Case 17 years old male presented with acute pain in the Right testicular area, progressively worsening over the last 4 hours. On exam, "bell clapper" deformity is noted. Also, the "blue dot" sign is noted on the scrotal wall.
Diagnosis: Testicular torsion
Bell clapper deformity is a congenital abnormality that makes it more prone to twisting (torsion). The affected testis may be elevated due to shortening of the spermatic cord, or it may lie horizontally, known as bell clapper deformity.
Also, the "blue dot" sign may be noted on the scrotal wall. Although not common, it strongly suggests the torsion.
Testicular torsion is a surgical emergency. Immediate bedside POCUS ultrasound should be performed, and an emergent urological consult should be obtained.
#surgical-critical-care
#urology
References:
1. Nassiri N, Zhu T, Asanad K, Vasquez E. Testicular Torsion From Bell-clapper Deformity. Urology. 2021 Jan;147:275. doi: 10.1016/j.urology.2020.06.045. Epub 2020 Jul 7. PMID: 32650017.
2. Khan F, Muoka O, Watson GM. Bell clapper testis, torsion, and detorsion: a case report. Case Rep Urol. 2011;2011:631970. doi: 10.1155/2011/631970. Epub 2011 Sep 19. PMID: 22606621; PMCID: PMC3350281.
3. Laher A, Ragavan S, Mehta P, Adam A. Testicular Torsion in the Emergency Room: A Review of Detection and Management Strategies. Open Access Emerg Med. 2020 Oct 12;12:237-246. doi: 10.2147/OAEM.S236767. PMID: 33116959; PMCID: PMC7567548.
No comments:
Post a Comment