TY - JOUR
T1 - Duplex sonographic findings in children with torsion of the testicular appendages
T2 - Overlap with epididymitis and epididymoorchitis
AU - Karmazyn, Boaz
AU - Steinberg, Ran
AU - Livne, Pinchas
AU - Kornreich, Liora
AU - Grozovski, Sylvia
AU - Schwarz, Michael
AU - Ziv, Nitza
AU - Freud, Enrique
PY - 2006/3
Y1 - 2006/3
N2 - Background and Purpose: Torsion of the testicular appendages (TTA) is the most common cause of acute scrotum in children, and yet there are only few dedicated studies of the imaging findings. Objective: To review our experience with the use of duplex sonography in children with TTA and to evaluate if sonography can successfully distinguish TTA from epididymoorchitis. Methods: We reviewed the medical files and imaging findings of 29 children aged 0.7 to 13.9 years (mean, 6.5 years) with a diagnosis of TTA based on testicular exploration who were evaluated preoperatively with duplex sonography. Results: A tender upper pole nodule, the typical sign of TTA, was palpated in only 2 (6.9%) children. Duplex sonography demonstrated an extratesticular upper pole nodule in 9 (31%) children. Secondary inflammatory changes included hydrocele in 22 (75.9%), enlarged epididymis in 22 (75.9%), scrotal wall edema in 16 (55.2%), and swollen testis in 9 (31%) children. Fourteen (48%) children had inflammatory changes with no evidence of an extratesticular nodule. Conclusion: Duplex sonography findings of secondary inflammatory changes in the absence of evidence of an extratesticular nodule may suggest an erroneous diagnosis of epididymitis or epididymoorchitis in children with TTA.
AB - Background and Purpose: Torsion of the testicular appendages (TTA) is the most common cause of acute scrotum in children, and yet there are only few dedicated studies of the imaging findings. Objective: To review our experience with the use of duplex sonography in children with TTA and to evaluate if sonography can successfully distinguish TTA from epididymoorchitis. Methods: We reviewed the medical files and imaging findings of 29 children aged 0.7 to 13.9 years (mean, 6.5 years) with a diagnosis of TTA based on testicular exploration who were evaluated preoperatively with duplex sonography. Results: A tender upper pole nodule, the typical sign of TTA, was palpated in only 2 (6.9%) children. Duplex sonography demonstrated an extratesticular upper pole nodule in 9 (31%) children. Secondary inflammatory changes included hydrocele in 22 (75.9%), enlarged epididymis in 22 (75.9%), scrotal wall edema in 16 (55.2%), and swollen testis in 9 (31%) children. Fourteen (48%) children had inflammatory changes with no evidence of an extratesticular nodule. Conclusion: Duplex sonography findings of secondary inflammatory changes in the absence of evidence of an extratesticular nodule may suggest an erroneous diagnosis of epididymitis or epididymoorchitis in children with TTA.
KW - Duplex sonography
KW - Epididymitis
KW - Testicular appendages
KW - Torsion
UR - http://www.scopus.com/inward/record.url?scp=33644683633&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2005.11.046
DO - 10.1016/j.jpedsurg.2005.11.046
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C2 - 16516624
AN - SCOPUS:33644683633
SN - 0022-3468
VL - 41
SP - 500
EP - 504
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 3
ER -