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Case report: testicular ischemia secondary to missed epididymal torsion: a diagnostic pitfall


MOJ Orthopedics & Rheumatology
Shehzad Khan, Tariq Alam, Zia ur Rahman, Dr. Anab Hayat, Wajid Ali, Dr. Sohail khan

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Abstract

Epididymal torsion is a critical surgical emergency where salvage rates are highly time dependent. We present the case of a 15-year-old male with acute scrotal pain, initially misdiagnosed as epididymitis at a private facility. Subsequent evaluation at Saidu Group of Teaching Hospital using Color Doppler Ultrasound (CDU) revealed the pathognomonic “whirlpool sign” and total absence of testicular perfusion. Despite surgical intervention, the delay resulted in testicular gangrene requiring orchidectomy. This case emphasizes the clinical necessity of recognizing specific sonographic markers to differentiate mechanical torsion from inflammatory conditions.

Keywords

ultrasound, epididymis, doppler, testis, ischemia

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