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Age, white blood cell count tied to testicular torsion risk in kids

10 May 2020

Testicular torsion (TT) appears to be relatively common among children with acute scrotum (AS), a new study has found. Older age and high white blood cell (WBC) counts are TT risk factors.

Researchers conducted a retrospective analysis of 165 paediatric AS patients (mean age, 9.4 years). Participants underwent colour Doppler ultrasonography for the assessment of scrotal and testicular blood flow. Overall, 115 patients underwent surgical treatment while the rest were given conservative interventions.

After further investigation, 72 patients were ultimately diagnosed with torsion of the appendix testis and 44 were found to have epididymitis. TT was initially identified in 61 patients, of whom 38 were eventually confirmed as cases. There were no missed true TT cases. The resulting sensitivity was 100 percent, while specificity was 84.7 percent.

TT was most prevalent in the 12–15-year age group, and relative to their no-TT comparators, TT patients were significantly older (mean age, 10.55±4.48 vs 9.13±3.59 years; p=0.006).

Risk estimates also showed that those in the 4–7-year (adjusted odds ratio [OR], 0.32, 95 percent confidence interval [CI], 0.11–0.19) and 8–11-year (adjusted OR, 0.13, 95 percent CI, 0.05–0.34) age brackets were significantly less likely to have TT than the older comparators.

WBC counts were also significantly higher in TT patients (10,105±3,683 vs 8,131±3,609 cells/m3; p=0.003). A left side laterality was also a significant risk factor.

Twenty-three cases of TT were salvageable. These patients had significantly lower levels of C-reactive protein, a shorter duration of symptoms and a lower degree of torsion.

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