Acute scrotum: A rare presentation

Bell clapper deformity in female?

“…The gubernaculum ovarii, a fibrous band from the lower pole of the ovary ends close to the external inguinal ring on each side, and becomes the ovarian suspensory ligament cranially and the round ligament caudally, extending up to labia majora. A saccus vaginalis extending into the inguinal canal (canal of Nuck), normally gets obliterated, but however may remain patent after birth and provide a canal for potential indirect inguinal hernia [1] , [2] , [3] , [4] .…”

“…The inguinal canal in females normally transmits the round ligament of the uterus and the ilioinguinal nerve to the labia majora, a vein and an artery from the uterus that forms a cruciate anastomosis with the labial arteries. Incarceration of the bowel and female adnexa may occur especially in infants with inguinal hernia, due to a relatively short and oblique direction of inguinal canal and presence of a diverticulum or canal of Nuck, with the round ligament [1] , [2] , [3] , [4] .…”

Testicular torsion; clinical diagnosis or imaging diagnosis?

“…Despite its high sensitivity and specificity, both false-negative and false-positive findings occur. However, Testis with color Doppler flow signals might be an obstacle for surgical exploration with resultant testicular loss in the false-negative cases [2] , [3] .…”

“…Heterogeneity of the testis with swelling and edema suggests no viability, whereas a homogenous echotexture suggests testicular viability on gray scale sonography [2] , [3] .…”

“…Scrotal scintigraphy using Technicium 99 pertechnate injected intravenously on an emergency basis is a valid and reliable test to diagnose testicular torsion whenever clinical and sonological findings are inconclusive [3 , 4] .…”