Presentation
This blue dot sign is present in 10% to 23% of patients with torsion of the appendix testis. 34,42 Over time, scrotal edema can obscure the physical findings. [aafp.org]
Background Torsion of testicular appendages can result in the clinical presentation of acute scrotum. [emedicine.medscape.com]
Mild hydrocele may or may not be present. [sumerdoc.blogspot.com]
These presentations are often prepubertal. Patients will present with sudden onset pain (more moderate in severity) and located midline in the scrotum. A “ blue dot sign ” is considered pathognomonic. [emdocs.net]
Respiratoric
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Pleural Effusion
Atresia 223 Thyreoglossal and Branchial Cysts Sinuses and Fistulas 228 Tracheostomy 235 Chest 245 Chest Wall Deformities 247 Breast Disorders in Children and Adolescents 257 Congenital Airway Malformations 262 Mediastinal Masses in the Children 277 Pleural [books.google.de]
Gastrointestinal
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Hypertrophic Pyloric Stenosis
Pyloric Stenosis 361 Gastrostomy and Jejunostomy 369 Duodenal Obstruction 383 Intestinal Malrotation 392 JejunoIleal Atresia 405 Meconium Ileus 415 Duplications of the Alimentary Tract 423 Necrotizing Enterocolitis 434 Constipation 445 Hirschsprungs [books.google.de]
Cardiovascular
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Heart Failure
Systolic and Diastolic Heart Failure. No known association. D. Coronary Artery Disease or Peripheral Vascular Disease. No known association. E. Diabetes or other Endocrine issues. Testicular torsion may be cause of infertility later in life. [clinicaladvisor.com]
Urogenital
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Testicular Pain
Background : Management of chronic idiopathic testicular pain may be difficult because of problems identifying the causes. [pubfacts.com]
Case 4 was a 19-year-old male who suffered from right testicular pain for the past seven days. He had a history of three intermittent episodes of similar right testicular pain during the past two years. [ncbi.nlm.nih.gov]
Another potential cause of acute testicular pain involves vestigial structures that you may remember in the deepest recesses of you medschool brain. [pemcincinnati.com]
Testicular and Scrotal Conditions The Acute Scrotum Torsion of the Appendix Testis or Epididymis The presentation of a patient with torsion of the appendix testis (ie, acute testicular pain and swelling) is similar to that of a patient with testicular [aafp.org]
PREOPERATIVE DIAGNOSIS: Right testicular pain. POSTOPERATIVE DIAGNOSIS: Right hydrocele, right appendix testis. [supercoder.com]
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Scrotal Mass
Anorchia (Medical Encyclopedia) Hydrocele (Medical Encyclopedia) Hydrocele repair (Medical Encyclopedia) Hypogonadotropic hypogonadism (Medical Encyclopedia) Orchitis (Medical Encyclopedia) Scrotal masses (Medical Encyclopedia) Testicle lump (Medical [icdlist.com]
Appendiceal torsion, Torsed appendage, Epididymitis, Idiopathic scrotal edema, Acute scrotum – vasculitis, Henoch-Schonlein Purpura, Acute scrotal pain – US, Algorithm, Acute scrotum – trauma, Hematocele, Testicular hematoma, Trauma, Testicular fracture, Scrotal [sonoworld.com]
A 16-HOUR-OLD boy was found to have a scrotal mass, on his initial physical examination. Exploration at 18 hours of age revealed a necrotic appendix testis (hydatid of Morgagni). [jamanetwork.com]
This technique holds great promise as an educational tool that could quickly increase clinician confidence and expand the use of point-of-care testicular ultrasound. 19 ACUTE SCROTAL MASS Painless scrotal masses are unlikely to represent an acute disease [radiologykey.com]
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Swelling of the Scrotum
Sonography of the scrotum was done in this child who had acute swelling of the scrotum and penis. [ultrasound-images.com]
Diagnosis Any swelling in the scrotum is torsion of the testis until proven otherwise. The child must be seen immediately because time is critical in trying to salvage the testis. Usually the diagnosis is made clinically. [pedclerk.bsd.uchicago.edu]
