Advertisement
Advertisement
Table of Contents
Definition / general | Treatment | Microscopic (histologic) images | Microscopic (histologic) description | Differential diagnosisCite this page: Torsion. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/testistorsion.html. Accessed July 15th, 2017.
Definition / general
- May cause testicular infarct if not treated quickly
- Usually occurs in first year of life, also towards puberty due to trauma or violent movement
- Associated with incomplete testicular descent, absent scrotal ligaments, absent gubernaculum testis or testicular atrophy causing testis to be abnormally mobile
- In 2/3 of cases, occurs in intravaginal portion of spermatic cord (i.e. within tunica vaginalis); extravaginal torsion associated with infancy
- Thick walled arteries remain patent, so get vascular engorgement and venous infarction (enlarged and painful testis)
- Torsion must last at least 6 - 24 hours to cause an infarct
- Torsion without an infarct causes infertility proportionate to duration of torsion
Treatment
- Untwist and fix testis to dartos muscle or orchiectomy
- Note: opposite testis should be fixed to dartos muscle as preventive measure
Microscopic (histologic) images
Images hosted on other servers:
Testicular torsion and infarction
Microscopic (histologic) description
- Up to 6 hours - venous congestion and interstitial hemorrhage
- Later neutrophils in capillaries; at 4 days see hemorrhagic infarction and coagulative necrosis
- Later granulation tissue; years later may see fibrosis and calcification
Differential diagnosis
- Testicular pain due to Henoch–Schönlein purpura (small vessel vasculitis)
- Torsion of testicular appendage: 90% of time involves appendix testis (dramatic pain out of proportion to minute size of appendage) 10% of time involves epididymis
Advertisement
