Parameters associated with testis viability include duration of symptoms and the sonographic echotexture of the testis. In order to maximize the chances of testicular survival, prompt diagnosis and treatment of testicular torsion is essential. The goal in managing testicular torsion is organ salvage. These findings, in association with an absent cremasteric reflex, are highly suggestive of testicular torsion. A high-riding testis in a transverse lie is often found on physical examination. Clinically, testicular torsion presents with an acute onset of scrotal pain, followed by scrotal swelling, nausea and vomiting. Testicular torsion is defined as a twisting of the spermatic cord along a longitudinal axis, with resultant ischemia due to compromised blood flow to the testicle. Although testicular torsion can occur at any age, it is most commonly seen in the adolescent population. Testicular torsion is a surgical emergency affecting 1 in 4,000 boys below the age of 25, and accounting for up to 25% of acute scrotal disease in pediatrics ( 1).
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