If a child says sudden pain is getting worse, go to the hospital at once — do not make them tough it out until after school
UpdatedGrade ABig benefitLifespanFreeLittle timeNo willpower
Some illnesses are counted in hours. Sudden severe pain on one side of a boy’s scrotum may be testicular torsion — the vessel feeding the testis twists and blood supply stops. Treated within 6 hours, the testis is saved in 97.2% of cases. Wait until 19 to 24 hours and only 42.5% remain. This pain will not wait until after school or until exams are over.
- Cost
- No money. Take a half day off and take the child to emergency care.
- Benefit
- Following the rules, 30 case series with 2116 patients with testicular torsion were collected and pooled. Of these, 1283 were timed in 6-hour bands. From pain onset, testis salvage was 97.2% at 0 to 6 hours, 79.3% at 7 to 12 hours, 61.3% at 13 to 18 hours, 42.5% at 19 to 24 hours, 24.4% at 25 to 48 hours, and 7.4% after 48 hours. In broader bands: 90.4% within 12 hours, 54.0% at 13 to 24 hours, and 18.1% after 24 hours. The authors conclude salvage can still happen past the usual 6 to 8 hour talk. So even if pain has gone on a long time, still get care — do not stay home because “it’s too late anyway.” In U.S. pediatric hospital data for 2000, 2003, and 2006, 2443 boys from 1 month to under 18 years had surgery for testicular torsion. Age of onset has two peaks: the first year of life, and early puberty
- Notes
- Tell boys in advance: if there is sudden severe pain down there, say so at once — no need to be shy. Testicular torsion is common in boys just entering puberty. Many kids are too embarrassed to speak and tough it out; that is the author’s experience. Other hour-counted problems include acute appendicitis (delay can lead to perforation), diabetic ketoacidosis, and meningitis. This section did not verify hour-by-hour harm for each of those. The author’s shared signal: sudden onset, keeps getting worse, unlike any prior episode. How to recognize emergencies and call a car is in Section 13.
Sources · 2
- Mellick LB, et al. (2019). A Systematic Review of Testicle Survival Time After a Torsion Event. Pediatric Emergency Care. doi.org/10.1097/PEC.0000000000001287
- Zhao LC, Lautz TB, Meeks JJ, Maizels M. (2011). Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care. Journal of Urology, 186(5), 2009-2013. doi.org/10.1016/j.juro.2011.07.024