Testicular torsion - intravaginal

Case contributed by Dr Ian Bickle

Presentation

3 day history of right testicular pain.

Patient Data

Age: 20 years
Gender: Male
Ultrasound

Both testicles contain microlithiasis.  The symptomatic testicle has altered echogenicity of the testicular parenchyma and absence doppler flow.  This is accompanied by a small reactive hydrocele and a thickened epididymis.

During scanning it was essentially impossible to get a true longitudinal view suggesting a mal-aligned axis to the testicle.

Photo

After prompt urological review the patient went to theatre.

Intra-operative images of a torted right testicle with resultant ischaemia/infarction.

Photo

Orchidectomy sample sent for histopathological review.

Case Discussion

The appearance is in keeping with testicular torsion.

Testicular findings

  • altered echogenicity of the testicular parenchyma
  • absence Doppler activity in the testicular parenchyma
  • a malaligned testicular axis

Associated signs:

  • epididymal thickening
  • hydrocele

Thanks to Mr Yusri Yahya, Urologist, RIPAS Hospital, Brunei for the intra-operative images.

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Case information

rID: 21606
Case created: 3rd Feb 2013
Last edited: 25th Mar 2018
System: Urogenital
Inclusion in quiz mode: Included

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