ASSESSMENT OF THE VALIDITY OF DOPPLER SONOGRAPHY IN THE DIAGNOSIS OF ACUTE SCROTUM IN BOYS
DOI:
https://doi.org/10.21164/pomjlifesci.72Keywords:
acute scrotum, testicular torsion, torsion of the appendix testis, orchitis, ultrasonographyAbstract
Purpose: Comparison of preoperative scrotal Doppler sonography and final diagnosis of subsequent exploration in patients with acute scrotum.
Material and methods: Retrospective analysis of the medical history of 61 patients operated on in The Department of Paediatric and Oncological Surgery in Szczecin in 2008–2014.
Results: Mean patient age (years) with testicular torsion was 12.7 ±4.0, with torsion of a testicular appendage was 8.6 ±4.5, and with orchitis or epididymitis was 7.2 ±8.5. During operation we diagnosed testicular torsion in 28 (45%) patients, torsion of the testicular appendage in 26 (43%), and orchitis or epididymitis in 7 (12%). The specificity of Doppler sonography for testicular torsion was 46%, for torsion testicular appendage 20%, and for orchitis/epididymitis 57%.
Conclusions: Doppler sonography of the scrotum shows limited specificity in the diagnosis of acute scrotum in boys. Surgical exploration is recommended even with apparently normal Doppler sonography examinations.References
Waldert M., Klatte T., Schmidbauer J., Remzi M., Lackner J., Marberbger R.: Color Doppler sonography reliably identifies testicular torsion in boys. Pediatr Urol. 2010, 75 (5), 1170–1174.
Pepe P., Panella P., Pennisi M., Aragona F.: Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 2006, 60 (1), 120–124.
Sidhu P.S.: Clinical and imaging features of testicular torsion: role of ultrasound. Clin Radiol. 1999, 54 (6), 343–352.
Karmazyn B., Steinberg R., Kornreich L., Freud E., Grozovski S., Schwartz M. et al.: Clinical and sonographic criteria of acute scrotum in children: a retrospective study of 172 boys. Pediatr Radiol. 2005, 35 (3), 302–310.
Yin S., Trainor J.: Diagnosis and management of testicular torsion, torsion of the appendix testis, and epididymitis. Clin Ped Emerg Med. 2009, 10, 38–44.
Kadish H.A., Bolte R.G.: A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendages. Pediatrics. 1988, 102 (1 Pt 1), 73–76.
Lin E.P., Bhatt S., Rubens D.J., Dogra V.S.: Testicular torsion: twists and turns. Semin Ultrasound CT MRI. 2007, 28 (4), 317–328.
Frush D.P., Babcock D.S., Lewis A.G., Paltiel H.J., Rupich R., Boke K.E. et al.: Comparison of color Doppler sonography and radionuclide imaging in different degrees of torsion in rabbit testes. Acad Radiol. 1995, 2 (11), 945–951.
Mansbach J.M., Forbes P., Peters C.: Testicular torsion and risk factors for orchiectomy. Arch Pediatr Adolesc Med. 2005, 159 (12), 1167–1171.
Kalfa N., Veyrac C., Lopez M., Lopez C., Maurel A., Kaselas C. et al.: Multicenter assessment of ultrasound of the spermatic cord in children with acute scrotum. J Urol. 2007, 177 (1), 297–301.
Rabinowitz R.: The importance of the cremasteric reflex in acute scrotal swelling in children. J Urol. 1984, 132 (1), 89–90.
Sanders L.M., Haber S., Dembner A., Aquino A.: Significance of reversal of diastolic flow in the acute scrotum. J Ultrasound. Med. 1994, 13 (2), 137–139.
van Glabeke E., Khairouni A., Larroquet M., Audry G., Gruner M.: Acute scrotal pain in children: results of 543 surgical exploration. Pediatr Surg Int. 1999, 15 (5-6), 353–357.
Patriquin H.B., Yazbeck S., Trinh B., Jequier S., Burns P.N., Grignon A. et al.: Testicular torsion in infants and children: diagnosis with Doppler sonography. Radiology. 1993, 188 (3), 781–785.
Kass E.J., Stone K.T., Cacciarelli A.A., Mitchell B.: Do all children with an acute scrotum reguire exploration? J Urol. 1993, 150, 667–669.
Bentley D.F., Ricchiuti J., Nasrallah F., McMahon R.: Spermatic cord torsion with preserved testis perfusion: initial anatomical observations. J Urol. 2004, 172, 2373–2376.
