4th September 2020

A 19-year-old male develops sudden onset, severe pain in his right scrotum

A 19-year-old male develops sudden onset, severe pain in his right scrotum. He has had one similar episode 2 weeks prior, which spontaneously resolved. However, when this pain did not resolve in 2 hours, he presented to A&E. He has also vomited twice in the past hour. His observations are normal aside from tachycardia. On examination, the right testicle is erythematous, swollen and high-riding. The cremasteric reflex is absent, and elevation of the scrotum does not relieve the pain. He is tender in the lower abdomen. 

What are the  important steps in the management of this type of presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.