scholarly journals Cocaine abuse that presents with acute scrotal pain and mimics testicular torsion

2016 ◽  
Vol 42 (5) ◽  
pp. 1028-1032 ◽  
Author(s):  
José Tadeu Nunes Tamanini ◽  
Vagner Tadeu Salzani ◽  
Juliana Milhomem Tamanini ◽  
Filipe Iessenco ◽  
Leonardo O. Reis
Keyword(s):  
Cocaine Abuse ◽  
Testicular Torsion ◽  
Scrotal Pain ◽  
Acute Scrotal Pain

Acute Testicular Torsion: Presentation and Diagnosis

2019 ◽  
Author(s):  
Claudia Berrondo ◽  
Robert A. Mevorach ◽  
Jimena Cubillos
Keyword(s):  
Testicular Torsion ◽  
Near Infrared ◽  
Color Doppler ◽  
Bimodal Distribution ◽  
Long Term Effects ◽  
Scrotal Pain ◽  
Unique Challenge ◽  
Acute Infarction ◽  
Hormonal Function ◽  
Acute Scrotal Pain

Testicular torsion is the most common pediatric urologic emergency and is a common cause of acute scrotal pain. Timely diagnosis is important for testicular salvage,as treatment delayed beyond 6 hours from the onset of symptoms is the most predictive factor of testicular death. There is a bimodal distribution of age with extravaginal torsion most commonly presenting in the neonatal period and intravaginal torsion most commonly presenting around the onset of puberty. Intermittent testicular torsion presents a unique challenge in making an accurate diagnosis, as patients most often present when asymptomatic. Several risk factors exist, although bell-clapper deformity is the most important. The diagnosis is made largely on history or physical examination. In equivocal cases, imaging with color Doppler ultrasonography may be helpful in making the diagnosis. Additional tools including near-infrared spectroscopy and Testicular Workup for Ischemia and Suspected Torsion score may be helpful in diagnosing testicular torsion. Possible long-term effects on fertility and hormonal function are also often a concern for the patient and clinician. This review contains 6 figures, 5 tables, and 34 references.  Keywords: acute, infarction, ischemia, orchidopexy, scrotum, spermatic cord, testis, torsion

Intermittent Testicular Torsion

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 908-911
Author(s):  
Thomas J. Stillwell ◽  
Stephen A. Kramer
Keyword(s):  
Primary Care Physicians ◽  
Testicular Torsion ◽  
Separate Entity ◽  
Scrotal Pain ◽  
Young Males ◽  
Testicular Pain ◽  
Acute Scrotal Pain ◽  
History Of ◽  
Scrotal Swelling ◽  
Physical Findings

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys and should be foremost in the minds of primary care physicians evaluating these children. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. Acute and intermittent sharp testicular pain and scrotal swelling, interspersed with long intervals without symptoms, are characteristic. Physical findings may include horizontal or very mobile testes, an anteriorly located epididymis, or bulkiness of the spermatic cord from partial twisting. Awareness of this entity and early elective orchiopexy will improve testicular salvage in patients with intermittent testicular torsion.

Approach to Male Urologic Emergencies

2019 ◽  
Author(s):  
Jonathan E. Davis ◽  
Jeffrey S. Dubin
Keyword(s):  
Emergency Department ◽  
Inguinal Hernia ◽  
Necrotizing Fasciitis ◽  
Testicular Torsion ◽  
Diagnosis And Treatment ◽  
Acute Scrotum ◽  
Scrotal Pain ◽  
Penile Pain ◽  
Emergency Department Setting ◽  
Acute Scrotal Pain

This review details the evaluation and management of the acute scrotum in the emergency department setting and emergent penile complaints in adults, with an emphasis on the most serious and most common conditions. Other emergent conditions include necrotizing fasciitis of the perineum (Fournier disease), incarcerated or strangulated inguinal hernia, and genitourinary (GU) trauma. Emergency practitioners need to be most concerned with the entities that, if left untreated, can result in ischemia and necrosis of the penis. Basic anatomy and bedside evaluation are reviewed. Acute scrotal and penile pain and GU trauma are discussed in terms of assessment and stabilization, diagnosis, and treatment and disposition.  This review contains 5 figures, 19 tables, and 71 references. Keywords: Acute scrotal pain, testicular torsion, priapism, Peyronie disease, paraphimosis, phimosis, balanitis, posthitis, epididymitis

scholarly journals Real-time Point-of-care Ultrasound for the Diagnosis and Treatment of Testicular Torsion

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 70-72
Author(s):  
Rahul V. Nene ◽  
Rachna Subramony ◽  
Michael Marcias ◽  
Colleen Campbell ◽  
Amir Aminlari
Keyword(s):  
Blood Flow ◽  
Real Time ◽  
Testicular Torsion ◽  
Point Of Care ◽  
Diagnosis And Treatment ◽  
Acute Scrotum ◽  
Point Of Care Ultrasound ◽  
Scrotal Pain ◽  
Real Time Analysis ◽  
Acute Scrotal Pain

Background: Testicular torsion is a surgical emergency that needs prompt diagnosis and treatment. Point-of-Care ultrasound (POCUS) can not only establish the diagnosis but also guide the Emergency Physician in evaluating the response to manual detorsion. Case Report: We describe the case of a 13-year-old male who presented with acute scrotal pain. We demonstrate how bedside ultrasound was used to make the diagnosis of testicular torsion, guide the technique for manual detorsion, and confirm adequate return of blood flow. Our case illustrates the ease with which POCUS can be used in real time to diagnose and treat organ-threatening pathology, but more importantly, it shows how real-time POCUS was used to detorse a testicle that was refractory to the standard detorsion technique. Conclusion: The acute scrotum is a time-sensitive presentation and if testicular torsion is present, the diagnosis should be made as soon as possible. Many Emergency Departments do not have 24-hour coverage of ultrasound technicians, which would delay the diagnosis and treatment. Moreover, when manual detorsion is attempted, it often does not work because the testicle may need more than the standard 180 degree medial to lateral rotation. POCUS provides real-time analysis of return of blood flow and can thus guide further rotation, or opposite direction rotation, as needed.  

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