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Tashkin DP, Celli B, Senn S, et al

Advances in ginsenosides

The presence of a twisted spermatic cord, often seen as the whirlpool sign (characterized by a sudden change in the course of the spermatic cord, forming a spiral twist at the level of the external inguinal ring or within the scrotal sac), and/or absent blood flow within the affected testicle confirms TT and necessitates immediate surgical exploration [354, 359,360,361]