A 16-year-old boy attended the Emergency Department with sudden severe right iliac fossa pain and associated vomiting. He denied any urinary symptoms, diarrhoea or testicular pain. On examination, he had a locally tender right iliac fossa with guarding. External genitalia and testicular examination revealed an absent right testicle, the left testicle was not tender. The patient was haemodynamically stable. A clinical diagnosis of acute appendicitis and possible testicular torsion was made and the patient sent for an urgent diagnostic laparoscopy. At laparoscopy, the patient was found to have a torted, non-viable right-sided testicle in the abdominal cavity. On discussion with urology, a decision was made to excise the torted testicle as it was atrophic and had significant malignant potential. The appendix was normal. The patient made an unremarkable recovery and was discharged.
- urological surgery
- general surgery
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MIKM and JA are joint first authors.
Contributors MIKM and JA contributed to the writing of the case report. It was reviewed by SS, GM and SE for approval and submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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