5. Torsion Testis Flashcards
(53 cards)
Torsion Testis
- Alternative name
- Etiology
- PATHOLOGY
- CLINICAL PICTURE
- Differential Diagnosis
- INVESTIGATIONS
- Treatment
Alternative name for Torsion Testis
- Torsion of the spermatic cord
* Winter syndrome
Etiology of Torsion Testis
- PREDISPOSING FACTORS
* PRECIPITATING FACTORS
PREDISPOSING FACTORS in Etiology of Torsion Testis
- Arrested and ectopic testis
- Inversion of the testis
- Long mesorchium
- High investment of the tunica vaginalis
Pathogenesis of Arrested and ectopic testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
The testis is improperly fixed.
Inversion of the testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
- Superior inversion
- Anterior inversion
- Lateral inversion
- Loop inversion
Pathogenesis of Superior inversion in Inversion of the testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
The longitudinal axis of the testis is directed forwards so that the epididymis lies horizontally.
Pathogenesis of Anterior inversion in Inversion of the testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
Epididymis lies anteriorly, the body of the testis & the tunica vaginalis posteriorly.
Pathogenesis of Lateral inversion in Inversion of the testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
Epididymis lies laterally
Pathogenesis of Loop inversion in Inversion of the testis in PREDISPOSING FACTORS in Etiology of Torsion Testis
Epididymis encircles the testis like a sling
Long mesorchium in PREDISPOSING FACTORS in Etiology of Torsion Testis
The body of the testis is separated from the epididymis by a long mesorchium.
High investment of the tunica vaginalis in PREDISPOSING FACTORS in Etiology of Torsion Testis
- Normal anatomy
* Pathogenesis
Normal anatomy in High investment of the tunica vaginalis in PREDISPOSING FACTORS in Etiology of Torsion Testis
In most males, the testis is attached posteriorly
to the inner lining of the scrotum.
Pathogenesis of High investment of the tunica vaginalis in PREDISPOSING FACTORS in Etiology of Torsion Testis
- In this anomaly, the testis is free floating in
the tunica vaginalis, only attached to the
spermatic cord, like a bell clapper. - Causes the testis to hang within the tunica like a clapper in a bell.
PRECIPITATING FACTORS in Etiology of Torsion Testis
Factors causing Contraction of cremasteric muscles
- Sudden straining.
- lifting a heavy object.
- Trauma.
- Sudden exposure to cold weather
The reason why Torsion testis is sometimes called “winter syndrome”
- This is because it often happens in winter, when it is cold outside.
- The scrotum of a man who has been lying in a warm
bed is relaxed. The sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion.
PATHOLOGY of Torsion Testis
1) Testis
2) Spermatic cord
3) Skin of the scrotum
Pathology of testis in PATHOLOGY of Torsion Testis
- Direction of Torsion
* Morphology of Torsion testis
Direction of Torsion in Pathology of testis in PATHOLOGY of Torsion Testis
- Usually the testis twists in a direction away from the septum dartos
- i.e. clockwise on the right & anti-clockwise on the left,
- owing to the direction of the spirally attached cremasteric muscle.
Morphology of Torsion testis in Pathology of testis in PATHOLOGY of Torsion Testis
It becomes edematous, congested and finally gangrenous
Pathology of Spermatic cord in PATHOLOGY of Torsion Testis
Thrombosis of the vessels will occur if torsion is not reduced
Pathology of Skin of the scrotum in PATHOLOGY of Torsion Testis
Becomes red & edematous.
CLINICAL PICTURE of Torsion Testis
- Symptoms
* Examination
Symptoms in CLINICAL PICTURE of Torsion Testis
- Sudden severe agonizing pain in the groin and lower abdomen
- Vomiting (once or twice, not persistent).
- Abdominal distension
