Intermittent Testicular Torsion in Adolescents: Underdiagnosed Entity

Abstract Intermittent scrotal pain in adolescents is often an underdiagnosed and missed entity because of the brief presentation and spontaneous resolution. Inadequate history and casual counseling can lead to acute torsion which is an important cause of surgical emergency in males leading to testicular ischemia. The adolescent boys with history of intermittent scrotal pain radiating from groin associated with nausea/vomiting should be examined clinically to rule out transverse lie of bilateral testis, Bell Clapper variant. An ultrasound scrotum should be done to rule out the oedema in cord structure and the bell clapper variant of testis. Presence of these signs should be kept as red flags to counsel parents for impending danger of testicular torsion. This advocates the need to offer prophylactic orchidopexy in such males to prevent testicular ischemia. The two comparative case presentations emphasize the importance of early pick of the clinical signs which can create the difference in management of these group of adolescent boys.