[10] Testicular Torsion Flashcards
What does testicular torsion usually occur secondary to?
Some exertion or minor trauma
When does testicular torsion usually present?
10-25 years
What are the symptoms of testicular torsion?
Sudden onset severe pain in one testis
May also have lower abdominal pain, and associated nausea and vomiting
Why might there be associated lower abdominal pain in testicular torsion?
Because the testis are supplied by T10
What may be present in the history in testicular torsion?
Previous testicular pain or torsion
What may be found on examination in testicular torsion?
Inflammation of one testis - hot, swollen, extremely tender
Testis rides high and lies transversely
What are the differential diagnoses for testicular torsion?
Epididymo-orchitis Torted hydatid of Morgagni Tumour Trauma Strangulated hernia Appendicitis
How can epididymo-orchitis be differentiated from testicular torsion?
Occurs in older patient
UTI symptoms
More gradual onset
What is the Hydatis of Morgagni?
The remnant of Mullerian duct
How can torted Hydatid of Morgagni be differentiated from testicular torsion?
Young patient
Less pain
Tiny blue dot visible on scrotum
What investigations may be done in testicular torsion?
Doppler US
What may be demonstrates on doppler US in testicular torsion?
Absence of flow
What should be considered when deciding on investigations in testicular torsions?
Investigations must not delay surgical exploration
How long from onset is there to salvage testis?
4-6 hours
How should testicular torsion be immediately managed?
Inform senior
NBM
IV access
Surgery
