Dirk Schaper, V. Hofmann (Halle/S.)  

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12 Years  

Male  

Pelvis-Testis  

physical  

12 year-old boy with stabbing pains in the left hemiscrotum. No vomiting, no swelling, no redness. Slight pain on pressure of the testicles. The testicles and epididymis were able to be palpated well. Maximum point of pain was at the testicular-epididymal border.  

Torsion of an embryonic rest of the testes or epididymis.  

<- view Ultrasound 1

Ultrasound 1: Depiction of the testicals in relation to each side. Echogenic structure on the left testicular-epididymal border, no stimulation effusion.




<- view Ultrasound 2

Ultrasound 2: Color doppler depiction of vascularisation of the testicular capsule. The echogenic structure shows no flow signal.




<- view OP-Situs 1

OP-Situs 1: Large testicular pedicle-turned Morgani hydatide with beginning infarction.

 

Surgery / Histo  

N/A  

Primary rejection of a testicular torsion through ultrasound. Surveillance of the course of illness. If symptoms persist, surgical removal.  

Because of high-resolution sonography, it has become possible to more critically state the indication for surgical repair of an acute scrotum. Hydatide torsions can be nicely shown even if the secondary changes such as swelling, pain and scrotal redness would initially lead the examiner to the diagnosis of testicular torsion. With the help of doppler sonography, it is possible to measure flow-spectra and to support the diagnosis. Therefore, one can avoid unnecessary surgical exploration in children.  

N/A  

1. Medline:
McAndrew, H.F., Pemberton, R., Kikiros, C.S., Gollow, I.
The incidence and invastigation of acute scrotal problems in children
Pediatr Surg Int 2002 Sep;18(5-6):435-7

2. Medline:
Munden, M.M., Trautwein, L.M.
Scotal pathology in pediatrics with sonographic imaging
Curr Probl Diag Radiol 2000 Nov-Dec;29(6):185-205 Review  

Hydatide torsion, acute scrotum, testicular pain, child, childhood, pediatric radiology  

Dirk Schaper, V Hofmann. Hydatid torsion. PedRad [serial online] vol 3, no. 4.
URL: www.PedRad.info/?search=20030417103834