Testicular Infarction and Incarcerated Inguinal Herniae

Mj, Hill; Pollock, William F.; Sprong, David H.

doi:10.1001/archsurg.1962.01310020181033

Cited by 17 publications

(10 citation statements)

References 7 publications

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“…Bennett-Jones (1937) described 2 of the earliest cases. According to Hill et al (1962) it is virtually confined to neonates, and the present case (Case 5 ) occurred in a 3-week-old boy. Reports by McFarland (1966) and Hanna (1972) have suggested that prompt operative treatment may save the testis, and in our case the early follow-up report promises that this may have been achieved.…”

Section: Other Causes Of Testicular Ischaemiamentioning

confidence: 77%

Torsion of the testis and allied conditions

Williamson

1976

Journal of British Surgery

326

161

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In 15 years at Bristol there have been 293 cases of torsion of the testis, 55 cases of torsion of a testicular appendage and 5 cases of testicular ischaemia due to other causes. The risk of a male developing torsion of the testis or its appendix by the age of 25 is about 1 in 160. Both conditions occurred primarily in adolescents, but among prepubertal boys torsion of an appendage was as common as torsion of a normally descended testis. There was a slight left-sided preponderance in testicular torsion, more marked in torsion of the appendages; the incidence of bilateral torsion was 2-0 and 1-8 per cent respectively. The clinical features and differential diagnosis of the two conditions are compared. Torsion of a testicular appendage is the most commonly misdiagnosed scrotal lesion, the preoperative diagnosis being correct in only 11 per cent of cases compared with 90 per cent for torsion of the testis. Twenty-one cases of recurrent torsion underwent prophylactic bilateral orchidopexy. There were 20 cases of torsion of undescended testes, with a salvage rate of only 20 per cent. The overall testicular survival rate was 55-3 per cent. Viability depends upon the possibility of spontaneous reduction, the preoperative delay after the onset of symptoms, the degree of torsion of the cord and the length of follow-up in doubtful cases. Urgent scrotal exploration is advised in every case of acute testicular pain unless there is overwhelming evidence of epididymoorchitis. Exploration of the opposite side is mandatory in torsion of the testis and advisable in torsion of an appendage.

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Section: Other Causes Of Testicular Ischaemiamentioning

confidence: 77%

Torsion of the testis and allied conditions

Williamson

1976

Journal of British Surgery

326

161

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“…If left unattended, venous thrombosis and hemorrhage occur. Tissue swelling and increased pressure within the tunica albuginea can ultimately lead to arterial insufficiency (8). This case report highlights the risk of testicular ischemia owing to an incarcerated inguinal hernia.…”

Section: Discussionmentioning

confidence: 81%

Incarcerated Inguinal Hernia: A Cause of Testicular Ischemia Without the ‘Twist’

Singh¹,

Kaur²,

Khanduja³

2017

J Emerg Med Case Rep

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A 25-year-old man presented to the ER with a painful lump in the right scrotal region for one day. The onset was sudden. The patient was passing flatus and stool. There was no significant medical or family history. His vital signs were stable. Physical examination revealed a firm, tender swelling in the groin and scrotum on the right side. The right testis was not separately palpable. The lump was irreducible. The abdomen of the patient was soft on palpation. Ultrasonogram was performed to evaluate the lump and delineate the right testis. It revealed the presence of omentum and a bowel loop in the inguinoscrotal region (Figure 1a). The bowel wall showed a normal echo pattern. The right testis was visualized and had a normal size and echo pattern. Color Doppler evaluation of the right testis revealed an absence of blood flow, although the left testis had normal blood flow 80 ABSTRACT Introduction: Acute scrotal pain is a common complaint encountered in the emergency room. Besides testicular torsion, incarcerated inguinal hernia is another important cause that requires urgent exclusion as it warrants emergency surgery. Case Report: Here we present a case of acute painful scrotal swelling in a young man owing to an incarcerated inguinal hernia that caused testicular ischemia. Ultrasound evaluation revealed the presence of bowel and omentum in the scrotum and normal echotexture of the testis. However, color Doppler revealed the absence of testicular blood flow. The patient underwent emergency surgery. The bowel and testis were salvaged by reducing the hernia. Conclusion: This case report illustrates the occurrence of testicular ischemia owing to compressed vascular supply by an incarcerated inguinal hernia. It also shows that testicular ischemia can occur in the absence of a twisted spermatic cord, thereby underscoring the requirement for evaluating the testis in the setting of an incarcerated inguinal hernia.

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“…Interrup tion of the venous drainage produces a marked edema, congestion, rupture of the venous wall, and interstitial hemorrhage. This occurs in the torsion of the spermatic cord [12,13], Since this torsion is not always demonstra ble [14], other causes, such as polycythemia and hyper viscosity in the newborn [15], venous compression by either hydrocele or an incarcerated hernia [16][17][18], and venal caval thrombosis [19] have been reported.…”

Section: Discussionmentioning

confidence: 99%