Testicular Torsion Flashcards
Clinical presentation of testicular torsion?
Common in boys 12-18yrs. Assoc with bell clapper deformity (anatomical abnormality which allows testicles to rotate freely within the tunica vaginalis).
Sudden onset unilateral scrotal pain. Not relieved by elevating scrotum.
Assoc with nausea, vomiting, left lower abo pain.
Scrotal discolouration
OE: tender, enlarged, high rising testicle with a transverse lie, Absent cremasteric reflex on affected side.
Investigations for testicular torsion?
USS Doppler: diagnostic
Scintigraphy has almost 100% specificity for torsion but takes longer and less readily available.
If urinalysis, FBC and CRP abnormal suspect alternate diagnosis like epididymitis.
How to manage testicular torsion in non neonate?
Immediate urological consultation for emergency operative repair.
Supportive: morphine sulphate sc/im and ondansetron iv if nausea
If surgery not available within 6 hrs then do manual de-torsion whilst waiting
