Testicular torsion

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Acute onset of severe right testicular pain of five hours duration with no fever.

Patient Data

Age: 14 years
Gender: Male
ultrasound

The ultrasound exam demonstrates:

  • increase in the size of the right testis and epididymis
  • homogeneous hypoechoic echotexture of the right testis with no blood flow on color Doppler on both testis and epididymis
  • twisting of the spermatic cord with the whirlpool sign well-demonstrated on the video
  • reactive hydrocele
  • reactive thickening of the scrotal skin

Normal appearance of the left testis and epididymis.

Case Discussion

Ultrasound features most consistent with a testicular torsion that was confirmed at surgery.

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