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Paediatrics & Child Health - part 9

tinh hoàn xoắn vào dây thuộc về tinh dịch, occluding cung cấp máu từ động mạch tinh hoàn. A: Intravaginal xoắn tinh hoàn điển hình được bao phủ bởi vaginalis-lớp, gắn vào bề mặt posterolateral của tinh hoàn và cho phép cho di động ít. Xoắn có thể tự phát hoặc do biến dạng lươi chuông bẩm sinh (12% trường hợp). | 166 Testicular torsion CONDITIONS D The testicle twists on the spermatic cord occluding its blood supply from the testicular artery. A Intravaginal torsion the typical testicle is covered by the tunica vaginalis which attaches to the posterolateral surface of the testicle and allows for little mobility. Torsion may be idiopathic or due to the congenital bell clapper deformity 12 of cases . In this condition patients have an inappropriately high attachment of the tunica vaginalis so the testis can rotate freely on the spermatic cord within the tunica vaginalis. Extravaginal torsion 5 develops antenatally in the spermatic cord proximal to the attachments of the tunica vaginalis. A R DD Torsion of testicular appendage hydatid of Morgagni 1 Occurs a little earlier 7-12 years . 2 Causes less pain patient can walk without pain . Epididymitis orchitis epididymo-orchitis 1 Occurs in older patients and onset of pain is gradual and usually associated with dysuria. 2 Commonly 2 to reflux from UTI or STD gonococcus chlamydia . 3 May be 2 to an underlying congenital acquired structural or urologic abnormality. Hydrocele painless swelling that transilluminates. Testicular tumour insidious onset of scrotal enlargement usually painless. Idiopathic scrotal oedema scrotal skin is thickened oedematous and often inflamed. The testis is not tender and is of normal size and position. Acute appendicitis torsion may mimic an acute abdomen. E 1 4000 boys. L R. Bilateral in 2 . Peak age intravaginal torsion 14 years range 11-30 years . BExtravaginal torsion manifests as a firm hard scrotal mass. The scrotal skin characteristically fixes to the necrotic testis. Intravaginal torsion 1 Sudden onset of severe unilateral scrotal pain followed by scrotal swelling and erythema. 2 Hard and tender testicle tends to lie high and horizontally in comparison to the other testis. 3 May have a history of prior episodes of intermittent testicular pain that has resolved spontaneously intermittent torsion .