Jul 10, 2008

Torsion of the testis

Introduction: Rotation of the testis on the spermatic cord causing interference with the blood supply is called torsion of the testis. It is an acute surgical emergency. If not operated within 6 hours, there can be irreversible damage to the testis.

Clinical presentation:
1. Painful swelling of the scrotum with redness
2. Onset is sudden
3. Lower abdominal pain
4. reflex vomiting

1. Clinically scrotum is red, tender
2. Doppler of testis reveal decreased blood supply in the affected testis

Treatment: Emergency surgery with derotation of testis and orchiopexy. At the same time other testis is also fixed (orchiopexy) as chances of torsion is high in contra lateral testis.

Differential diagnosis:
1. Epididymo-orchitis
2. Idiopathic scrotal edema