hrvatski

Torzija testisa u diferencijalnoj dijagnozi akutnog abdomena u dječaka

Aim: The differential diagnosis for a child with abdominal pain is extensive. It includes problems from organs within the abdomen as well as from organs outside of the abdomen. Testicular torsion can present with abdominal pain that mimics appendicitis, and can lead to significant morbidity if not quickly diagnosed. As a result, it is important to always perform a complete physical examination, including examining the genitals, when a child presents with abdominal pain. The aim of this paper was to evaluate management and outcomes of pediatric patients with testicular torsion initially presented as acute abdominal pain. Methods: From January 1999 through January 2013 case records of 92 children operated on for testicular torsion were retrospectively reviewed. Of total number of operated patients 21 (23%) patient presented with abdominal and scrotal pain and 9 (10%) patients presented with abdominal pain only without initial scrotal pain and only they were included in study. Results: The most common presenting symptoms were abdominal pain and vomiting. The patient's scrotum and testicles were never examined during the first evaluation in 6 cases, while in 3 cases testicles were examined during the first physical examination of abdominal pain. At surgery, 4 testes have been salvaged, while 5 has been lost because of testicular necrosis. The mean duration of symptoms was 4 hours in group of salvaged testes and 39 hours in group of orchidectomies. There were no major complications. Conclusion: Testicular torsion should always be included in differential diagnosis when evaluating lower abdominal pain in young males. An external genital organ has to be examined in every child or adolescent with acute abdominal pain. Bearing in mind this fact, if the patients come in time, the testicle can be salvaged.

Acute abdomen; child; childhood disease; human; major clinical study; necrosis; orchiectomy; pediatric surgery; physical examination; retrospective study; review; salvage therapy; scrotal pain; scrotum; testis; testis torsion; vomiting

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