Stephenson Graham S, Langdorf Mark I
University of California, Irvine, Department of Emergency Medicine, Orange, California.
Clin Pract Cases Emerg Med. 2022 May;6(2):117-120. doi: 10.5811/cpcem.2022.2.55315.
Testicular torsion, or the twisting of the spermatic cord compromising blood flow to the testis, is a urologic emergency with the potential to cause infertility in male patients. The diagnosis may be clinical or confirmed using imaging, with ultrasound being the modality of choice.
We present a case of right lower quadrant pain with radiation to the groin and right scrotum in a young male. A computed tomography of the abdomen and pelvis was ordered to assess for appendicitis, which showed a "whirl" sign on the inferior periphery of the images near the scrotum. The finding was not appreciated during the emergency department visit and the patient was discharged home. He returned 48 hours later due to continued pain and was ultimately diagnosed with testicular torsion via ultrasound and surgical pathology.
This is the first reported case to our knowledge identifying "whirl" sign for the diagnosis of testicular torsion. This finding was not appreciated by multiple clinicians during the initial patient presentation, highlighting the uncommon nature of the finding.
睾丸扭转，即精索扭转导致睾丸血流受损，是一种泌尿外科急症，有可能致使男性患者不育。诊断可通过临床判断或借助影像学检查来确诊，超声是首选的检查方式。
我们呈现了一名年轻男性右下象限疼痛并放射至腹股沟和右侧阴囊的病例。为评估是否患有阑尾炎，对其进行了腹部和盆腔的计算机断层扫描，结果在靠近阴囊的图像下周边显示出“漩涡”征。在急诊科就诊时未发现这一征象，该患者随后出院回家。48小时后，因疼痛持续他再次前来就诊，最终通过超声和手术病理诊断为睾丸扭转。
据我们所知，这是首例报告的通过识别“漩涡”征诊断睾丸扭转的病例。在患者初次就诊时，多名临床医生均未发现这一征象，凸显了该发现的罕见性。
