Question

Consider the following statements about their correctness regarding the diagnosis and treatment of the acute scrotum: (A) Torsion of the testis must be assumed until proven otherwise (B) Testicular torsion can present with chronic inguinal or abdominal pain (C) Torsion of a testicular appendage usually occurs just before puberty (D) An incarcerated inguinal hernia must be considered in the differential diagnosis (E) If torsion is confirmed, an orchidopexy should not be performed on both sides Choose the correct answer from the options given below:

• A. \( \text{A, B and C only} \)
• B. \( \text{B and E only} \)
• C. \( \text{A, C and D only} \)
• D. \( \text{A, B, C, D only} \)

Hint:

\textbf{Key Concept: Time Sensitivity in Testicular Torsion.} Early diagnosis and surgical intervention (within 6 hours) are crucial in managing testicular torsion to maximize the chances of testicular salvage. Always consider and rule out torsion in cases of acute scrotum.

Answer 1

The Correct Option is C

Statement A is correct: Acute testicular torsion requires immediate attention, and a high index of suspicion is crucial. Therefore, it should be assumed until proven otherwise to avoid delays in treatment. Statement B is incorrect: Testicular torsion typically presents with sudden onset of severe scrotal pain, often accompanied by nausea and vomiting. Chronic inguinal or abdominal pain is less likely to be the primary presentation of acute torsion. Statement C is correct: Torsion of a testicular appendage is a common cause of acute scrotal pain in prepubertal boys, with a peak incidence around puberty. Statement D is correct: An incarcerated inguinal hernia can also present with scrotal swelling and pain, mimicking acute scrotum. Therefore, it must be considered in the differential diagnosis. Statement E is incorrect: If torsion is confirmed in one testis, a contralateral orchidopexy (fixation of the other testis) is strongly recommended to prevent future torsion in the healthy testis.