9 min
Testicular Torsion (Deep Dive MW R19) EM Clerkship
-
- Medicine
* Common during the first year of life as well as during puberty
* Presents with nausea/vomiting, abdominal pain, and/or testicular pain
* ALWAYS examine a child for signs of torsion who presents with abdominal pain (especially lower abdominal pain)
* Look for tenderness, firmness, high riding testicle or testicle with unequal lie, swelling, and the absence of a cremasteric reflex
* Consult Urology IMMEDIATELY if you have high suspicion, otherwise proceed to ultrasound
* Ultrasound is only 85% sensitive, so clinical gestalt can trump even a negative US
* Attempt manual detorsion if there will be a significant delay to surgery
* Common during the first year of life as well as during puberty
* Presents with nausea/vomiting, abdominal pain, and/or testicular pain
* ALWAYS examine a child for signs of torsion who presents with abdominal pain (especially lower abdominal pain)
* Look for tenderness, firmness, high riding testicle or testicle with unequal lie, swelling, and the absence of a cremasteric reflex
* Consult Urology IMMEDIATELY if you have high suspicion, otherwise proceed to ultrasound
* Ultrasound is only 85% sensitive, so clinical gestalt can trump even a negative US
* Attempt manual detorsion if there will be a significant delay to surgery
9 min