Undescended Testis Torsion. Clinical Observations

Abstract

Objective. Demonstration of the possibilities of ultrasound diagnosis of Undescended testis torsion (UTT) in children.Materials and Methods. The publication presents clinical observations of UTT in small children, illustrated with echographic scans and intraoperative images.Results. UTT is a rare urgent urological disease, accounting, according to our own data, for only 2,8% of all cases of postnatal testicular torsion. Acute ischemia is extremely dangerous for the testicle, but the clinical symptoms of the pathology are nonspecific, and surgical care may be delayed. This determines the probability of an unfavorable outcome of the disease (necrosis, testicular sclerosis), which determines not only the medical, but also the social significance of the problem. At present the only fast method of radiological imaging for UTT is ultrasonography, according to the results of which an urgent revision of the testicle is performed. At the same time, the echographic image of UTT is difficult to interpret due to the predominance of young patients, when severe soft tissue edema, structural changes in the twisted gonad and behavioral characteristics of the patient sharply complicate the examination.Conclusion. The clinical presentation of UTT in the form of painful swelling in the inguinal region requires an emergency differential diagnosis. Clinically and echographically UTT is similar to the manifestations of a pinched inguinal hernia and destructive lymphadenitis of the inguinal region, which in some cases requires an expansion of the examination area: it is necessary to scan the abdominal cavity to assess the presence/absence of echographic symptoms of intestinal obstruction.