Presentation Acute swelling of the scrotum in a boy indicates torsion of the testis until proven otherwise. [patient.info]
H ydroc ele A hydrocele is the most common cause of scrotal swelling. The normal scrotum contains small amounts of serous fluid between the layers of the tunica vaginalis. [acep.org]
Differential Diagnosis of the Acute Scrotum A list of potential medical conditions that can present as acute pain or swelling of the scrotum are found in Table 1. Table 1. [auanet.org]
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Testicular Mass
Microcalcifications associated with a testicular mass in a 32-year-old male with a non-tender left scrotal mass. A, B. [e-ultrasonography.org]
When the patient presents complaining of pain from the testicular mass, it may be from hemorrhage into the neoplasm itself. [radiologykey.com]
Other testicular tumors include gonadal stromal tumors, lymphoma, leukemia, and metastases. 2 The differential diagnosis of focal testicular mass includes hematoma, abscess, focal orchitis, infarction, and granulomatous disease. [appliedradiology.com]
The rapidly increasing testicular mass in the peripubertal male increases the chance of testis rotation. 3, 13 With respect to TAT, several studies have reported that the age for peak incidence of TAT is significantly younger than that of peripubertal [dovepress.com]
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Epididymal Tenderness
tenderness with or without testicular tenderness WBC, LE, nitrites Body of testis similar to asymptomatic side with hypoechoic epididymis Antibiotics Possible scarring, possible impaired fertility While ultrasound is the most useful diagnostic modality [cdemcurriculum.com]
There is also noted diffusely tender swollen testes or epididymal tenderness. Scrotal swelling and erythema and reactive hydrocele may also be present in delayed presentations. [clinicaladvisor.com]
Workup
Testicular torsion is doubtful, and no further workup is indicated. Patients may be treated with narcotic analgesics if needed (nonsteroidal anti-inflammatory drugs [NSAIDs] if not contraindicated) and antibiotics. [aneskey.com]
Owing to the local policy during the study period, CDUS was not yet a part of the diagnostic workup of the acute scrotum. [dovepress.com]
Acute testicular torsion in children: the role of sonography in the diagnostic workup. Eur Radiol 2006;16:2527–32. Mirochnik B, Bhargava P, Dighe MK, Kanth N. Ultrasound evaluation of scrotal pathology. Radiol Clin North Am 2012;50:317–32, vi. [racgp.org.au]
X-Ray
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Mediastinal Mass
Child Abuse 213 Head and Neck 221 Choanal Atresia 223 Thyreoglossal and Branchial Cysts Sinuses and Fistulas 228 Tracheostomy 235 Chest 245 Chest Wall Deformities 247 Breast Disorders in Children and Adolescents 257 Congenital Airway Malformations 262 Mediastinal [books.google.de]
Pleura
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Pleural Effusion
Atresia 223 Thyreoglossal and Branchial Cysts Sinuses and Fistulas 228 Tracheostomy 235 Chest 245 Chest Wall Deformities 247 Breast Disorders in Children and Adolescents 257 Congenital Airway Malformations 262 Mediastinal Masses in the Children 277 Pleural [books.google.de]
Treatment
Here, the practicing urologist will find informative, easy-to-read reviews of the modern evaluation of prenatal hydronephrosis, the standard treatment of reflux vs the newer injectable techniques, and the spectrum of hypospadias treatment along with new [books.google.de]
Conservative treatment is indicated, as this is a self-limited process. Infarction and subsequent atrophy of the appendage will occur. 26 [aafp.org]
[Testicular torsion in children: Factors influencing delayed treatment and orchiectomy rate]. Arch Pediatr. 2013 Apr. 20(4):364-8. [Medline]. Rakha E, Puls F, Saidul I, Furness P. [emedicine.medscape.com]
In most cases, testicular cancer can be cured if the person seeks medical treatment early. Surgical removal of the affected testicle (orchidectomy) is usually the first treatment for all testicular cancer. [betterhealth.vic.gov.au]
Prognosis
