Case 358

Medical History

A 26-year-old male patient, with neither comorbidities nor use of medicines, seeks for urgency health service complaining of severe left inguinal pain radiating to the ipsilateral testicular region, which had started approximately one hour before. Physical examination demonstrated that the left testicle was painful, elevated and horizontalized over its longest axis. Prehn’s sign was negative and left cremasteric reflex was absent. Clinical diagnosis of testicular torsion was made and manual detorsion was attempted, with partial relief of pain. Scrotal scintigraphy was requested (images 1 and 2).

Considering the clinical history and scintigraphy imaging findings, what is the most appropriate approach?

Test Question

(EBSERH – Urologist – 2015) You are called for the evaluation of an adolescent with acute onset pain and swelling in the right testicle, without a history of genital trauma.
Regarding the diagnosis, mark the correct alternative:

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