Pampiniform Venous Plexus Thrombosis Presenting As Testicular Pain: Report of a Rare Case.

Spontaneous thrombosis of the pampiniform venous plexus is a rare vascular disorder that can manifest as acute testicular pain, often mimicking conditions such as epididymitis, orchitis, or testicular torsion. Due to its uncommon presentation, clinical diagnosis can be challenging, and a high level of suspicion is required. Scrotal Doppler ultrasonography serves as an effective, non-invasive diagnostic tool by demonstrating absent venous flow within the pampiniform plexus while confirming normal testicular perfusion. We present a case of spontaneous pampiniform venous plexus thrombosis diagnosed using Doppler ultrasound. The patient was successfully managed with conservative measures, including anticoagulation, analgesics, and brief bed rest, resulting in complete resolution of symptoms and normalization on follow-up imaging. This case underscores the importance of including pampiniform plexus thrombosis in the differential diagnosis of acute testicular pain and highlights the pivotal role of scrotal Doppler in guiding timely and appropriate treatment, thereby preventing unnecessary surgical intervention. Awareness of this rare entity is essential, particularly in outpatient and emergency settings, to ensure accurate diagnosis and optimal patient care.