Suspected Testicular Torsion With an Atypical Presentation

Testicular torsion is a urological emergency that occurs when the spermatic cord twists, cutting off blood supply to the testicle, and it requires immediate surgical intervention to prevent irreversible damage. Although it typically presents with sudden, severe scrotal pain and swelling, atypical presentations can complicate diagnosis and delay treatment. We report the case of a 25-year-old male who presented to the emergency department with a sudden onset of left lower abdominal pain and left inguinal swelling. Despite the absence of testicular tenderness, scrotal ultrasound revealed reduced blood flow to the left testicle, raising suspicion for torsion. Emergency scrotal exploration confirmed a torsed spermatic cord, which was successfully detorsed, and the testicle was secured with orchidopexy. Postoperative recovery was uneventful, and the patient was discharged in good condition. This report highlights the importance of maintaining a high index of suspicion for testicular torsion, even when symptoms deviate from the typical presentation, as early clinical recognition and prompt surgical intervention are essential to optimize outcomes and preserve testicular function.