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2017 ; 9
(ä): 169-174
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Distinguishing testicular torsion from torsion of the appendix testis by clinical
features and signs in patients with acute scrotum
#MMPMID28920055
Fujita N
; Tambo M
; Okegawa T
; Higashihara E
; Nutahara K
Res Rep Urol
2017[]; 9
(ä): 169-174
PMID28920055
show ga
PURPOSE: Many physicians encounter confusion and difficulty in distinguishing
testicular torsion (TT) from torsion of the appendix testis (TAT) in patients
with acute scrotum because of the overlapping signs and symptoms. The objective
of our study was to evaluate the clinical features and signs that can help
distinguish TT from TAT. PATIENTS AND METHODS: We performed a retrospective study
of patients with surgically confirmed TT and TAT at our institute from January
1990 to December 2013. Clinical findings, physical examination findings, climatic
conditions, laboratory data, and color Doppler ultrasound (CDUS) findings were
compared between the TT and TAT groups. RESULTS: Seventy patients were included
in this study (49 with TT and 21 with TAT). Patients with TT were significantly
older than those with TAT (p < 0.001). The ambient temperature at onset was
significantly lower in patients with TT than in patients with TAT (p = 0.038).
Testicular swelling, high-riding testes, onset during sleep, high leukocyte
counts, and high creatine phosphokinase levels were significantly more common in
patients with TT than with TAT (p = 0.021, 0.032, 0.006, 0.003, and 0.043,
respectively). Multivariate analysis showed that age and onset during sleep were
significant independent factors for detection of TT. Eight patients (16.3%)
underwent preoperative CDUS evaluation, and an absent or decreased blood signal
in the involved testes was significantly correlated with the presence of TT (p =
0.018). CONCLUSION: In clinical features, age and onset during sleep might be
helpful to distinguish TT from TAT. When supported by findings, urgent surgical
exploration is warranted in patients with suspected TT based on symptoms and CDUS
features.