title: [Testis necrosis following repeated misdiagnosis of testicular torsion: a case report and literature review].
abstract: 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.
authors.affiliation: Department of Urology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. zhangjiqing2001@yahoo.com.cn
authors.forename: Ji-Qing
authors.initials: JQ
authors.lastname: Zhang
authors.forename: Xiao-Peng
authors.initials: XP
authors.lastname: Hu
authors.forename: Xiu-Zhen
authors.initials: XZ
authors.lastname: Kong
authors.forename: Ming-Liang
authors.initials: ML
authors.lastname: Huang
authors.forename: Ju-Min
authors.initials: JM
authors.lastname: Gou
authors.forename: Jia-Hui
authors.initials: JH
authors.lastname: Liu
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhang
mesh_terms: D000328:Adult; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D009336:Necrosis; D013086:Spermatic Cord Torsion / Q000175:diagnosis*; D013737:Testis / Q000473:pathology*