29th April 2024

A 19-year-old man presents to the emergency department with sudden onset of severe pain in his left testicle since the night.

A 19-year-old man presents to the emergency department with sudden onset of severe pain in his left testicle since the night. The pain started abruptly while he was asleep and has progressively worsened. He also reports nausea but no fever. On examination, the left testicle is swollen, retracted higher in the scrotum, and extremely tender. There is no transillumination. He denies any recent trauma or sexual activity.

Which is the most likely diagnosis?