Testicular torsion

Case contributed by Bruno Di Muzio
Diagnosis certain


Left testis acute pain for about 3 hours.

Patient Data

Age: 20 years
Gender: Male

US Testes


Testes are normal in size and echotexture, without focal lesion. Normal color Doppler flows pattern seen with the right testis. No vascular flow in the left testis.

Epididymides: the right one is normal in size and echotexture, without focal lesion. On the left, it appears to be retracted and twisted forming a heterogeneous avascular mass, which measures approximately 37 x 17 x 21 mm (volume ~7.2 mL).

Small hydrocele on the left with fine floating echoes.

Conclusion: Features are consistent with left testis complete torsion.

Case Discussion

This case illustrates an acute testicular torsion characterized on ultrasound by a twisted spermatic cord and epididymis with complete flow absence in the left testis.

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