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Testicular
torsion (Management (Medical (Analgesia
Indication: pain
E.g…
Testicular
torsion
Management
Conservative
Information, advice, support
Medical
Analgesia
Indication: pain
E.g. paracetamol, ibuprofen
Surgical
Fixation
Indication: ?torsion
MOA: exploration and surgical fixation of BOTH
sides to scrotum; may need orcidectomy
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Diagnosis
Examination
Genital exam
Erythematous, oedematous, tender, high lying testis,
blue dot/lump of testicular skin (appendix torsion)
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History
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PC/HPC
Pain (SOCRATES)
Swelling, triggering activity
FH
Testicular disease, cancers
SH
Living arrangements, occupation/school,
leisure activities, smoking, alcohol
Epidemiology
True torsion uncommon,
occurs post pubertal
Appendix torsion more common,
affects pre pubertal
Pathophysiology
Testicle
Spermatic cord twists, cutting off
blood supply to the testicle
Ischemia and necrosis
Appendix (Hydatid of Morgani)
Remenant of Mullerian ducts on upper pole of testis
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