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[A young man with a painful scrotum]
Linda J de Vries1, H Vos1, Tommy G W Speel2
1Medisch Centrum Leeuwarden, afd. Spoedeisende Hulp, Leeuwarden.
Nederlands Tijdschrift Voor Geneeskunde
|October 4, 2019
Summary
Delayed diagnosis of testicular torsion can lead to loss of the testis. This case highlights the importance of re-evaluating scrotal pain to preserve fertility.
Area of Science:
- Urology
- Emergency Medicine
- Pediatric Surgery
Background:
- Testicular torsion is a surgical emergency requiring prompt diagnosis and treatment.
- Epididymitis can present with similar symptoms, potentially delaying torsion diagnosis.
Observation:
- A 16-year-old male presented with right hemiscrotal pain and swelling, initially diagnosed as epididymitis.
- Symptoms persisted and worsened, leading to a delayed diagnosis of testicular torsion.
- Color Doppler ultrasonography confirmed testicular torsion, approximately two days old at presentation.
Findings:
- The patient underwent surgery for testicular torsion, but the testis was non-viable.
- An orchidectomy was performed due to the irreversible ischemia.
- The initial misdiagnosis of epididymitis contributed to the delay in definitive treatment.
Implications:
- Persistent or worsening scrotal pain warrants re-evaluation to rule out testicular torsion.
- Early recognition and intervention for testicular torsion are crucial for testicular salvage and fertility preservation.
- Clinicians must maintain a high index of suspicion for torsion, even with initial epididymitis diagnosis.
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