surgical slides

1. Sunday, May
14, 2023
1
Rare cause of acute abdomen
Intraabdominal testicular torsion
PROFESSOR DR. HIWA OMER AHMED
GENERAL AND BARIATRIC SURGERY

2. Sunday, May
14, 2023
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Undescended testis
 The cryptorchidism is defined as an undescended testis into the scrotum
 It affects 1–5% of term births and between 1.1 and 45% of premature
infants

3. Sunday, May
14, 2023
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Complications
1. Testicular torsion
2. Malignancy
The risk of cancer is 35–40 times higher compared to the normal subject
due to higher abdominal temperature than scrotal one
1. Infertility
2. Exposure to trauma

4. Sunday, May
14, 2023
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Intra-abdominal position
 The intra-abdominal position of the testis is rare and must be evoked
ahead of any
1. Vacuity of the scrotum
2. A non-palpable testis in the inguinal canal
Indeed, in the proportion of impalpable testes 50–60% are intra-
abdominal.

5. Sunday, May
14, 2023
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Intra-abdominal testicular torsion
 Gerster was the first author to report a similar case in
1898
 Is a rare surgical emergency involving the functional
prognosis of the testis.
 It is manifested by an atypical clinical picture
dominated by an abdominal symptomology which is a
source of diagnostic delay

6. Sunday, May
14, 2023
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Why itraabdominal testis has higher
risk of torsion
 Because of lack of anatomical attachment
structures
 The absence of gubernaculum
 The size of the spermatic cord which is not in
adequacy with the size of the testicle which is often
atrophic

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14, 2023
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Features
1. Vacuity of the scrotum
2. A non-palpable testis in the inguinal canal
3. Iiliac fossa pain radiating to the flank
4. Up to a week
5. Without fever.
6. The pain is dull, little sensitive to the usual analgesics, with
periods of remission. It progressively worsened.
7. Digital rectal examination found lateralized pain on the one
side of the Douglas pouch

8. Sunday, May
14, 2023
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8. Irritability
9. Nausea, and vomiting
10. Constipation
11. Atypical abdominal pain
12. Hematuria
13. even shock,
which can be misdiagnosed as appendicitis or
diverticulitis.
14. Sometimes it can manifest as an abdominal mass

9. Sunday, May
14, 2023
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Diagnosis
1. Features mentioned
2. High index of suspicion
3. Leukocytosis
4. Us
5. MRI
6. CT
7. The tumor markers:
 βHCG (choriogonadotrophic hormone)
 αFP (alpha fetoprotein)
 LDH (Lactodeshydrogenase),

10. Sunday, May
14, 2023
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Exploration