Bilateral testicular torsion in an adolescent: a case with challenging diagnosis

Vol. 43 (x): 2017 November 11.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0371


CHALLENGING CLINICAL CASES

Lorenzo 1, E. Martínez-Cuenca 1, E. Broseta 1
1 Hospital Universitario y Politécnico La Fe, Valencia, Espanha

ABSTRACT

Bilateral testicular torsion is a very uncommon emergency, with a challenging dif­ferential diagnosis. We describe the case of a 15-year-old patient with a left testicular torsion of 48 hours of duration and a sudden onset of right scrotum pain during his stay at the emergency area. Bilateral testicular torsion was diagnosed after repeat physical examination and doppler ultrasound, which had been normal for right testis in a first evaluation. Surgical exploration was performed with orchiectomy in left testis and fixation in right testis. In previous literature, there are reported bilateral torsion only in four adolescents and five adults. With this case, we demonstrate that bilateral spermatic cord torsion may be easily overlooked in a patient with acute scrotum and we emphasize the importance of bilateral exploration in testicular torsion.

Keywords: Testis; Spermatic Cord Torsion; Adolescent

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