2018Russian Journal of Pediatric SurgeryOpen access

TESTICULAR TORSION IN THE INGUINAL CANAL IN CHILDREN

D. N. Shchedrov

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Abstract

There was performed analysis of diagnostic methods and modes of surgical treatment of testicular torsion in the inguinal canal, a comparison with similar indices in the torsion of a scrotally located gonad. The anatomical premises and features of a testicle in the inguinal canal associated with atypical anatomy are discussed. The results of the study indicate to a greater severity of testicular ischemia and, accordingly, the frequency of unsatisfactory results, despite a somewhat lower degree of torsion, which is explained by the compression of the gonad in the inguinal canal. Difficulties and peculiarities of clinical diagnostics, other differential-diagnostic set are shown. Difficulties and peculiarities of ultrasonic and Doppler diagnostics, typical ultrasonic symptoms of testicular torsion in the inguinal canal, their diagnostic value are demonstrated. The modalities of surgical treatment of this pathology are considered. Several different variants of surgical tactics are presented in various clinical and anatomical conditions. The research materials confirm the legitimacy and the possibility of using each of them. The total loss of the gonad in the torsion in the inguinal canal amounts of 8 (66.7%) of the cases out of 12, which is significantly higher than when the testicle is turned in conditions of a typical anatomy. However, the results of the study confirm that with the timely treatment, clinical and radiation diagnosis, taking into account the features of the shape of the torsion and emergency intervention that takes into account the specific clinical situation, despite the difficulties, the result of treatment can be positive.

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What this paper is about

There was performed analysis of diagnostic methods and modes of surgical treatment of testicular torsion in the inguinal canal, a comparison with similar indices in the torsion of a scrotally located gonad. The anatomical premises and features of a testicle in the inguinal canal associated with atypical anatomy are discussed. The results of the study indicate to a greater severity of testicular ischemia and, accordingly, the frequency of unsatisfactory results, despite a somewhat lower degree of torsion, which is explained by the compression of the gonad in the inguinal canal. Difficulties and peculiarities of clinical diagnostics, other differential-diagnostic set are shown. Difficulties and peculiarities of ultrasonic and Doppler diagnostics, typical ultrasonic symptoms of testicular torsion in the inguinal canal, their diagnostic value are demonstrated. The modalities of surgical treatment of this pathology are considered. Several different variants of surgical tactics are presented in various clinical and anatomical conditions. The research materials confirm the legitimacy and the possibility of using each of them. The total loss of the gonad in the torsion in the inguinal canal amounts of 8 (66.7%) of the cases out of 12, which is significantly higher than when the testicle is turned in conditions of a typical anatomy. However, the results of the study confirm that with the timely treatment, clinical and radiation diagnosis, taking into account the features of the shape of the torsion and emergency intervention that takes into account the specific clinical situation, despite the difficulties, the result of treatment can be positive.

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Available abstract

There was performed analysis of diagnostic methods and modes of surgical treatment of testicular torsion in the inguinal canal, a comparison with similar indices in the torsion of a scrotally located gonad. The anatomical premises and features of a testicle in the inguinal canal associated with atypical anatomy are discussed. The results of the study indicate to a greater severity of testicular ischemia and, accordingly, the frequency of unsatisfactory results, despite a somewhat lower degree of torsion, which is explained by the compression of the gonad in the inguinal canal. Difficulties and peculiarities of clinical diagnostics, other differential-diagnostic set are shown. Difficulties and peculiarities of ultrasonic and Doppler diagnostics, typical ultrasonic symptoms of testicular torsion in the inguinal canal, their diagnostic value are demonstrated. The modalities of surgical treatment of this pathology are considered. Several different variants of surgical tactics are presented in various clinical and anatomical conditions. The research materials confirm the legitimacy and the possibility of using each of them. The total loss of the gonad in the torsion in the inguinal canal amounts of 8 (66.7%) of the cases out of 12, which is significantly higher than when the testicle is turned in conditions of a typical anatomy. However, the results of the study confirm that with the timely treatment, clinical and radiation diagnosis, taking into account the features of the shape of the torsion and emergency intervention that takes into account the specific clinical situation, despite the difficulties, the result of treatment can be positive.

Key concepts: Inguinal canal, Gonad, Medicine, Torsion (gastropod), Testicular torsion, Differential diagnosis, Surgery, Radiology

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