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Case Reports
. 2023 Jul 22;18(10):3457-3462.
doi: 10.1016/j.radcr.2023.07.008. eCollection 2023 Oct.

Neglected trauma-induced testicular torsion: Clinical, sonographic, and surgical correlation in a 13-year-old adolescent

Manar Ezzahi  1 , Sara El Malih  1 , Zaid Ennasery  1 , Naoufal Boumahdi  2 , Amal Akammar  1 , Nizar El Bouardi  3 , Meriem Haloua  1 , Badreeddine Alami  3 , Moulay Youssef Alaoui Lamrani  3 , Mustapha Maaroufi  3 , Youssef Bouabdallah  2 , Meryem Boubbou  1
Affiliations
Case Reports

Neglected trauma-induced testicular torsion: Clinical, sonographic, and surgical correlation in a 13-year-old adolescent

Manar Ezzahi et al. Radiol Case Rep. .

Abstract

Post-traumatic testicular torsion is a rare condition, accounting for approximately 4%-8% of all reported cases of testicular torsion in the literature. Prompt clinical suspicion and intervention are crucial; as testicular torsion is considered a medical and surgical emergency that may lead to testicular necrosis. Ultrasound imaging plays an important role in assessing the integrity of the traumatized scrotum and facilitating early detection of associated testicular torsion. In this case report, we present a neglected post-traumatic testicular torsion in a 13-year-old child that led to orchiectomy.

Keywords: Necrotic; Orchidectomy; Testicular; Torsion; Traumatic.

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Figures

Fig 1
Fig. 1
Clinical picture on patient admission: bursa increased in volume and erythematous.
Fig 2
Fig. 2
Study of the testicles in mode B: ascended left testicle, which is heterogeneous and hypoechoic with visualization of very hypoechoic areas within it. We also note a swollen and heterogeneous appearance of the head of left epididymis, as well as a left low abundance hematocele.
Fig 3
Fig. 3
Comparative color Doppler study of the testicles: demonstrates the absence of vascularization of the left testicle. We also note the hyperhemia and thickening of scrotal wall.
Fig 4
Fig. 4
Color Doppler study of the left testicle, objectifying the absence of vascularization of the testicle.
Fig 5
Fig. 5
Study of the left spermatic cord in Doppler mode: presence of torsion with an image of a “Whirlpool sign” turn.
Fig 6
Fig. 6
Hyperechoic thickening of the scrotal envelopes compatible with scrotal wall hematoma.
Fig 7
Fig. 7
Surgical exploration: twisting of the left spermatic cord and rotation of left testicle with a necrotic blackish left testicle.
See this image and copyright information in PMC

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