Testicular torsion

Case contributed by Joshua Freeman

Presentation

Presented with a 5 day history of intermittent right testicular pain associated with a 1 day history of swelling of the same testicle.

Patient Data

Age: 14 years
Gender: Male

Testicular Doppler Ultrasound

ultrasound

Right testicle is edematous and relatively hypoechogenic with absent flow on Doppler.

Left testicle non-edematous, with adequate flow seen on Doppler

Case Discussion

This patient was brought into the ED with a 5 day history of intermittent right testicular pain and a 1 day history of testicular swelling. On physical exam, he was found to have significant edema and firmness to the right hemiscrotum with erythema and the cremasteric reflex was not intact. He had an emergent ultrasound performed which showed no blood flow to the right testicle. He was emergently taken to surgery for exploration and was found to have a non-viable right testicle and right orchiectomy was performed with left orchiopexy.

 

Acknowledgements: This case was reviewed and written in conjunction with resident physician Dr. Samuel Patterson, MD and attending physician Dr. Megan Chandran, DO.

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