25 years practice in PEM, success times 2, denominator 100s.
E Izsak
Toledo, OHIO

On Mon, Aug 10, 2009 at 1:06 PM, Gutierrez, Camilo <[log in to unmask]
> wrote:

> Dear Jay -
>
> In the presence of an acute testicular torsion with acute pain I usually
> try manual detorsion. I have used bedside ultrasound occasionally as
> described in the recent article (Bedside ultrasound of a painful testicle:
> before and after manual detorsion by an emergency physician. Bomann JS,
> Moore C. Acad Emerg Med. 2009 Apr;16(4):366) but will consider strongly its
> use in every case.
>
> I don't have the exact number, but I have seen immediate relief of pain on
> a few occasions after attempting 180 degrees rotation outwards. If pain
> increases I might rotate 180 degrees internally as described in the
> literature  (although I have yet to do this).
>
>
>
> Camilo E. Gutiérrez M.D.
> Pediatric Emergency Medicine - Boston Medical Center
> Assistant Professor of Pediatrics - Boston University School of Medicine
>
> Office: 617.414.5514  -  617.414.3605  /  Fax:  617. 414-4393
> 88 E. Newton St. Vose 5
> Boston, MA. 02118
> [log in to unmask] <mailto:[log in to unmask]>
>
> ________________________________
>
> From: Pediatric Emergency Medicine Discussion List on behalf of Jay Fisher
> Sent: Mon 8/10/2009 12:31 AM
> To: [log in to unmask]
> Subject: manual detorsion?
>
>
>
> Clinicians and Scholars-
>
> How many of you employ manual detorsion of the testes in your ED practice?
>
> Has the data demonstrating that one third of torsions occur laterally made
> an impact on your approach? (Sessions AE et al. J Urol 2003
> Feb;169(2):663-5.
>
>
> Jay D. Fisher MD FAAP
> Director of Pediatric Emergency Services
> Emergency Physicians Medical Group
> University Medical Center, Las Vegas NV
> St. Rose Sienna Hospital, Henderson NV
>
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>
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