An 18-year-old boy presented with left scrotal pain and skin color changes after sports. Ultrasound showed an avascular left testis compared to the right, with no blood flow to the left testis. Emergency surgery found the left testis was black and avascular, requiring removal due to testicular torsion.

1. CASE 422: TESTIS TORSION, Dr PHAN THANH HẢI,
MEDIC MEDICAL CENTER, HCMC, VIETNAM
Boy 18 yo 3 days ago..onset pain at left scrotum after sport playing.
No fever but changing of color skin of left scrotum ( foto)
Ultrasound in emergency:
US 1: avascular testis in comparison left side to right side.
US 2: very soft left testis on elastoscan.
US 3 : left cord is cut of vascular supply to left testis.
Blood test : WBC 12k 28 Neutro 8k25 CRP= 0.58
Clinical examination and emergency ultrasound showed intra vaginalis torsion of left testis
Operation detected black left testis, avascular for a long time, then resection of left testis.
Conclusion: torsion of testis in long time due to diagnostic delay and testis necrosis that must
be removed the testis torsion.