Testicular Torsion
Definition
twisting of spermatic cord that ‘holds’ the testes —> blood supply cut off —> schema —> necrosis
Aetiology
mostly idiopathic, congenital, post trauma
Epidemiology
any age, most often 11-30yo
Clinical Features
Symptoms
sudden onset of severe pain in one testes which makes walking difficult, abdo pain, N&V, lightheadedness
Signs
inflammation (hot, swollen, tender), high lying or transverse lying testes
Differential Dx
Investigations
USS doppler
Management
SUGERY!, explain and gain consent for possible orchidectomy + bilateral fixation
Prognosis
if surgery performed <6hrs of onset, salvage rate 90-100%; if >24hrs later, 0 - 10%
Source
OHCM 9th Ed 2014
Harrison's 18th Ed 2012
Toronto Notes 2012
twisting of spermatic cord that ‘holds’ the testes —> blood supply cut off —> schema —> necrosis
Aetiology
mostly idiopathic, congenital, post trauma
Epidemiology
any age, most often 11-30yo
Clinical Features
Symptoms
sudden onset of severe pain in one testes which makes walking difficult, abdo pain, N&V, lightheadedness
Signs
inflammation (hot, swollen, tender), high lying or transverse lying testes
Differential Dx
- Epipdidymo-orchitis - but age grp usually older, and more gradual onset of pain, may be associated with urinary Sx
- Trauma, tumor, hydrocele (would be transilluminable)
- Torsion of hydatid of Morgagni - remnant of mullein duct, occurs usually 7-12yo, < pain, tiny blue nodule might be visible under scrotum
Investigations
USS doppler
Management
SUGERY!, explain and gain consent for possible orchidectomy + bilateral fixation
Prognosis
if surgery performed <6hrs of onset, salvage rate 90-100%; if >24hrs later, 0 - 10%
Source
OHCM 9th Ed 2014
Harrison's 18th Ed 2012
Toronto Notes 2012