Torsed appendage Diagnosis and management: Blue dot sign

doi:10.1016/0090-4295(73)90116-7

Urology

Volume 1, Issue 1, January 1973, Pages 63-66

https://doi.org/10.1016/0090-4295(73)90116-7 Get rights and content

Abstract

Torsed appendage ranks second in causes of acute scrotal swelling in children. Yet the diagnosis and treatment in many centers lag behind the information reported in the scientific literature. Most often only a postoperative diagnosis of torsed appendage is made. The “blue dot sign” is an aid to early diagnosis. In the Children's Memorial Hospital series, a preoperative diagnosis was made in almost 30 per cent of patients with torsed appendages. Immediate surgical intervention is recommended.

References (28)

A.J. Randall
Torsion of appendix of testis (hydatid of Morgagni)
J. Urol.
(1939)
G.W. Kaplan et al.
Acute scrotal swelling in children
J. Urol.
(1970)
D. Rolnick et al.
Anatomical incidence of testicular appendages
J. Urol.
(1968)
R.F. Seidel et al.
Torsion of the appendix testis and appendix epididymis: a report of 8 cases
J. Urol.
(1950)
R.J. Fitzpatrick
Torsion of the appendix testis
J. Urol.
(1958)
H.C. Rolnick
Torsion of hydatid of Morgagni
J. Urol.
(1939)
S.S. Ambrose et al.
Torsion of appendix epididymis and testis
J. Urol.
(1957)
G.B. Morgagni
De Sedibus et Causis Morborum
(1769)
G.H. Colt
Torsion of the hydatid of Morgagni
Brit. J. Surg.
(1922)
L. Ombredanne
Torsion of the spermatic cord
Bull. mem Soc. Chir.
(1913)

C.T. Oeconomopoulos et al.

Torsion of the appendix testis with observations on its etiology, an analysis of 26 cases

Pediatrics

(1960)

P. Jones

Torsion of the testis and its appendix during childhood

Arch. Dis. Child.

(1962)

J.J. Klingerman et al.

Torsion of the spermatic cord

J.A.M.A.

(1967)

A.S. Litvack et al.

Torsion of the hydatid of Morgagni

J. Urol.

(1964)

Cited by (30)

Scrotal Emergencies
2011, Emergency Medicine Clinics of North America
Citation Excerpt :
Therefore, its use should be abandoned. The blue dot sign is pathognomonic for appendage torsion.35 This finding is very specific, yet insensitive.10,13,14
The Acute Scrotum
2010, Ashcraft's Pediatric Surgery
THE ACUTE SCROTUM
2009, Ashcraft's Pediatric Surgery, Fifth Edition
Mesorchial Testicular Torsion: Case Report and a Review of the Literature
2009, Urology
Testicular torsion can be extravaginal, intravaginal, or mesorchial. Mesorchial torsion is less well defined and has an atypical presentation. Here we present the case of a 13-year-old with severe, intermittent right scrotal pain, erythema, and a large hydrocele. Color Doppler ultrasound examination showed epididymal enlargement and normal flow. Weeks after presentation, serial color Doppler ultrasound examinations showed epididymal enlargement and decreased perfusion. A literature review for testicular torsion etiology and clinical and radiologic findings documents this as the only recorded case of mesorchial testicular torsion with clinical and radiologic findings. Atypical pain, if persistent, requires careful reassessment, radiologic studies, and surgical exploration.
Current management of the acute scrotum
2007, Seminars in Pediatric Surgery
Citation Excerpt :
Radionuclide imaging of the scrotum was historically the study of choice. Ultrasound with color Doppler now has become a more popular study in most institutions because it allows determination of blood flow, is less time consuming, is more readily available, and does not expose the patient to ionizing radiation.11,12 Recent studies show a sensitivity of 89.9%, specificity of 98.8%, and false-positive rate of 1% for color flow Doppler ultrasound in experienced hands.13
Pediatric surgeons and urologists are often asked to evaluate boys with acute scrotal pain and inflammation. Although there are myriad etiologies for this syndrome, testicular torsion should be at the top of the list. It is the one diagnosis that must be made accurately and rapidly if there is any hope for testicular salvage. The purpose of this article is to update/review the appropriate evaluation and management of the acute scrotum and to guide the clinician in distinguishing testicular torsion from the other conditions that commonly mimic this surgical emergency.
Pediatric Urologic Emergencies and Urgencies
2006, Pediatric Clinics of North America

View all citing articles on Scopus

^☆: Presented at the 41st Annual Meeting of the American Academy of Pediatrics, Section on Urology, New York City, October 14, 1972.

View full text

Scientific articleTorsed appendage Diagnosis and management: Blue dot sign☆

Abstract

J. Urol.

J. Urol.

J. Urol.

J. Urol.

J. Urol.

J. Urol.

J. Urol.

De Sedibus et Causis Morborum

Torsion of the hydatid of Morgagni

Brit. J. Surg.

Torsion of the spermatic cord

Bull. mem Soc. Chir.

Torsion of the appendix testis with observations on its etiology, an analysis of 26 cases

Pediatrics

Torsion of the testis and its appendix during childhood

Arch. Dis. Child.

Torsion of the spermatic cord

J.A.M.A.

Torsion of the hydatid of Morgagni

J. Urol.

Scientific article
Torsed appendage Diagnosis and management: Blue dot sign☆