Testicular torsion occurs when the spermatic cord twists, leading to impaired blood circulation in the testicle, which can cause testicular ischemia or necrosis.

bubble_chart Clinical Manifestations

1. Sudden onset of severe testicular pain, persistent, radiating to the ipsilateral lower abdomen and groin area, accompanied by nausea and vomiting.
2. Physical examination reveals an elevated and swollen affected testicle with significant tenderness, redness and swelling of the scrotal skin. Elevating the testicle does not alleviate the pain but instead worsens it.
3. The relative positions of the testis and epididymis change, with the epididymis shifting to the front of the testis.

bubble_chart Auxiliary Examination

Testicular torsion is an emergency, and the purpose of examination is to promptly diagnose and rule out acute epididymo-orchitis. Therefore, diagnosis primarily relies on medical history and the doctor's experience, and one should not overlook the history and physical examination while relying solely on auxiliary tests. Option "B" can aid in diagnosis, but it requires specialized instruments and equipment and may be performed when diagnosis is difficult. However, if a definitive diagnosis cannot be made, surgical exploration is preferable for safety.

bubble_chart Diagnosis

1. Symptoms and signs: Sudden onset of severe testicular pain, which may radiate to the ipsilateral lower abdomen and groin. Often accompanied by nausea and vomiting. Examination may reveal testicular swelling and upward displacement, marked tenderness, and redness, swelling, and warmth of the scrotal skin. After 2-3 days of onset, the pain gradually subsides, but the swelling does not resolve, and fluid may accumulate in the tunica vaginalis cavity.
2. 99mTc testicular scan: Can show reduced blood perfusion on the torsed side, aiding in diagnosis.
3. Comparison of blood flow patterns between both testes or Doppler ultrasound auscultation may reveal reduced blood flow on the affected side.

bubble_chart Treatment Measures

Early diagnosis and treatment can prevent testicular necrosis. Therefore, when testicular torsion is suspected, surgical exploration should be performed promptly to reposition the twisted testicle. If blood circulation is restored after repositioning, the testicle should be fixed to the scrotal wall, and the contralateral testicle should also be fixed, along with performing a tunica vaginalis inversion. If blood supply remains poor after repositioning and necrosis has occurred, the testicle should be removed.

The use of antibiotics is to combat or prevent infection. Due to testicular torsion, patients experience severe pain and reduced resistance, making prophylactic antibiotics necessary. If the testicle has already necrosed, antibiotics are even more essential. Additionally, supportive therapy is crucial to enhance the body's resistance.

bubble_chart Cure Criteria

1. Cure: Testicular repositioning, pain relief, wound healing; if the testicle has necrosed, symptoms disappear and the wound heals after testicular removal.
2. Improvement: Symptoms not completely resolved, poor wound healing.