Cases reported "Spermatic Cord Torsion"

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1/189. appendicitis simulating torsion of the spermatic cord: a case report.

    A case of acute non-perforated appendicitis presenting as acute scrotal swelling and erythema is reported. A communicating hydrocele containing serous cloudy fluid was encountered on examination, suggesting the intra-abdominal pathology. ( info)

2/189. Clinics in diagnostic imaging (33). Missed testicular torsion.

    A 13-year-old boy presented with a painful scrotal swelling. On examination, the left testis was enlarged and tender. Ultrasound scan showed diffuse hypoechogenicity, with absent intra-testicular but increased peri-testicular blood flow. The diagnosis of missed testicular torsion was confirmed at surgery. The role of imaging in differentiating among other causes of painful scrotal swelling, such as infection, trauma and tumour, are discussed. ( info)

3/189. Testicular torsion: can the testicle be saved one week later?

    An unusual case of a 15-year-old male who presented with a characteristic clinical syndrome of testicular torsion one week prior to our observation, is reported. During our intervention the testicle was not removed but, on the contrary, restoration of a satisfactory testicular albugineal appearance was achieved. ( info)

4/189. Synchronous torsion of testicular appendages: a rare mechanical cause of bilateral scrotal pain.

    We describe a case of synchronous torsion of testicular appendages, a previously unreported cause of bilateral scrotal pain. Exploration and excision was curative. ( info)

5/189. Metachronous bilateral torsion of the testicular appendices.

    BACKGROUND: Torsion of the appendix testis is a common cause of scrotal pain in children and a common cause for surgical exploration of the pediatric scrotum. The first case of metachronous bilateral torsion of the testicular appendices managed by a non-operative approach is reported. methods/RESULTS: A case report and a computer-assisted review of the literature are presented. Physical findings of a tender, mobile mass over the anterior surface of the testis characterize the presentation. Doppler findings of normal blood flow to the testes with increased flow to the adjacent appendix testis can be utilized as an adjunct to diagnosis. Ultrasonographic findings of a pedunculated mass with a central hypoechoic area at the superior aspect of the testis support the diagnosis. Accurate non-operative diagnosis of torsion of the appendix testis permits successful conservative management with non-steroidal anti-inflammatory agents. CONCLUSIONS: Improvements in ultrasonographic and Doppler imaging of torsion of the appendix testis have facilitated the diagnosis of this entity and decreased the need for surgical exploration of the scrotum. ( info)

6/189. Ultrasonographic diagnosis of testicular torsion by emergency physicians.

    Testicular torsion has an incidence of one case per 4,000 men/boys. Most frequently affected are pubescent boys. Average testicular salvage rate is only 50%, and infertility can result Testicular torsion remains problematic for emergency physicians (EPs) as clinical diagnosis can be difficult and other testicular pathology can present similarly. In many institutions there are delays in obtaining Doppler or Scintigraphy studies during off-hours. We report two cases of testicular torsion diagnosed by the treating EPs using power Doppler in the emergency department (ED). Rapid diagnosis of torsion led to successful salvage of the affected testicle in both cases. These represent the first cases for emergency screening ultrasound examinations (ESUEs) of testicular torsion in the literature. Rapid technological advances over the last decade have brought portable equipment with high-resolution capability to the bed-side for EPs, who should consider using it more frequently to evaluate testicular torsion. ( info)

7/189. Mullerian-type epithelial tumor arising within a torsed appendix testis.

    Because it is a remnant of the mullerian duct system, the appendix testis contains mullerian epithelium that theoretically may produce epithelial tumors similar to those that occur in the female genital tract. Few reports of tumors of mullerian origin arising in the testis exist, and rarely are neoplasms arising from the appendix testis identified. We present a case of a serous cystic neoplasm of low malignant potential derived from mullerian-type epithelium that was located in the torsed appendix testis of a young, otherwise healthy, boy. ( info)

8/189. A rare simultaneous presentation of testicular mixed germ cell tumor with a contralateral testis torsion.

    We report a rare case of a 27-year-old man presenting with an acute scrotum with simultaneous occurrence of testicular tumor and contralateral torsion. Preoperative imaging demonstrated the testicular missed torsion, yet findings were equivocal with regard to the testicular tumor. On scrotal exploration the left testis was found to be ischemic due to threefold rotation. The right testis was not identifiable, being composed of numerous necrotic lesions. Frozen section suggested malignancy, hence high right orchiectomy was performed. Histologic examination of the right testis showed mixed germ cell tumor, containing all the subtypes. To our knowledge no similar case has been reported. ( info)

9/189. Bilateral asynchronous perinatal testicular torsion: a case report.

    Bilateral perinatal testicular torsion (PTT) is an extremely rare condition. A baby boy at the postnatal 28th hour presented with right scrotal erythema and swelling, and left hydrocele were detected. There were no systemic symptoms. Right hydrocele had been detected during prenatal ultrasonography at the 34th week of gestation. Emergency technetium Tc 99m pertechnetate scintigraphy showed hypoperfusion in both sides suggesting testicular torsion. The patient underwent surgery immediately. Right necrotic testis was removed, left testis was judged as viable, and thus was treated with detorsion. Bilateral PTT in the neonate is a true emergency because of the risk of anorchia. Controversy still exists regarding the treatment of unilateral PTT. Some investigators suggest delayed operation regarding the anesthetic risk imposed on the neonate and the reality that operative salvage of the prenatally torsed testicle is a remote possibility. However, although asynchronous bilateral PTT is rare, the patient with unilateral PTT is at risk of contralateral testicular torsion in the waiting period of delayed operation. Therefore, the authors recommend early surgical intervention. ( info)

10/189. Trauma induced testicular torsion: a reminder for the unwary.

    Trauma induced testicular torsion is a well recognised entity, the incidence being 4-8% in most studies reporting on testicular torsion. The signs and symptoms of testicular torsion may easily be mistakenly attributed to preceding testicular trauma if there was such an event. A patient is described with trauma induced testicular torsion who presented on three occasions before a decision was made to perform scrotal exploration. Unfortunately, an orchidectomy was the outcome. The message that trauma can and not infrequently does precipitate torsion, needs to be reiterated. awareness of the entity and constant vigilance is required of clinicians to avoid a delay in definitive treatment. ( info)
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