Presentation
4-hour duration of left testicular pain, associated with left testicular swelling and dysuria.
Patient Data
A spiral twist is demonstrated in the course of the left spermatic cord giving the appearance of a whirlpool sign, better demonstrated on the color Doppler scan.
The left testicle appears normal in size, shape, and position with normal parenchymal vascularity.
The resistive index (RI) of the left intratesticular arteries was normal measuring about 0.6
Heterogeneously enlarged hyperemic left epididymis.
Minimal right and moderate left-sided hydrocele.
The right testicle and epididymis appear unremarkable.
Case Discussion
The patient underwent surgical exploration of the left testicle which showed that the left spermatic cord was twisted with a viable testicle.
Testicular torsion is a medical emergency where the spermatic cord twists, cutting off blood supply to the testicle, and causing severe pain and swelling.
Testicular torsion can initially present with a normal testicular flow on Doppler ultrasound, especially if the torsion is intermittent or partial.
The whirlpool sign indicates testicular torsion and necessitates immediate medical intervention to prevent testicular damage.
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