4th September 2020

A 16-year-old male is awoken from sleep with sudden onset and severe pain in his right scrotum

A 16-year-old male is awoken from sleep with sudden onset and severe pain in his right scrotum. He arrives at A&E 2 hour later. The pain has not subsided, and he has vomited twice in that time. His observations are normal aside from tachycardia. On examination, the right testicle is erythematous and swollen, with a horizontal lie. The cremasteric reflex is absent, and elevation of the scrotum does not relieve the pain. He is tender in the lower abdomen. He has a past medical history of sickle cell anaemia and takes only hydroxycarbamide regularly.

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