Aboughalia Hassan,  Oztek Murat Alp,  Noda Sakura

Final Pr. ID: Poster #: EDU-008

A whirlpool describes rotating water created by opposing currents or upon an encounter with an obstacle. On imaging, it refers to a twist of the vascular pedicle of an organ, with a subsequent characteristic appearance on color Doppler images. Multiple abdominal pediatric emergencies are associated with a whirlpool sign, including midgut and other intestinal volvulus, testicular torsion, and ovarian torsion. This exhibit aims to review the underlying embryologic mechanism predisposing to this characteristic appearance, the role of this sign in the diagnosis of these conditions, the supporting imaging features that can help further define the diagnosis, as well as some pitfalls and differential diagnoses that can lead to a fallacious diagnosis. Read More

Authors:  Aboughalia Hassan , Oztek Murat Alp , Noda Sakura

Keywords:  Whirlpool sign, Midgut malrotation, Testicular torsion

Sinayuk Boris,  Swenson David,  Herliczek Thaddeus,  Wallach Michael,  Cassese John

Final Pr. ID: Poster #: EDU-054

1. Highlight recent literature on ultrasound (US) imaging of the spermatic cord for testicular torsion.
2. Present illustrative cases of testicular torsion from our institution that demonstrate the spectrum of US findings, highlighting the importance of evaluating the spermatic cord and how relying solely on grayscale US and doppler of the testicle itself can be misleading in the setting of torsion.
3. Encourage real-time US evaluation of the spermatic cord in all suspected cases of testicular torsion. Read More

Authors:  Sinayuk Boris , Swenson David , Herliczek Thaddeus , Wallach Michael , Cassese John

Keywords:  testicular torsion, ultrasound, spermatic cord

Chen Paula,  Misseri Rosalia,  Karmazyn Boaz

Final Pr. ID: Poster #: EDU-042

Testicular torsion occurs in 3.8 per 100,000 boys and is a medical emergency as salvage of the testicle depends on prompt diagnosis and intervention. Testicular torsion has a bimodal distribution, during the perinatal period where the torsion is extravaginal type, and during puberty where the torsion is intravaginal type.

Newborns may not have pain related symptoms and perinatal testicular torsion can mimic hernia, tumor or epididymitis. In ultrasound (US), comparison of testicular flow to the contralateral testis may be challenging due to both limitation in detecting testicular blood flow in this age group and that increased peritesticular flow can mimic epididymo-orchitis. We will show rare cases of perinatal testicular torsion with preserved testicular flow.

Diagnosing testicular torsion in older age group can be challenging in cases of intermittent testicular torsion or incomplete/partial testicular torsion. Only few children with recurrent hemiscrotal pain have intermittent testicular torsion and US can be normal between the episodes. The purpose of this educational poster is to show limitations and pitfalls of scrotal US in diagnosis of testicular torsion and highlight US features such as spermatic cord whirlpool sign, horizontal testis lie, and epididymal and testicular swelling with normal rather than increased testicular flow. Additionally, we will discuss the potential role of contrast enhanced US that would facilitate timely diagnosis and intervention. We will also show how a swollen and redundant spermatic cord in epididymitis can mimic whirlpool sign as an example of potential pitfall leading to misdiagnosis of testicular torsion. Read More

Authors:  Chen Paula , Misseri Rosalia , Karmazyn Boaz

Keywords:  Ultrasound, Testicular, Torsion