Trauma-Induced Testicular Torsion Successfully Salvaged Five Days After Blunt Scrotal Trauma: A Case Report

Abstract

Testicular torsion is an emergency medical condition that requires prompt diagnosis and surgical treatment. However, the correct diagnosis of trauma-induced testicular torsion may often be delayed and the testicular salvage rate is low. We report the case of 14-year-old boy who presented with persistent mild left testicular pain and scrotal swelling five days after blunt scrotal trauma, for which he was brought to the emergency department. Ultrasonography and magnetic resonance imaging suggested swelling of the left spermatic cord with testicular rapture; therefore, surgical treatment was decided. Surgical exploration revealed a 720-degree intravaginal torsion in the lateral direction of the left testis without any injury of the tunica albuginea and hematoma. Detorsion of the affected testis resulted in improvement of testicular appearance; bilateral orchiopexy was then performed. His postoperative course was uneventful, and he was discharged on the fourth postoperative day. Follow-up examination at six months after operation showed good blood flow and no atrophy of the affected testis. Trauma-induced testicular torsion is a rare entity; however, emergency physicians should be aware of the possibility of testicular torsion following blunt scrotal trauma. Pediatric patients with persistent scrotal pain should be actively scrutinized and treated immediately.