British Journal of Urology (1978), 50. 428

Torsion of the Mesorchium-The Testis Twisted upon the Epididymis Case Report A 12-year-old Japanese boy was admitted with a tender swelling of 2 weeks’ duration in the left scrota1 region. Antibiotics had been given without effect at another hospital with a diagnosis of epididymitis. On palpation, there was a mass in the left scrotum, the size of a hen’s egg, retracted to its upper region as compared with that of the opposite side. The testis and the epididymis could not be separated. The white blood cell count was not elevated and the remainder of the physical examination was normal. By opening the tunica vaginalis, the testis twisted upon the epididymis which had relatively strong adhesion to its neighbouring tissue. The testis was dark red and swollen, in attachment to the epididymis only at the globus mayor. Incision of the testis showed haemorrhagic infarction. Left orchidectomy was carried out. Histological examination showed gangrene of the testis, whereas the epididymis appeared almost normal (Figs. 1 and 2).

Fig. 2 Testis (H.and E. staining ~40).

Comment Torsion of the spermatic cord has a relatively high incidence among prepubertal children (Williamson, 1976), whereas torsion of the mesorchium-the testis twisted upon the epididymis-is very rare. In our case, a fundamental anatomical abnormality, namely the testis detached from the epididymis except at the globus major, was thought to be an aetiological factor. Reference Williamson, R. C. N. (1976). Torsion of the testis and allied conditions. British Journal of Surgery, 63,465476.

The Authors Fig. 1 Epididymis (H. and E. staining x 40).

M. Oka, K. Nakashima and R. Sakoda, Department of Urology, Kumamoto Chuo Hospital, 1-16-1, Shinyashiki, Kumamoto 862, Japan.

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Torsion of the mesorchium--the testis twisted upon the epididymis.

British Journal of Urology (1978), 50. 428 Torsion of the Mesorchium-The Testis Twisted upon the Epididymis Case Report A 12-year-old Japanese boy wa...
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