[Testis necrosis following repeated misdiagnosis of testicular torsion: a case report and literature review].
OBJECTIVE
To improve clinicians' ability of diagnosing testicular torsion.


METHODS
We reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiagnosis and relevant literature.


RESULTS
The patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for non viability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis.


CONCLUSIONS
Timely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.
Zhang
Ji-Qing
JQ
Department of Urology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. zhangjiqing2001@yahoo.com.cn
Hu
Xiao-Peng
XP
Kong
Xiu-Zhen
XZ
Huang
Ming-Liang
ML
Gou
Ju-Min
JM
Liu
Jia-Hui
JH
Zhang
Xiao-Dong
XD
D000328:Adult; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D009336:Necrosis; D013086:Spermatic Cord Torsion / Q000175:diagnosis*; D013737:Testis / Q000473:pathology*