Testis necrosis following repeated misdiagnosis of testicular torsion: a case report and literature review.
- Author:
Ji-Qing ZHANG
1
;
Xiao-Peng HU
;
Xiu-Zhen KONG
;
Ming-Liang HUANG
;
Ju-Min GOU
;
Jia-Hui LIU
;
Xiao-Dong ZHANG
Author Information
- Publication Type:Case Reports
- MeSH: Adult; Diagnostic Errors; Humans; Male; Necrosis; Spermatic Cord Torsion; diagnosis; Testis; pathology
- From: National Journal of Andrology 2009;15(5):445-448
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo improve clinicians' ability of diagnosing testicular torsion.
METHODSWe reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiagnosis and relevant literature.
RESULTSThe patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for non viability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis.
CONCLUSIONTimely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.