Testicular torsion

Case contributed by Dr. Abdalla Al-Khashmani

Presentation

Sudden onset of right sided severe scrotal pain.

Patient Data

Age: 25
Gender: Male
Ultrasound

Selected sonographic images of both testes

The right testis appears slightly swollen, with diffuse coarsened echotexture and no detectable parenchymal flow on Doppler examination. Findings are highly suggestive of testicular torsion.

The right epididymus appears enlarged/swollen and heterogeneous in echotexture.

There is also associated mild right sided hydrocele as well.

The left testis appears unremarkable with normal parenchymal color flow pattern.

Normal left epididymis.

Case Discussion

This patient came with severe right scrotal pain. Ultrasound was requested to rule out torsion versus epididymo-orchitis. On sonographic examination, neither the color Doppler nor the power Doppler ultrasound picked up any flow within the right testicle, whereas the left one showed normal vascularization.

Surgical team was immediately informed of the findings. The diagnosis was intraoperatively confirmed, and detorsion with fixation was done within 3-4 hours after the initial scan. 

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Case information

rID: 34248
Published: 11th Feb 2015
Last edited: 20th Mar 2018
System: Urogenital
Inclusion in quiz mode: Excluded

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