Abstract

The incidence of acute torsion of the spermatic cord (TOSC) has been estimated to be 4.5 cases per 100,000 population.¹ Others have cited an annual incidence of 1 in 4000 males under 25.² While not especially common in the emergency department (ED), these cases are important to the patient, the clinician, and the consultants who might be needed. Sorting out the etiology can be vexing. Doing so frequently involves not only examination but also imaging and consultation with surgery or urology colleagues. When faced with an acutely swollen and painful scrotum, the surgeon must decide quickly whether or not to explore the scrotum, and if a testicular torsion is found, choose between testicular salvage and removal. Both decisions can have consequences for the patient. The outcome for the patient is as dependent on the time elapsed from the onset of the attack, as it is on the decisions of the surgeon.

Keywords: torsion, testicular cord, spermatic cord