title: A novel approach for manual de-torsion of an atypical (outward) testicular torsion with bedside Doppler ultrasonography guidance.
abstract: A 17-year-old boy presented with right testicular torsion to the lateral side. Torsion was diagnosed by physical examination; the colour Doppler ultrasonography (CDU) confirmed right testicular torsion with minimal peripheral hydrocele. Transverse and longitudinal examination of the spermatic cord with ultrasound and CDU revealed a counter-clockwise testicular torsion. Manual de-torsion was performed in a clockwise direction (720o) and testicular blood flow and the neutral position of the spermatic cord were confirmed by CDU. We did not encounter a residual twist of the spermatic cord upon surgical exploration. In our experience, ultrasound and CDU may predict the direction of testicular torsion and may allow appropriate management of cases prior to surgery.
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey;
authors.forename: Mustafa
authors.initials: M
authors.lastname: Güneş
authors.affiliation: Department of Urology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey;
authors.forename: Mehmet
authors.initials: M
authors.lastname: Umul
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey;
authors.forename: Ahmet Orhan
authors.initials: AO
authors.lastname: Çelik
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
authors.forename: Hamit Hakan
authors.initials: HH
authors.lastname: Armağan
authors.affiliation: Department of Radiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey;
authors.forename: Bumin
authors.initials: B
authors.lastname: Değirmenci