Document Detail


Sonographic diagnosis of acute spermatic cord torsion. Rotation of the cord: a key to the diagnosis.
MedLine Citation:
PMID:  12107581     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although the primary abnormality in testicular torsion is at the spermatic cord, imaging studies up to now have mostly been oriented to evaluation of the testicle itself, with emphasis on color Doppler ultrasonography (US). However, findings can be inaccurate when there is incomplete interruption of testicular flow. Indirect findings, such as morphological changes in the testis alone, are not reliable for the diagnosis since they become evident late in the disease. OBJECTIVE: To call to attention to the fact that sonographic visualization of the spermatic cord can be the key for diagnosis in those patients with acute scrotal pain as a result of testicular torsion, particularly when color Doppler US shows that intratesticular flow is present within the affected testis. PATIENTS AND METHODS: Six patients who presented clinically with acute scrotal pain and had spermatic cord torsion, proven at surgery. All patients were initially studied with color Doppler US, and intratesticular flow was detected in all of them. Patients who showed structural abnormalities on gray-scale US and/or absence of intratesticular vascular flow in the affected testis were not included. In addition to a conventional study, the spermatic cord was examined. RESULTS: The spermatic cord was shown to be rotated on the symptomatic side in all patients. Local morphological and vascular flow changes, distal and at the site of the torsion, were found and registered. CONCLUSIONS: The finding of a rotated spermatic cord could be a highly reliable and direct sign for the diagnosis of a testicular torsion, and this is especially important when vascular flow is present within the affected testis on color Doppler US examination. Examination of the spermatic cord should be added to evaluation of the testis in patients with suspected testicular torsion to enhance sensitivity of the examination.
Authors:
José D Arce; Marcela Cortés; Juan C Vargas
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2002-04-10
Journal Detail:
Title:  Pediatric radiology     Volume:  32     ISSN:  0301-0449     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-10     Completed Date:  2002-11-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  485-91     Citation Subset:  IM    
Affiliation:
Department of Radiology, Clínica Santa María, Av. Santa María 0410, Santiago, Chile. jarce@csm.cl
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Child
Humans
Male
Pelvic Pain
Rotation
Spermatic Cord / anatomy & histology,  pathology
Spermatic Cord Torsion / diagnosis*,  pathology
Torsion Abnormality
Ultrasonography, Doppler, Color / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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