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Heather Borders, MD
over 10 years ago
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Bilateral Scrotal Pearls

Case Detail

Anatomy: Genitourinary
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 9 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: CR US
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Teenager with cystic fibrosis and abdominal pain, rule out distal intestinal obstruction.

Case Images


Scrotal Pearls


CR – Moderate stool in the colon but no radiographic evidence of obstruction. Incidental finding of bilateral scrotal calcifications.

US – Color Doppler image confirms calcification. 3D volume rendered image shows the relationship of the left-sided calcification to the testicle.


Scrotoliths (scrotal pearls) are calcified bodies within the scrotum that have no clinical importance. In an older child, chronic appendageal torsion is the most likely etiology for these scrotal calcifications. There are five testicular appendages, which are the remnants of the mesonephric and paramesonephric ducts. Torsion of an appendage results in intense pain, usually localized in the upper pole of the testis and associated with a palpable nodule with bluish scrotal discoloration. Necrosis of the appendage leads to calcification and detachment. Occasionally, bowel perforation spilling meconium or barium may produce scrotoliths.


Aso C, Enriquez G, Fite M, et al. Gray-Scale and Color Doppler Sonography of Scrotal Disorders in Children: An Update. Radiographics (2005); 25: 1197-1214.

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