Torsion of testicular appendices is the leading cause of acute scrotum in children. [2, 3, 5, 6] Prognosis The prognosis is excellent. Long-term sequelae to this condition do not exist. Virtually all patients have uneventful recoveries. [emedicine.medscape.com]
Prognosis This will depend on the duration of torsion and the viability of the testis after detorsion has been performed. Some authors report decreased fertility when a testis is left in situ following a unilateral torsion. [pedclerk.bsd.uchicago.edu]
More than 50% of testicular ruptures occur from a direct blow to the groin during sporting activity. 4 Testicular injuries are surgical emergencies with good prognosis if treated within 72 hours. [appliedradiology.com]
Subfertility is found in 36-39% of patients after torsion. [ 4 ] Prognosis The extent and duration of torsion have a major influence on both the immediate salvage rate and late testicular atrophy. [patient.info]
Prognosis and Patient Counseling. There can be psychological issues which occur with losing a testicle. Not only is there the cosmetic deformity but also the concerns of infertility. Saline implant prosthetic device may be helpful. VI. [clinicaladvisor.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
The 3 most common etiologies of acute scrotal pain in the pediatric age group are epididymitis, torsion of the appendix testis, and testicular torsion. [scholars.northwestern.edu]
Torsion of the appendix testis is a common cause of acute scrotal pain in children. [ Boettcher, 2013 ; Sakellaris, 2008 ] Etiology of torsion is unknown. Usually occurs in boys 7-14 years of age. More common than epididymitis in children. [pedemmorsels.com]
A urinalysis is sometimes obtained to access for pyuria or bacturia which would suggest an infectious etiology. [clinicaladvisor.com]
Viral etiologies most common, but can also be bacterial (brucellosis). Incarcerated inguinal hernia – Pain with a scrotal mass. Bowel sounds may be present. HSP – acute or insidious onset of pain. Look for other signs of HSP. [pedclerk.bsd.uchicago.edu]
Epidemiology
Epidemiology Most common in boys under age 3-5 years up to age 12 years old III. Differential Diagnosis IV. [fpnotebook.com]
Epidemiology Frequency United States Torsion of testicular appendices is one of the most common causes of acute scrotum; it is the leading cause of acute scrotum in children. [emedicine.medscape.com]
Epidemiology Testicular torsion is a common urological emergency among adolescent boys and young men. The condition typically occurs in neonates or post-pubertal boys but can occur in males of all ages. [patient.info]
Abstract Objective To evaluate the epidemiologic, diagnostic and therapeutic features of testicular torsion in adults aged 15 years and older. [bacandrology.biomedcentral.com]
Definition and epidemiology Testicular torsion is ischaemia of the testicle due to rotation along the longitudinal axis of the spermatic cord. [racgp.org.au]
Pathophysiology
Testicular torsion must be diagnosed quickly and accurately, because delay of the diagnosis and subsequent delay of surgery, if needed, can lead to loss of testicular viability and orchidectomy. [1] Pathophysiology The vestigial tissues forming the appendices [emedicine.medscape.com]
Pathophysiology During development, the testicle becomes invested by the tunica vaginalis, to which it is fixed inferiorly by the gubernaculum testis. [pedclerk.bsd.uchicago.edu]
Pathophysiology The vestigial tissues forming the appendices are commonly pedunculated and are structurally predisposed to torsion. Torsion of an appendage leads to ischemia and infarction. [elearning.sumdu.edu.ua]
Prevention
Prevention of bacterial endocarditis. [books.google.de]
This is to help prevent severe problems. During surgery, the health care provider will be able to see if the condition is testicular appendage torsion. [saintlukeshealthsystem.org]
Torsion of the other testicle can't be prevented by changes in activity or by taking medicine. Only sewing stitches around the testicle will prevent future torsion. [practo.com]
Later, gross swelling prevents this finding. The testes on both sides are characteristically in the 'bell-clapper position' with a horizontal long axis. [patient.info]