated dilated, non-compressible pampiniform veins containing a hypoechoic thrombus and absent venous flow, confir-ming pampiniform plexus thrombosis. The patient was treated conservatively with nonsteroidal anti-inflammatory drugs and scrotal elevation, without anticoagulation. Symptoms resolved within two weeks, and follow-up ultrasonography at one month showed a persistent thrombus with partial recanali-zation. This case underscores the diagnostic value of Doppler ultrasonography in this uncommon entity.