Testicular Torsion
A 15-year-old male presents to the emergency department with sudden onset of severe pain in his left testicle that began while he was at school. The pain has been constant for the past two hours and is associated with nausea. He denies any recent trauma or prior episodes of similar pain. On questioning, he mentions some mild discomfort in the same area the previous evening, but it resolved on its own.
On physical examination, the left testicle is swollen, very tender to touch, and sits higher than the right testicle. The cremasteric reflex is absent on the left side. Scrotal elevation does not relieve the pain (negative Prehn’s sign). Doppler ultrasound shows absent blood flow to the left testicle, confirming the diagnosis of testicular torsion.
The patient is taken to the operating room for urgent surgical detorsion and orchiopexy. Fortunately, the procedure is performed within the critical 6-hour window, and the testicle is successfully salvaged. The patient recovers well postoperatively.
a). Epididymitis
b). Testicular torsion
c). Inguinal hernia
d). Varicocele
a). Tenderness in the groin
b). Positive Prehn’s sign
c). Absence of the cremasteric reflex on the affected side
d). Presence of a fluctuating mass in the scrotum
a). Abdominal X-ray
b). MRI of the scrotum
c). Doppler ultrasound of the scrotum
d). CT scan of the abdomen and pelvis
a). 12 hours
b). 24 hours
c). 6 hours
d). 48 hours
