5th May 2024

A 16-year-old male presents with sudden onset severe pain in his left testicle, which began 3 hours ago while playing football.

A 16-year-old male presents with sudden onset severe pain in his left testicle, which began 3 hours ago while playing football. He also reports nausea but no fever. On examination, the left testicle is elevated and tender, and the cremasteric reflex is absent. An ultrasound suggests decreased blood flow to the left testicle.

Which is the most appropriate initial management?