Acute and sudden scrotal pain in 16 years old boy
In the late evening, I was called by the doctor on duty in the ER department of my hospital. He told me about a 16 years old boy came for acute left scrotal pain associated with vagal symptoms (nausea and vomiting) with only partial response to painkillers. The sudden onset in a young boy let me known about a testicular torsion and when I was in the car directed to the hospital I called to alert the Operating Room.
As I arrived I found the patient severely in pain with the testis completely retracted to the upper part of the scrotum, it was untouchable and stuck in its position.
I asked for a point-of-care Ultrasound and, even if either symptoms and signs were clear enough for testicular torsion, I demonstrate the complete absence of vascular flow in the affected testicle.
In the operating room, as I incised the scrotal skin I pulled out the testicle that appeared ischemic and blue/gray in color. The spermatic cord was coiled because of the testis turned around two times. The derotation improved almost immediately its bad aspect. As it gained a normal aspect I did orchidopexy and I closed without drainage.
This young boy was discharged after 12 hours.