Surgery Flashcards
Presentation of testicular torsion?
Very painful testicles Vomiting due to pain Redness later on Oedema High-riding testicle Abdominal pain
What’s the differential of red, painful testicles?
Testicular torsion! Most important one.
Epididymo-orchitis Hydrocele Idiopathic scrotal oedema Trauma Torsion of hydatid
Painful swollen testicles presenting in adults is more likely to be what?
STD
Investigations for an acute scrotum (red, painful, swollen)?
Testicular USS
Surgery straight away within 4 hours
What age group is testicular torsion most common?
Neonatal
Puberty
Any time
What’s the hydatid of the tests?
An embryological remnant found on the testicle
What is hypospadias?
When the urethral meatus is not at the end but somewhere along the shaft of the penis
Bend in penis
Hooded foreskin
Causes of groin swelling?
Hernia
Lymph nodes
Hydrocele
What goes through the inguinal canal?
3 nerves: gentiofemoral (L1/2), Ilioinguinal
3 arteries: cremasteric, testicular, ductus deferens
3 others: vas deferens, lymphatic vessels
Indirect vs direct inguinal hernia?
Direct: weakness in posterior wall of inguinal canal means bowel comes into canal and out through s. ring
Indirect: no weakness, but bowel comes in through the d. ring and out through s. ring
Where do testicles come from? How do they descend to scrotum?
They develop in abdomen, near kidney
Then come down through inguinal canal
How do you differentiate between hydrocele and scrotal hernia?
If you can get above where the swelling is, more likely to be hydrocele
If you’re able to feel the testicle separately, more likely to be hernia
If you can trans-illuminate it its a hydrocele (in adults only)
What are the 4 symptoms of bowel obstruction?
Pain
Vomiting
No bowel movements
Abdominal distention
Management of hydrocele?
Under 2, leave it alone
Over 2, operate as less likely to self resolve now
Management of inguinal hernia?
Operate, need to be quicker the younger the child is.
