In Agony 2

A 45 year old man presents with severe lower abdominal pain for 2 hours, in association with nausea and vomiting. No other symptoms are present.

Close questioning reveals a history of similar but much milder episodes of pain for many years, all of which resolved spontaneously without treatment.

His medical, surgical, and family histories are otherwise unremarkable.

Select Relevant Investigations
Urine Cultures


Culture results will be available in 48 to 72 hours.
Color Doppler Scrotum


The color doppler sonogram shows absence of blood flow to the left testis. The right testis demonstrates normal blood flow.
Ultrasound Abdomen


The ultrasound scan of the abdomen shows no abnormalities.
Scrotal Scintigraphy


Scrotal scintigraphy demonstrates markedly decreased uptake of technetium-99m into the left testis.

Select Relevant Management
Opioid Analgesics
Oral Fluoroquinolones
L/s Orchidectomy
R/s Orchidopexy