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Testicular Torsion

Introduction

Occasionally lower abdominal pain may be due to a testicular torsion. This is a congenital abnormality where the connective tissue support of the testicle is slightly unstable.  The testicle twists itself around. This condition can occur in infants and young children and it may be difficult to diagnose.

The anatomy of a normal spermatic cord is such that it contains the duct that transports sperm from the testicles, called “vas deferens” and the blood vessel bundle that supplies the structures with blood. When the spermatic cord is twisted as shown in this image here the vas deferens and affected testicle are swollen and very painful.

Symptoms

The patient experiences severe pain in the affected testicle, which can irradiate through nerve connections into the lower abdomen on the same side. There can be nausea and vomiting and there is usually local swelling of the scrotum overlying the testicle with torsion. Young children and infants may present only with a high fever. The physician can miss this condition, if he/she does not examine and palpate the  genitals also.

Treatment

Treatment consists of a quick surgical exploration with testicle surgery where the testicle is repositioned and fixated to prevent a reoccurrence. Often the other side has to also be fixed at the same time to prevent testicular torsion on the other side in the near future.

 Testicular Torsion (Normal Anatomy, Compare With Above Link)

Testicular Torsion (Normal Anatomy, Compare With Above Link)

References

1. DM Thompson: The 46th Annual St. Paul’s Hospital CME Conference for Primary Physicians, Nov. 14-17, 2000, Vancouver/B.C./Canada

2. C Ritenbaugh Curr Oncol Rep 2000 May 2(3): 225-233.

3. PA Totten et al. J Infect Dis 2001 Jan 183(2): 269-276.

4. M Ohkawa et al. Br J Urol 1993 Dec 72(6):918-921.

5. Textbook of Primary Care Medicine, 3rd ed., Copyright © 2001 Mosby, Inc., pages 976-983: “Chapter 107 – Acute Abdomen and Common Surgical Abdominal Problems”.

6. Marx: Rosen’s Emergency Medicine: Concepts and Clinical Practice, 5th ed., Copyright © 2002 Mosby, Inc. , p. 185:”Abdominal pain”.

7. Feldman: Sleisenger & Fordtran’s Gastrointestinal and Liver Disease, 7th ed., Copyright © 2002 Elsevier, p. 71: “Chapter 4 – Abdominal Pain, Including the Acute Abdomen”.

8. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008

Last modified: August 29, 2018

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.