A 30-year-old man has sudden severe left scrotal pain with nausea and a high-riding testis. When should surgical exploration occur?
Answer and explanation
Correct answer: D. Immediately
- Step 1: Sudden severe testicular pain with a high-riding testis is torsion until proven otherwise.
- Step 2: Salvage is high within 6 hours and falls steeply afterwards, so exploration should not wait for imaging.
Answer
Immediately.
Why not the others: As a planned day case within two weeks, once the swelling has settled: A delay of two weeks leads to infarction. After a seven-day course of oral antibiotics, if the pain has not settled: Antibiotics treat epididymitis, not torsion. After a scrotal ultrasound booked for the following morning list: Waiting for imaging delays exploration when torsion is clinically likely.
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