Lecture notes for medical students

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2. Definition

3. Definition
• Twisting of testis jeopardizing its
blood supply.

4. Etiology

5. Etiology
• Abnormal high attachment of cord to testis.

6. Clinical Features

7. Clinical Features
• Between 10 and 25 years of age although a
few cases occur in infancy.
• sudden agonising pain in the groin and the
lower abdomen.
• Nausea, vomiting.
• Testis is high
• Cord is tender and twisted .

8. Investigations
–

9. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies Doppler
• Tissue diagnosis
– Cytology
•FNAC contraindicated
–

10. Differential Diagnosis
•

11. Differential Diagnosis
• Epididymoorchitis.
– Elevation of the testis reduces the pain in
epididymo-orchitis but makes it worse in
torsion
• Mumps orchitis the cord is not particularly
thickened.
• Strangulated inguinal hernia
• Idiopathic scrotal oedema

12. Management

13. Management
• ?Gentle manipulation.
• Early operative fixation
– fixation with non-absorbable
– sutures between the tunica vaginalis and the
tunica albuginea.
– The other testis should also be fixed
• Orchiectomy if infarction has occurred.

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