Scrot and test 2 Flashcards
2 main causes of pediatric pain or swelling of testes
torsion
epididymitits with or without orchitis
teste torsion is
testis and cord test one or more times
when is teste torsion most common
infancy and adolescence
2 types of torsion
extravaginal intravaginal (more common)
if torsion occurs below the epididymitis it is
torsion of mesorchium
extravaginal torsion occurs most in
neonates and in utero
what is extravaginal torsion
spermatic cord poorly fixed in inguinal canal. All of the scrotal contents are strangulated
intravaginal torsion is seen more in
adolescents
what is intravaginal torsion
Tunica vaginalis completely surrounds testis and inserts high on spermatic cord
Testis rotates freely on its vascular pedicle
predisposing factor for torsion is
bell and clapper deformity
does extravaginal have pain
noope. just swollen, red and enlarged
does intravaginal have pain
oh yea, Severely tender scrotum, swollenness, hyperemia
is intravaginal a medical emergency
yes will have immediate surgery
recent extravaginal torsion US appearance
heterogeneously enlarged with hypo and hyper echoic areas
chronic extravaginal torsion US appearance
normal size or enlarged, peripehral Ca2+
early stage, 4-6hrs and after 24 hours appearance of intravaginal torsion
Early stage – normal
4-6 hrs – hypoechoic from edema
After 24 hrs – heterogenous from hemorrhage and infaction (missed torsion)
does presence of flow exclude torsion in painful testis?
no, incomplete torsion can still show some flow
who is acute epididymitis seen in
pubertal boys
clinical signs of acute epididymitis is like torsion but
more gradual onset of pain, fever, pyuria
mumps orchitis seen in
postpubertal boys infected with mumps
acute epididymitis US appearance
coarse echoes hypo echoic areas hyperaemic blood flow hydrocele skin thickening
Most common cause of acute scrotal pain in prepubertal boys
torsion of the appendages of the the cord or testicle
what is blue dot sign
small, firm, round, mobile, tender paratesticular mass with bluish discolouration visible through skin, showing torsion of appendix in that location
torsion of testicular appendix seen as
Solid, ovoid mass with variable sized hypoechoic centre and hyperechoic rim
testicular torsion can cause hematoma which appears as
avascular masses with varying echogenisity
when looking for testicular rupture we are looking at
disruption of thetunica albuginea, which is normallya smooth echogenic line
and presence of possible hematocele
