Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

A 34-year-old male presented to the emergency department with a 3-hour complaint of pain in the rightlower quadrant and right testicle. He stated that his pain began suddenly while standing at work. Onphysical examination, he had a small, firm, unreducible bulge in his right inguinal canal and an enlargedright scrotum. The patient was placed in trendelenburg position; intravenous fentanyl, valium, anddilaudid were administered; and surgery consult was obtained. A testicular ultrasonogram (Figure) wasobtained owing to continued pain in the right scrotum and inability to evaluate the testicle. After viewingthe ultrasound pattern, the patient was promptly taken to the operating room 6 hours after onset ofsymptoms. [West J Emerg Med. 2012;13(1):131–132.]