Acute scrotum after myocardial infarction

Mr Hamid and his colleagues (February 2003 JRSM¹) report a case of intratesticular haemorrhage after use of abciximab. Such incidents have been reported previously with other anticoagulants.² Spontaneous haemorrhage should additionally be considered in the differential diagnosis of an acute scrotum even in the absence of underlying disease or concomitant anticoagulant administration.³ Furthermore, haematoma formation may not be restricted to the testis, having been reported at other sites including the spermatic cord.⁴ Of particular concern when making a presumptive diagnosis of haemorrhage is the association of bleeding with testicular neoplasms, the outcome of which can be critical if associated with a metastatic extension.⁵ In view of the limitations of ultrasonography, follow-up imaging is desirable, to ensure the absence of an underlying neoplasm.