Testicular torsion in the pediatric age group: diagnosis and treatment.
Links Testicular torsion in the pediatric age group: diagnosis and treatment. Livne PM, Sivan B, Karmazyn B, Ben-Meir DPediatr Endocrinol Rev. 2003 Dec;1(2):128-33. Links Testicular torsion in the pediatric age group: diagnosis and treatment. Livne PM, Sivan B, Karmazyn B, Ben-Meir D. Institute of Urology, Rabin Medical Center, Pediatric Urology, Tel Aviv University, Tel Aviv, Israel. plivne@clalit.org.il PURPOSE: To review and update several aspects of testicular torsion. INCIDENCE: The relative incidence of testicular torsion, torsion of testicular appendix and epididymo-orchitis is variable and depends on mode of diagnosis and patients' age. AGE: Testicular torsion can occur at any age. The peak is in adolescents below the age of 18 years. SYMPTOMS: Classical symptoms are not always present. Range of duration is varied. Nausea and vomiting are positive predictive value for testicular torsion. PHYSICAL EXAMINATION: Main findings predicting testicular torsion are absence of cremasteric reflex and diffuse tenderness. IMAGING: Color Doppler Ultrasound can assess in equivocal and low clinical suspicious conditions for testicular torsion. NEONATAL TORSION: There are two conditions in this age group; the prenatal that urgent exploration is in controversy and postnatal that urgent surgery is required. LATE OUTCOME: Early salvage rate and late atrophy depends on duration and degree of torsion. MEDICOLEGAL: Testicular torsion is an active area of malpractice litigation. Late presentation and atypical presentations do not affect the medicolegal outcome. PMID: 16437018 [PubMed - indexed for MEDLINE] Related Links Clinical and sonographic criteria of acute scrotum in children: a retrospective study of 172 boys. [Pediatr Radiol. 2005] PMID: 15503003 An analysis of clinical outcomes using color doppler testicular ultrasound for testicular torsion. [Pediatrics. 2000] PMID: 10699116 Clinical predictors for differential diagnosis of acute scrotum. [Eur J Pediatr Surg. 2004] PMID: 15543483 A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages. [Pediatrics. 1998] PMID: 9651416 Spiral twist of the spermatic cord: a reliable sign of testicular torsion. [Pediatr Radiol. 1998] PMID: 9880639 See all Related Articles... Display Summary Brief Abstract AbstractPlus Citation MEDLINE XML UI List LinkOut ASN.1 Related Articles Cited Articles Cited in Books CancerChrom Links Domain Links 3D Domain Links GEO DataSet Links Gene Links Gene (GeneRIF) Links Genome Links Project Links GENSAT Links GEO Profile Links HomoloGene Links Nucleotide Links Nucleotide (RefSeq) Links OMIA Links OMIM (calculated) Links OMIM (cited) Links BioAssay Links Compound Links Compound via MeSH Substance Links Substance via MeSH PMC Links Cited in PMC PopSet Links Probe Links Protein Links Protein (RefSeq) Links SNP Links Structure Links Taxonomy via GenBank UniGene Links UniSTS Links Show 5 10 20 50 100 200 500 Sort by Pub Date First Author Last Author Journal Send to Text File Printer Clipboard E-mail Order .
Institute of Urology, Rabin Medical Center, Pediatric Urology, Tel Aviv University, Tel Aviv, Israel. plivne@clalit.org.il
PURPOSE: To review and update several aspects of testicular torsion. INCIDENCE: The relative incidence of testicular torsion, torsion of testicular appendix and epididymo-orchitis is variable and depends on mode of diagnosis and patients' age. AGE: Testicular torsion can occur at any age. The peak is in adolescents below the age of 18 years. SYMPTOMS: Classical symptoms are not always present. Range of duration is varied. Nausea and vomiting are positive predictive value for testicular torsion. PHYSICAL EXAMINATION: Main findings predicting testicular torsion are absence of cremasteric reflex and diffuse tenderness. IMAGING: Color Doppler Ultrasound can assess in equivocal and low clinical suspicious conditions for testicular torsion. NEONATAL TORSION: There are two conditions in this age group; the prenatal that urgent exploration is in controversy and postnatal that urgent surgery is required. LATE OUTCOME: Early salvage rate and late atrophy depends on duration and degree of torsion. MEDICOLEGAL: Testicular torsion is an active area of malpractice litigation. Late presentation and atypical presentations do not affect the medicolegal outcome.
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