title: Ultrasonography of Extravaginal Testicular Torsion in Neonates.
abstract: BACKGROUND
  Extravaginal testicular torsion (ETT), also called prenatal or perinatal, occurs prenatally and is present at birth or appears within the first month of life. It has different etiology than intravaginal torsion, which appears later in life. Testicular torsion must be taken into consideration in differential diagnosis of acute scrotum and should be confirmed or ruled out at first diagnostic step. Ultrasonography is a basic imaging modality, however diagnostic pitfalls are still possible. There is still wide discussion concerning management of ETT, which varies from immediate orchiectomy to conservative treatment resulting in testicle atrophy.
  
  
  METHODS
  In this article we present ultrasonographic spectrum of ETT in neonates, which were diagnosed and treated in our hospital during the last 8 years (2008-2015), in correlation with clinical and intraoperative findings.
  
  
  RESULTS
  Thirteen neonates with ETT were enrolled in the study - 11 patients with a single testicle affected and 2 patients with bilateral testicular torsion. Most common signs on clinical examination were: hardened and enlarged testicle and discoloration of the scrotum. Most common ultrasonographic signs were: abnormal size or echostructure of the affected testicle and absence of the blood flow in Doppler ultrasonography. In 3 patients ultrasound elastography was performed, which appeared very useful in testicle structure assessment.
  
  
  CONCLUSIONS
  Testicular torsion may concern boys even in the perinatal period. Ultrasonographic picture of acute scrotum in young boys may be confused. Coexistence of the abnormal size or echostructure of the torsed testicle with absence of the blood flow in Doppler ultrasonography appear as very specific but late ultrasonographic sings. Ultrasound elastography may be a very useful tool for visualisation of a very common clinical sign - hardening of the necrotic testicle.
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Bombiński
authors.affiliation: Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Warchoł
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Brzewski
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Majkowska
authors.affiliation: Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Teresa
authors.initials: T
authors.lastname: Dudek-Warchoł
authors.affiliation: Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Żerańska
authors.affiliation: Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Panek
authors.affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Drop
keywords: Child; General Surgery; Pediatrics; Radiology