Introduction:

Spermatic vein thrombosis (SVT) is a very rare event with no specific epidemiological data. Its presentation is predominantly on the left, and in most cases, its cause is unknown. Its diagnosis is usually made by exclusion when studying acute scrotum pain. The following is the first case of SVT reported in Colombia and one of the few cases of right laterality in the world.

Case presentation.

A 21-year-old male patient consulted the emergency department of a tertiary care institution in Bogotá, Colombia, due to pain in the right inguinoscrotal region for a week that progressively increased in intensity and was accompanied by unquantified fever, without other associated symptoms. The patient reported only a medical history of a mild cranioencephalic trauma without sequelae at the age of 20 years. A testicular Doppler ultrasound was performed, revealing right spermatic cord thrombosis. He started antibiotic therapy, low molecular weight heparins and coumarin, which resulted in an adequate response and resolution of the condition.

Conclusion:

SVT poses a diagnostic challenge that requires a high clinical suspicion, which is achieved by having knowledge of this condition and establishing it as a differential diagnosis of acute scrotum pain. Once suspected, Doppler ultrasound becomes a useful tool for diagnosis because, in addition to being cost-efficient, it allows the initiation of a timely, safe and effective conservative treatment, thus avoiding unfavorable outcomes for the patient.

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