Round 4 (Flank Pain)

10.01.2019 - By EM Clerkship

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Case Introduction

The nurse tells you that you have a new patient and is requesting a verbal order for nausea medicine. She advises you that the patient is the CEO of your hospital…

Initial Vitals

* Temp 98.9* HR 99* RR 18* BP 120/80* O2 98%

Critical Actions

* Perform Genitourinary Exam* Rule Out Abdominal Aortic Aneurysm* Consult Urology* Treat the Patient’s Pain* Resist Delays on Consultant Pushback

Dangerous Actions

* Delaying Urology Consultation to Obtain an Ultrasound

Final Diagnosis

Testicular Torsion with Referred Pain

Tips and Tricks

Don’t forget to verbalize genitourinary exam when appropriate

Additional Reading

* Testicular torsion overview (EM Clerkship)


It is rare for testicular torsion to occur at this age

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