Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura

Dayanir, Yelda Özsunar; Akdilli, Alev; Karaman, Can Zafer; Sönmez, Ferah; Karaman, Göksun

doi:10.1007/s003300100843

Cited by 19 publications

(13 citation statements)

References 8 publications

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“…In the literature there are a lot of reports of acute scrotum simultaneously or subsequently to HSP (13,14,15) but according to our knowledge, except the report by Hardoff et al, there is no case of scrotal swelling mimicking testicular torsion preceding HSP.…”

Section: Discussionmentioning

confidence: 86%

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

Akgün¹

2012

BLL

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Henoch-Schönlein purpura, is one of the most common types of multisystemic vasculitis seen in childhood. The major clinical manifestations are cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis. Isolated central nervous system vasculitis, seizures, coma and hemorrhage, Guillan--Barré syndrome, ataxia and central and peripheral neuropathy, ocular involvement, orchitis, epididymitis or testicular torsion are medical or surgical complications. In this study, we report a 7-year-old boy with scrotal swelling mimicking testicular torsion with ultrasonographic and clinical fi ndings that the typical clinical features of Henoch-Schönlein purpura including rashes and arthritis were developed after one week of surgery (Ref. 15) Henoch-Schönlein purpura (HSP) is one of the most common types of multisystemic vasculitis seen in childhood and characterized by non-thrombocytopenic, non-blanching purpura, arthritis, abdominal pain, and renal involvement (1). The epidemiology of HSP is obscure and in the literature there are different values of incidence of this disease. An incidence of 13.5 cases per 100,000 children per year was observed by Stewart M. et al. whereas 0.2-10 cases per 100,000 were reported by Farley et al (2, 3). Although the major clinical manifestations are cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding, and nephritis, other manifestations include an isolated central nervous system vasculitis, seizures, coma and hemorrhage, Guillan-Barré syndrome, ataxia and central and peripheral neuropathy, ocular involvement, orchitis, epididymitis or testicular torsion are other medical or surgical conditions that can be seen with HSP (4). The present report details a case of a young Turkish boy with scrotal swelling mimicking testicular torsion with ultrasonographic fi ndings and with the typical clinical features of HSP developed one week after the surgery. Case reportA 7-year-old boy was brought to emergency department with complaints of scrotal swelling and pain lasting 1 day. Except a history of brucellosis 2 years ago, the personal and family histories were unremarkable. Moreover, recent history of infectious disease or trauma was not described. At the time of admission, there were left scrotal edema and testicular pain and he had no rash in any part of the body. The laboratory investigations revealed hemoglobin 13.1 g/dl, white blood cell count 13000/μL and platelet count 462,000/μL. Serum electrolytes, liver enzymes, blood coagulation tests, antinuclear antibody, rheumatoid factor, antistreptolysin O, serum IgA level and urinalysis were within normal levels. On ultrasonographic examination decreased blood fl ow and enlarged testis were seen. Surgical exploration revealed a hematocele, with bloody fl uid accumulation mainly in the tunica vaginalis testis and an edematous, hyperemic testis and epydidymis without torsion of both of them. Edema of testis and epydidymis resolved after surgery. The patient was discharged without any complication on t...

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Section: Discussionmentioning

confidence: 86%

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

Akgün¹

2012

BLL

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“…None of these are accompanied by elevated gonadotrophins and no such laboratory constellation was found in our patients. Disease-induced affection of the testes by the vasculitis itself resulting in direct damage of the testes might be an explanation for sexual dysfunction and hypogonadism in our patients as involvement of the testes and the lower genitourinary tract has been described occasionally in WG, and in other forms of systemic vasculitis (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). However, proposed biopsies for the verification of necrotizing vasculitis in small vessels will rarely include biopsies of the testicles or ovaries (32).…”

Section: Discussionmentioning

confidence: 95%

Hypogonadism in Wegener's granulomatosis

Becker

Specker

Schneider

2008

Scandinavian Journal of Rheumatology

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Data of our study revealed an unexpected high rate of hypogonadism irrespective of cyclophosphamide use, and subclinical involvement of the testes by the vasculitis itself might be an alternative explanation. Screening during the course of the disease is reasonable as hypogonadism might severely affect patients' quality of life. Further prospective studies with respect to gender-specific changes in the reproductive system are warranted.

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“…Normally, there is about 50 mL of fluid in the pericardial space. [ 17 ] The noncompliant pericardium can accommodate an acute accumulation of 80 mL to 100 mL of fluid before pressures begin to rise rapidly. [ 11 ] The rise in intrapericardial pressure impedes venous return to the right atrium and right ventricle resulting in hypotension, tachycardia, and pulsus paradoxus.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of cardiac tamponade with transesophageal echocardiography following the induction of anesthesia for suspected testicular torsion

2015

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Transesophageal echocardiography (TEE) is a valuable tool for evaluating hemodynamic instability in patients under general anesthesia. We present the case of a 28-year-old man who presented with complaints of testicular pain concerning for testicular torsion. After induction of general anesthesia for scrotal exploration and possible orchiopexy, the patient developed severe and persistent hypotension. Using intraoperative TEE, the diagnosis of pericardial tamponade was made, and an emergent pericardial window was performed.

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Epididymoorchitis mimicking testicular torsion in Henoch-Schönlein purpura

Cited by 19 publications

References 8 publications

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

A case of scrotal swelling mimicking testicular torsion preceding Henoch-Schönlein vasculitis

Hypogonadism in Wegener's granulomatosis

Diagnosis of cardiac tamponade with transesophageal echocardiography following the induction of anesthesia for suspected testicular torsion

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