Significance of the initial symptom in the correct diagnosis of testicular torsion and its immediate management.

概要

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A series of experiences with delayed diagnosis of testicular torsion in patients whose initial symptom, pain, was localized in the lower abdomen on one side, led us to investigate whether the site of the initial pain influenced the promptness of diagnosis. Among 21 patients with surgically proven testicular torsion, 13 initially complained of scrotal pain (group 1) while 8 presented with lower abdominal pain (group 2) as the initial symptom. In group 1, the time required to make the correct diagnosis was shorter and the testis could be preserved in 7 cases (53%). Much longer periods were needed for diagnosis in group 2 patients, and none of the testes could be preserved by surgery. All group 2 patients were first seen either by medical doctors or general surgeons, and 3 patients in the care of the latter had undergone appendectomy. These findings suggest that general physicians should be aware that unilateral lower abdominal pain can be the initial symptom of testicular torsion, and patients suspected of having testicular torsion should be further examined to immediately confirm the diagnosis.
一般社団法人日本救急医学会の論文