EP.FRI.596 A Tale of Two Ultrasounds

Abstract Background Testicular torsion is a common cause of acute testicular pain, which requires immediate investigation and treatment. We describe unique presentation torsion, required the operating surgeon to assess viability clinically dead testis through surgical manipulation, 16 hours after onset pain. Case Report A 19 year old male presented with 12 hour history pain swelling in left scrotum. Examination revealed testes was hard, swollen tender palpable spermatic cord. Clinical diagnosis mass or epididymo-orchitis suggested scrotal ultrasound organised. This reported no blood flow testis, so suspected. Patient taken immediately theatre. performed under general anaesthetic, clinically. Midline incision made. On visual examination, black but there obvious However, during softened started change colour, eventually becoming dusky. small into showed bright red blood, decision made replace fix both testes. The patient an excellent recovery post-operatively. Repeat return vascularity. Conclusion case showcases importance considering salvage patients who have even generally accepted 6-8 time window. It also highlights value experienced surgeon’s judgement unusual presentations unexpected events intraoperatively.