Retrospective Review of Diagnosis and Treatment in Children Presenting to the Pediatric Department With Acute Scrotum

Liang, Teresa; Metcalfe, Peter; Sevcik, William; Noga, Michelle

doi:10.2214/ajr.12.10036

Cited by 83 publications

(61 citation statements)

References 31 publications

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“…[1] It has two peaks in age distribution occurring in the perinatal and early adolescent age groups. [2] As a matter of fact, any male in the peripubertal age presenting with acute scrotal pain should be presumed to have testicular torsion and diagnostic evaluation should be utilised until otherwise confirmed.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

Karthikeyan¹,

Ashiq²,

J³

et al. 2016

jemds

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BACKGROUNDTesticular torsion is a surgical emergency, which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in our Institution, Sree Balaji Medical College and Hospital, Chennai -44. In this cross-sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2012 and 2015 in our Institution. All 32 cases were reviewed and several clinical data including duration of symptoms and operative findings were collected. Misdiagnosing testicular torsion can lead to organ loss, cosmetic deformity and compromised fertility. The differential diagnosis of the acutely painful scrotum includes testicular torsion, trauma, epididymitis/orchitis, incarcerated hernia, varicocele, idiopathic scrotal oedema and torsion of the appendix testis.

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Section: Introductionmentioning

confidence: 99%

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

Karthikeyan¹,

Ashiq²,

J³

et al. 2016

jemds

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“…Using a transverse image of both testes, the torted testis and epididymis will appear larger and have a more homogenous in echotexture than the normal testis, and this appearance itself is highly suspicious of acute torsion [2]. A heterogenous echotexture of the testis with hypoechoic regions would represent necrosis, and is a late sign of torsion, and may indicate a testis which can not be salvaged [2].…”

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confidence: 99%

“…A heterogenous echotexture of the testis with hypoechoic regions would represent necrosis, and is a late sign of torsion, and may indicate a testis which can not be salvaged [2].…”

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confidence: 99%

“…The absence of flow in the testis is a sign of complete torsion [2], this is best assessed on a transverse image when comparing it to the contralateral side, which will show normal flow. Torsion can cause the scrotal wall to become hyperaemic, this will easily be seen on Doppler imaging.…”

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confidence: 99%

“…Data shows that Doppler ultrasound can have a variable specificity for testicular torsion varying from as low as 46% [1] to as high as 97% [2] depending on various studies. In studies where Doppler and contrast enhanced ultrasound were compared to each other in acute scrotal pathology, sensitivity and specificity were 76% and 45% for ultrasound and 96% and 100% for CEUS [3].…”

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confidence: 99%

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A Case of Testicular Torsion Demonstrated on Contrast Enhanced Ultrasound

Syed¹,

Pranay²,

Chua³

et al. 2017

Rejr

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urpose. To demonstrate the potential of contrast enhanced ultrasound (CEUS) for the diagnosis of torsion taking the example of a man with equivocal clinical findings. Materials and Methods. A 43 year old gentleman with no significant past medical history presented to the Accident and emergency following acute onset right testicular pain. The clinical differential was of either epididymo-orchitis or testicular torsion.Results. The patient underwent an ultrasound scan which revealed a normal left testicle but a swollen right testicle with no discernible flow on Doppler, thus raising the suspicion of acute torsion. To increase our confidence of the diagnosis the patient was immediately cannulated and a contrast enhanced ultrasound was performed. Within a few seconds, microbubbles could be seen within the parenchymal blood vessels in the left testicle as expected, however microbubbles could not be seen within the right testicle even after 5 minutes of scanning. The clinical team were informed of the findings and the patient was taken directly to theatre where testicular torsion was confirmed and orchidopexy was performed, preserving function of the right testicle.Conclusions. In order to exclude testicular torsion, the imaging modality of choice which is used is ultrasound.Keywords: ultrasound, contrast enhanced ultrasound, epididymo-orchitis, testicle torsion. DOI:10.21569/2222DOI:10.21569/ -7415-2017 ель. Продемонстрировать потенциал ультразвукового исследования с внут-ривенным контрастированием в диагностике перекрута яичка. Материалы и методы. Мужчина 43 лет поступил в госпиталь с жалобами на резкую боль в области правого яичка. Наследственный анамнез не отягощен. По клини-ческим признакам были поставлены предварительные диагнозы: орхоэпидидимис или перекрут яичка.Результаты. Пациенту было выполнено ультразвуковое исследование, которое выявило увеличение и отѐк правого яичка с отсутствием видимого кровотока, левое яичко без особенностей. Таким образом, было выставлено предположение о наличии острого перекрута правого яичка. Для уточнения диагноза пациенту было проведено ультразвуковое исследование с внутривенным контрастированием. Через несколько се-кунд микровезикулы были видны в паренхиматозных кровеносных сосудах левого яич-P Ц СЛУЧАЙ ИЗ ПРАКТИКИ

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Pathologies of the Male Reproductive Tract

Sajjad¹,

Akhtar²,

Sajjad³

2018

Clinical Reproductive Science

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Retrospective Review of Diagnosis and Treatment in Children Presenting to the Pediatric Department With Acute Scrotum

Abstract: Color Doppler ultrasound is accurate and sensitive for diagnosis of torsion in the setting of acute scrotum. Despite heterogeneity on preoperative ultrasound, many testes were considered to be salvageable at surgery. The salvage rate of torsed testes was high.

Cited by 83 publications

References 31 publications

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

A Case of Testicular Torsion Demonstrated on Contrast Enhanced Ultrasound

Pathologies of the Male Reproductive Tract

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