To the Editor:
Recently, we read with great interest an article in your journal about the time to presentation of testicular torsion in the midst of COVID-19.1 As pediatric surgeons, we should consider the practical problems that pediatric surgery faces in this special period. It is clear that the management of pediatric diseases in the post–pandemic period is fraught with difficulties and challenges, not to mention the particularity of children from adults. As a large tertiary children's medical center in the region, we have witnessed the changes and characteristics of pediatric surgical hospitalizations during the pandemic.
We recently treated an 8-year-old child with suspected testicular torsion. The child was initially admitted to the emergency department with enlargement of the right scrotum, which was diagnosed as testicular torsion, and the pediatric surgeon performed manual reduction, and the gross enlargement disappeared. However, his scrotal enlargement did not disappear, and he was readmitted to our hospital 12 days later for further treatment. There was no torsion of the testis during the operation, and a mass of about 15 × 14 mm was seen in the testicular cortex. Postoperative pathology indicated teratoma of testis.
This particular child with testicular enlargement was initially diagnosed as a common testicular torsion, but it turned out to be teratoma testis, a rare condition that pediatric surgeons often overlook. This should arouse enough attention of clinicians, especially in this special period, children who go to hospital face more risk of infection. Pediatric clinicians cannot think of certain clinical symptoms in the same way they think of common diseases. The pandemic has added more difficulty and uncertainty to hospital prevention and control and also led to the possibility of misdiagnosis and missed diagnosis of some rare diseases in children. More importantly, the frequency of unnecessary visits to the hospital during this period should be minimized. In short, accurate and comprehensive diagnosis and treatment thinking are particularly important in the context of the pandemic.
Xianqiang Yu, PhD
Southeast University
Nanjing, Jiangsu Province, China
yuxianqiang302@126.com
Footnotes
Disclosure: The author declares no conflict of interest.
Supported by a scholarship of the Southeast University (Project No. 189351).
Ethics approval and consent to participate.
X.Y. completed the design and writing of the article all the content.
X.Y is the guarantor of this article.
REFERENCE
- 1.Littman AR Janssen KM, et al. Did COVID-19 affect time to presentation in the setting of pediatric testicular torsion? Pediatr Emerg Care. 2021;37:123–125. [DOI] [PMC free article] [PubMed] [Google Scholar]