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Epididymoorchitis
Joseph Junewick, MD FACR
over 8 years ago
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Prenatal Testicular Torsion

Case Detail

Anatomy: Genitourinary
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

Newborn with discolored left hemiscrotum and firm ipsilateral testicle.


Case Images


Diagnosis

Prenatal Testicular Torsion

Findings

US – Heterogeneous acoustical architecture of left testicle with rim calcification. No left testicular flow on color Doppler. The right testicle demonstrates normal echogenicity and color Doppler flow.

Discussion

Testicular torsion in the newborn period may be acute or chronic. Chronic torsion usually presents as a painless, firm scrotal mass often associated with bluish-red discoloration of the scrotum; acute torsion is associated with significant discomfort and scrotal swelling.

Neonatal torsion is usually extravaginal where both the tunica and the contents of the tunica rotate. This is related to loose attachment of the tunica to the scrotal wall at this stage of development. Vigorous cremasteric reflex during birth may contribute to acute torsion. Prenatal torsion is thought to occur during its retroperitoneal descent into the scrotum and is one of the main causes of monorchidism.

The incidence of testicular torsion in the newborn is 6.1 per 100,000 live births. Salvage rate of acute neonatal torsion is extremely low; prenatal torsion invariably results in testicular loss.

Reference

Traubici J, et al. Testicular Torsion in Neonates and Infants: Sonographic Features in 30 Patients. AJR 2003; 180:1143-1145.



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