Emergency - Testicular torsion

From CambridgeNotes

10-30y, more in undescended testes

ABC

History and Examination

Differential Diagnosis

  • Epididymo-orchitis – longer history, symptoms of urinary tract infection, discharge (urethritis), swollen epididymis separate from testis
  • Trauma, tumour, acute hydrocoele
  • Torsion of hydatid of Morgani – less pain, blue dot

Investigations

  • Midstream urine sample: dipstix, microscopy, culture and sensitvity (if infection likely)
  • Routine bloods (for surgery)
  • Doppler ultrasound

Definitive Treatment

  • Surgical exploration if any doubt
    • Untwist testis and bilateral orchidopexy
    • Consent for possible orchidectomy (if infarcted)

Complications

  • Infarction within hours
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