A 12-year-old child presented with sudden severe onset of scrotal pain after a history of trauma 6 hours before. Intraoperative image is given. What is the likely diagnosis?
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Testicular torsion is a surgical emergency, and prompt intervention within 6 hours is crucial to save the testis from gangrene.
The clinical presentation of sudden severe scrotal pain after trauma, along with the time frame of 6 hours, suggests a serious underlying condition. The options provided refer to different testicular pathologies, but the specific details point to one situation. In cases of scrotal pain with a history of trauma, the possible diagnoses usually include torsion of the testis or testicular hematoma among others. However, considering the time elapsed and the description, the most likely diagnosis is torsion of the testis coupled with gangrene.
Torsion of the testis occurs when the spermatic cord twists, cutting off the blood supply to the testis. If left untreated, this can progress to gangrene due to the prolonged ischemia, typically within 6 to 12 hours.
Given that the problem states the child presented with pain 6 hours after trauma, it aligns with the window for torsion leading to ischemia and potential gangrene development. Therefore, the correct diagnosis based on the symptoms and the critical time interval mentioned is torsion testis with gangrene.
