Testicular torsion
Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- testicular pain
- intermittent pain
- no pain relief upon elevation of scrotum
- scrotal swelling or edema
- scrotal erythema
- reactive hydrocele
- high-riding testicle
- horizontal lie
- absent cremasteric reflex
Outros fatores diagnósticos
- nausea and vomiting
- abdominal pain
- fever
Fatores de risco
- age <25 years
- neonate
- bell clapper deformity
- trauma/exercise
- intermittent testicular pain
- undescended testicle
- cold weather
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Testicular Workup for Ischemia and Suspected Torsion (TWIST) score
- ultrasound with Doppler flow imaging
Investigações a serem consideradas
- urinalysis
- scintigraphy
Algoritmo de tratamento
non-neonate
neonate
Colaboradores
Autores
Hemanshoo Thakkar, MBBS, BSc, FRCS (Paed)
Consultant Paediatric Surgeon
Evelina London Children’s Hospital
Guy's and St Thomas' NHS Foundation Trust
London
UK
利益声明
HT declares that he has no conflicting interests.
鸣谢
Dr Hemanshoo Thakkar would like to gratefully acknowledge Dr Richard Lee, Dr Caroline Kang, and Dr Jessica Marinaro, Dr George Kaplan, Dr Deborah Dean, and Dr Paul Hamilton, the previous contributors to this topic.
利益声明
RL has received funding from the Bill and Melinda Gates Foundation. CK, JM, GK, DD, and PH declared that they had no competing interests.
同行评议者
Eugene Minevich, MD, FAAP, FACS
Associate Professor
Division of Pediatric Urology
Cincinnati Children's Hospital Medical Center
Cincinnati
OH
利益声明
EM declares that he has no competing interests.
Simon E. Kenny, BSc, ChB (Hons), MD, FRCS (Paed), FAAP
Consultant Pediatric Surgeon/Urologist
Alder Hey Children's NHS Foundation Trust
Liverpool
UK
利益声明
SEK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
National Confidential Enquiry into Patient Outcome and Death. Testicular torsion. Feb 2024 [internet publication].全文
Royal College of Surgeons of England. Commissioning guide topics: management of paediatric torsion. Oct 2016 [internet publication].全文
European Association of Urology. Paediatric urology. Apr 2024 [internet publication].全文
Expert Panel on Urological Imaging, Gerena M, Allen BC, et al. ACR appropriateness criteria® acute onset of scrotal pain-without trauma, without antecedent mass: 2024 update. J Am Coll Radiol. 2024 Nov;21(11s):S364-71.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Diagnósticos diferenciais
- Testicular appendix torsion
- Epididymitis or epididymo-orchitis
- Hydrocele
更多 鉴别诊断Diretrizes
- Appropriateness criteria: acute onset of scrotal pain - without trauma, without antecedent mass
- Paediatric urology
更多 DiretrizesFolhetos informativos para os pacientes
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