%0 Journal Article
%T Unusual cause of a painful right testicle in a 16-year-old man: a case report
%A Khalid N Shehzad
%A Amjid A Riaz
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-27
%X A 16-year-old Caucasian man presented as a surgical emergency with a five to six hour history of a painful, red, and swollen right hemiscrotum. He also complained of vague lower abdominal pain, vomiting, and watery diarrhea. He had a temperature of 38.5¡ãC and a tender, red, and swollen right hemiscrotum. The right testicle appeared elevated. He was mildly tender in his central and upper abdomen and less so in the lower abdomen. No convincing localizing abdominal signs were noted. He had an increased white cell count (15 ¡Á 109/L) and C-reactive protein (CRP; 300 mg/L). Urgent right hemiscrotal exploration revealed about 5 ml of pus in the tunica vaginalis and a normal testicle. A right iliac fossa incision identified the cause: a perforated retrocecal appendix. Appendectomy was performed, and both the abdomen and scrotum washed copiously with saline before closure. The patient made an uneventful recovery.Acute appendicitis presenting with scrotal signs due to a patent processus vaginalis is an extremely rare clinical entity. To date, fewer than five such cases have been reported in the medical literature. It is, therefore, extremely important to be aware of this unusual clinical scenario, as only a high index of suspicion will enable prompt, successful management of both the appendicitis and the scrotal abscess.A painful, swollen testicle is a common surgical emergency, especially in young children and teenagers. The diagnosis that must be excluded is testicular torsion. Prompt surgical exploration of the scrotum is important, as delay can jeopardize the viability of a twisted testicle. It is very rare for a non-testicular pathology to present with acute scrotal signs. Such an unusual clinical conundrum can easily confuse the clinician. Clinical astuteness and a high index of suspicion are paramount if successful management is to be instituted.We present the case of a 16-year-old Caucasian man who attended the acute admissions unit of our hospital with a history of a
%U http://www.jmedicalcasereports.com/content/5/1/27