Unusual presentation of testicular torsion. A review of 40 cases.

The symptomatology of testicular torsion was atypical in 16 patients among the 40 that we treated. The occurrence of fever together with the torsion (8 cases), the existence of intense local inflammatory signs (16 cases), its occurrence in adults (23 cases), ectopic testicle (2 cases), and the possibility of a traumatism (5 cases) are misleading and may delay its urgent surgical treatment. In most cases, testicular torsion forms a characteristic clinical picture with easy diagnosis, requiring most urgent operation. There are, however, cases where symptomatology is atypical and deceptive forms delay recognition of the torsion, leading to ischaemic necrosis.