Clinical Practice and Cases in Emergency Medicine

Introduction: Tension hydrocele is a rare but serious complication that can threaten testicular viability. This case report describes how testicular point-of-care ultrasound (POCUS) enabled timely recognition of a large hydrocele compromising testicular perfusion and guided management.
Case Report: A 57-year-old male presented to the emergency department (ED) with painful right scrotal swelling. Testicular POCUS demonstrated a large hydrocele with reduced intratesticular blood flow. A scrotal centesis performed by the emergency physician led to symptom resolution and restoration of normal flow.

Conclusion: Testicular POCUS can rapidly identify impaired perfusion and guide scrotal centesis in the ED, a temporary yet potentially testis-saving intervention.