Retrospective review of pediatric patients with acute scrotum

Mushtaq, Imran; Fung, Michael Fung Kee; Glasson, M. J.

doi:10.1016/s0022-3468(03)00235-5

Cited by 6 publications

(15 citation statements)

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“…However, around 13-20% will have testicular torsion, with epididymo-orchitis the most common of the other contributing conditions. [1][2][3][4][5] Other conditions to consider in the differential diagnosis range from mumps orchitis, hematoma, renal colic, appendicitis and strangulated inguinal hernias and, rarities like the scrotal manifestations of Henoch-Schonlein purpura and communicating hematocoeles following abdominal trauma. 6,7 Testicular torsion can occur in several different ways, and can be classified as intravaginal, extravaginal or mesorchial.…”

Section: Resultsmentioning

confidence: 99%

“…However, patients with TT tend to have a shorter duration of symptoms before presentation. 1,18 Early presentation in TT is associated with higher likelihood of salvage. The presence of nausea and vomiting, caused by reflex stimulation of the coeliac ganglion, can be a useful clue in diagnosing TT, but incidence varies significantly in the literature.…”

Section: Resultsmentioning

confidence: 99%

“…9,10 Other series have shown that nausea and vomiting do occur in torsion of the testicular appendix and epididymo-orchitis, but the complaint is much rarer. 1,18 Dysuria is an uncommon complaint in testicular torsion, and its presence likely indicates an alternate diagnosis such as epididymoorchitis. 19 A history of trauma should not discount the possibility of TT.…”

Section: Resultsmentioning

confidence: 99%

“…1 The term testicular torsion is a misnomer as the twisting occurs at the cord and not in the testes. It accounts for 10% to 15% of acute scrotal disease in children, and results in an orchiectomy rate of 42% in boys undergoing surgery for testicular torsion.…”

Section: Introductionmentioning

confidence: 99%

“…10 Other studies have demonstrated a rate of organ loss of 64%-90%. 1,34,35 Manual detorsion can lessen the severity of testicular torsion, if tolerated by the patient. The classical description is that detorsion should be performed with medial-to-lateral rotation of the testicle, likened to the action of "opening a book."…”

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Surgical management of testicular torsion

et al. 2016

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confidence: 99%

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical management of testicular torsion

et al. 2016

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Re‐exploration of the acute scrotum

2006

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RESULTSThe median (range) age of the patients was 11.5 (2-15) years; 61 had two scrotal explorations and three were explored three times. Of the patients, 32 presented with right testicular pain, 31 had left pain, and one had bilateral testicular pain. In the second exploration, 56 of 64 had the contralateral testis explored, five had an ipsilateral exploration and three had bilateral exploration. Forty-eight of the 64 boys (70%) had torsion of the contralateral appendix testis at the second exploration, and 5.3% (45/ 840) of the total number of children operated for acute scrotum had metachronous torsion of the appendix testis. The median interval between the first and second exploration was 8 months (1 day to 10.5 years). Two boys had three scrotal explorations, and three of 64 (4.7%) boys developed complications that required re-exploration. CONCLUSIONSMost indications for recurrent scrotal exploration in this study are because of a twisted contralateral appendix testis, but the risk of developing this pathology is similar to the complication rate of repeat scrotal exploration. These data support our policy that the contralateral testis should not be routinely explored nor its appendix removed unless there is ipsilateral testicular torsion. KEYWORDSrecurrent scrotal exploration, appendix testis, torsion, children OBJECTIVETo investigate children and adolescents who had scrotal exploration more than once. 1994 and 2004, 64 of 840 (7.6%) boys had more than one scrotal exploration at our institution. The age, laterality of the explorations, the interval between and findings at operation, whether the testes were managed by orchidopexy and how, and the complications, were reviewed from the medical records and the operating reports of the patients. All the boys were followed at the outpatient clinic 2-4 weeks after surgery. PATIENTS AND METHODS Between

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Torsion of the Testicular Appendages in Adult Acute Scrotum

Saito¹

2019

IJCU

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Adult patients with acute scrotum sometimes tend to be treated for epididymitis without undergoing ultrasonographic examination, although precise ultrasonography reveals that there are some patients with torsion of the testicular appendages. In this report, I investigate the incidence of patients with torsion of the testicular appendages among patients with adult acute scrotum, who mainly used to be treated for epididymitis. In the last 5 years, 46 patients (23~62, average age 43.5 years) with scrotal pain and swelling visited our clinic for diagnosis and treatment. On an outpatient basis, their symptoms were evaluated, and blood tests, urinalysis, and grey scale and color Doppler ultrasonography with a 5-12 MHz linear scan were performed. Five (10.9%) of the 46 patients were diagnosed as having torsion of the testicular appendages. Although none of them had a high fever, 4 of the 5 (80%) had nausea and abdominal pain. Leukocytosis and pyuria were not found in any case. Typical ultrasound appearances were reactive hydrocele and a hyperechoic swollen mass or enlarged hyperechoic, spherical mass of the appendage. On color Doppler ultrasonography, there was no blood flow within the torsed appendage testis, and an increase in periappendiceal blood flow was seen in all of the cases. They were treated conservatively with anti-inflammatory agents and cooling, and their symptoms disappeared within 2 weeks. It is suggested that as many as 10.9% of adult patients with scrotal pain and swelling may suffer from torsion of the testicular appendages. We should conduct ultrasonography for adult patients with acute scrotum.

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Retrospective review of pediatric patients with acute scrotum

Cited by 6 publications

References 0 publications

Surgical management of testicular torsion

Surgical management of testicular torsion

Re‐exploration of the acute scrotum

Torsion of the Testicular Appendages in Adult Acute Scrotum

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