Testicular torsion

Summary of Testicular torsion
Testicular torsion occurs when the spermatic cord twists, cutting off the testicle's blood supply, leading to ischemia. The principal symptom is rapid onset of testicular pain. The most common underlying cause in adolescents and neonates is a congenital malformation known as a "bell-clapper deformity" wherein the testis is inadequately affixed to the scrotum allowing it to move freely on its axis and susceptible to induced twisting of the cord and its vessels. Testicular malignancy is the most common etiology in adults. Diagnosis is clinical, with surgical detorsion urgently performed to prevent necrosis of the testicle and possible subfertility.

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Pathology

Reproductive system

Male and female reproductive system disorders
Male reproductive system disorders
Female reproductive system disorders
Reproductive system pathology review

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Testicular torsion

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Testicular torsion

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The deformity is the most common underlying etiology of testicular torsion in adolescents.

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A 10-year-old boy presents to the emergency department complaining of severe scrotal pain. History reveals that four days prior his left testicle became swollen and mildly painful. He states the pain has progressively worsened and is why his father brought him to the hospital today. He denies sexual activity, fever, nausea and vomiting, or urinary symptoms. He does not recall any traumatic events prior to the onset of his symptoms. Physical examination reveals a small firm, blue mass at the top of his left testicle. Which is the most likely diagnosis in this patient?

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