Testicular Torsion

From WebHealth

[edit] Testicular torsion Introduction

Occasionally abdominal pain may be due to a congenital abnormality where the connective tissue support of the testicle is slightly unstable and the testicle can get twisted around (testicular torsion). In this case there this condition can occur in infants and young children and it may be difficult to come to a diagnosis.

The anatomy of the relationship of the duct that transports sperm from the testicles (vas deferens) and the blood vessel bundle that supplies the structures with blood is shown in an image here. On the left you see the normal anatomy, on the right the torsion has left the vas deference all swollen and painful.

Symptoms:

The patient experiences severe pain in the affected testicle, which can irradiate through nerve connections into the lower abdomen on the same side. There can be nausea and vomiting and there is usually local swelling of the scrotum overlying the testicle with torsion. Young children and infants may present only with a high fever and the physician would miss this condition, if the genitals do not get examined and palpated.

Treatment:

Treatment consists of a quick surgical exploration with normal repositioning of the testicle and fixation of the testicle to prevent a reoccurrence. Often the other side has to also be fixed at the same time to prevent a reoccurrence of a similar problem in the near future on the other side.

Home page

Abdominal pain

References:

1. DM Thompson: The 46^th Annual St. Paul's Hospital CME Conference for Primary Physicians, Nov. 14-17, 2000, Vancouver/B.C./Canada

2. C Ritenbaugh Curr Oncol Rep 2000 May 2(3): 225-233.

3. PA Totten et al. J Infect Dis 2001 Jan 183(2): 269-276.

4. M Ohkawa et al. Br J Urol 1993 Dec 72(6):918-921.

5. Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc., pages 976-983: "Chapter 107 - Acute Abdomen and Common Surgical Abdominal Problems".

6. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice, 5th ed., Copyright © 2002 Mosby, Inc. , p. 185:"Abdominal pain".

7. Feldman: Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 7th ed., Copyright © 2002 Elsevier, p. 71: "Chapter 4 - Abdominal Pain, Including the Acute Abdomen".

8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.