1/10. Prenatal testicular torsion: sonographic appearance in the newborn infant.The prenatal diagnosis of spermatic cord torsion is often really difficult and the diagnosis is usually retrospective. Herein, we report a case of a male newborn baby who presented at delivery with an enlarged, swollen and tender scrotum. US showed an enlarged right testis, with dishomogeneous texture, fluid collection between the testis and the tunica vaginalis and large hydrocele. Differential diagnosis included hydrocele complicated by infection or hemorrhage, testicular tumor or postnatal testicular torsion. color and power Doppler did not reveal any flow signal, and the diagnosis of antenatal torsion with initial necrosis was made. The role of color Doppler US is emphasized in directing the patient to emergency surgical exploration, when testicular salvage may be possible. Delayed surgical treatment can be proposed, when the diagnosis of antenatal torsion has a high degree of certainty. However, the Doppler examination of a newborn baby's testis is a very difficult challenge even for an experienced radiologist.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
2/10. Torsion of a benign cyst arising from the tunica vaginalis testis.We describe a rare case of torsion of a benign cyst originating from the parietal layer of tunica vaginalis. This case presented with acute scrotum. Surgical exploration revealed a cyst arising from the parietal layer of tunica vaginalis of which the pedicle was twisted. When a cystic mass is detected in the scrotum of boys with acute scrotum, torsion of a cyst in the cavum tunica vaginalis testis should be considered.- - - - - - - - - - ranking = 7keywords = tunica (Clic here for more details about this article) |
3/10. Polyorchidism and torsion. A lesson from 2 cases.Two cases of polyorchidism with 2 left scrotal testes are referred. In both patients, the segmented gonads showed a "bell clapper" deformity. In the first patient, the contralateral gonad also presented a large mesorchium and absence of scrotal ligament, whereas in the second case, the right gonad was firmly adhered to the tunica vaginalis because of a previous appendix testis torsion. Orchidopexy of all testes, judged at risk for torsion, was performed. Contrary to what is recommended by recent literature, we consider scrotal exploration and testis fixation mandatory of the contralateral, apparently normal gonad as well, even in the absence of clinical and ultrasound signs of associated abnormalities or complications.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
4/10. Testicular torsion after orchiopexy.We report 2 cases of testicular torsion after orchiopexy, which is rare but potentially catastrophic. A review of the literature revealed that absorbable suture was used in 15 of 16 cases of recurrent torsion. We conclude that the tunica albuginea should be secured to the scrotal wall with several nonabsorbable sutures to pex the testes permanently.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
5/10. The "window" orchidopexy for prevention of testicular torsion.Torsion of the testicle is often due to the "bell-clapper" deformity. This deformity is frequently bilateral. Prevention of future episodes of torsion depends upon the creation of a broad area of dense adhesion between the tunica albuginea and the scrotal wall. The results of this study indicate that this may be best accomplished by creating a window in the tunical vaginalis so that during healing a broad area of the tunica albuginea is held in apposition to a raw surface devoid of tunica vaginalis. Simply suturing the testical to the wall of the hemiscrotum does not always result in permanent fixation.- - - - - - - - - - ranking = 4keywords = tunica (Clic here for more details about this article) |
6/10. Torsion of the testis following previous "fixation".Two cases of torsion of the testis following previous "fixation" are reported. Prompt recognition of this emergency situation and detorsion may save the ischaemic organ. The importance of adequate bilateral fixation of the testicles within the tunica vaginalis is stressed to prevent possible recurrences.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
7/10. Torsion of the contralateral testis 5 years after orchiopexy.We report a case of spermatic cord torsion in the contralateral testicle 5 years after surgical fixation. Since diagnosis of such a lesion is difficult a high degree of suspicion is necessary. If torsion is suspected exploration is mandatory. We strongly recommend the use of a nonabsorbable reaction-producing suture (for example silk) when an orchiopexy is performed, with the point of fixation being between the visceral tunica vaginalis and the dartos muscle.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
8/10. Recurrent torsion of the testis following previous surgical fixation.Two cases of recurrent torsion of the testis following previous surgical fixation are described. The significance of this rare occurrence is discussed and it is recommended that total excision of the parietal tunica vaginalis is used for surgical fixation.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
9/10. Acute pancreatitis masquerading as testicular torsion.A 40-year-old man presented with fat necrosis of scrotum as the complication of acute pancreatitis. Excessive fluid accumulation in the pancreas and the extrapancreatic spaces, including around the spermatic cord, was seen on computed tomography. Surgical specimen showed typical fat necrosis of tunica vaginalis and the spermatic cord. After the surgery, pain of the testicle subsided completely, without recurrence. From the clinical presentation alone, it had been difficult to differentiate this patient's condition from torsion of the spermatic cord.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
10/10. Testicular torsion after previous orchidopexy for undescended testis.We report one case of acute testicular torsion following orchidopexy for an undescended testis. A review of the literature reveals only ten similar cases. history of a previous testicular surgery should not preclude the possibility of a torsion in that testicle. We conclude that at orchidopexy for an undescended testis, eversion of the tunica vaginalis is an essential step to avoid any future torsion.- - - - - - - - - - ranking = 1keywords = tunica (Clic here for more details about this article) |
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