If a child with acute scrotal pain and swelling where testicular torsion is highly suspected, how would you proceed:
Ans. (C) Immediate scrotal exploration on both sides(Ref: Bailey & Love's Short Practice of Surgery 27th Ed; Page No-1506)Torsion TestisMost common in adolescent 10-25 years.Sudden onset of pain in the testis.Preceded by vigorous activities just before (Example sexual activity).One important predisposing factor is ''Bell Clapper deformity.Investigation of choice: Color Doppler-detects the decreased blood flow to testis in torsion.In the 1st hour of torsion can be treated by manipulation (but later on surgery has to be done to fix the testis.If not correctable by manipulation or more than one hour has passed then Surgery has to be done. Surgery must be done within 4 hours. Otherwise the testis will be dead.Both the affected and unaffected testis should undergo orchidopexy because the anatomical variation responsible for torsion is likely to be bilateral.Different diagnosis: Epididymo-orchitis
Immediate scrotal exploration only on side of swelling
Immediate scrotal exploration on same side and delayed exploration on other side
Immediate scrotal exploration on both sides
Observation
Testis & Scrotum