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Testicular Torsion (smartypance.com)
Terms in this set (10)
What is testicular torsion?
Torsion (twist) of the spermatic cord, resulting in venous outflow obstruction, and subsequent arterial occlusion and infarction of the testicle
What is the classic history?
Acute onset of scrotal pain usually after vigorous activity or minor trauma
What is a "bell clapper" deformity?
Bilateral nonattachment of the testicles by the gubernaculum to the scrotum (free like the clappers of a bell)
What are the symptoms?
Pain in the scrotum, suprapubic pain
What are the signs?
Very tender, swollen, elevated testicle; non illumination; absence of cremasteric reflex
What is the differential diagnosis?
Testicular trauma, inguinal hernia, epididymitis, appendage torsion
How is the diagnosis made?
Surgical exploration, U/S (solid mass) and Doppler flow study, cold Tc-99m scan (nuclear study)
What is the treatment?
Surgical detorsion and bilateral orchiopexy to the scrotum
How much time is available from the onset of symptoms to detorse the testicle?
< 6 hours will bring about the best results; > 90% salvage rate
What are the chances of testicle salvage after 24 hours?
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