Whirlpool sign (testicular torsion)

Case contributed by Dr Maulik S Patel

Presentation

Left hemiscrotal pain and swelling for the last 5 days. No fever/ trauma.

Patient Data

Age: 45 years
Gender: Male
Ultrasound

1st loop shows a unidirectional sweep from cranial to caudal. 2nd loop shows to and fro sweeping. The loops show the twisting of the spermatic cord.

Static images show hypoechoic left testis as well as epididymis without internal vascularity along with mild hydrocele of tunica vaginalis. There is twisted left spermatic cord.

The right testis and epididymis show normal echopattern and vascularity.

Case Discussion

The case shows testicular torsion and infarction. The primary sign of the torsion is a twisted spermatic cord (whirlpool sign) which is demonstrated here in the loop as well as in static images. The secondary signs of the torsion are seen in the testis which becomes hypoechoic, avascular as seen in this case.

Surgery revealed 360 degrees twist of the spermatic cord and testicular infarction. Orchiectomy was done.

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