• Dong Young Lee, Sung Hyeok Lee, Jung A Yoon, Changshin Kang, Yong Chul Cho, Hong Joon Ahn, Jung Soo Park, Seung Ryu, Yeonho You, Seung Whan Kim, Jin Woong Lee, and Won Joon Jeong.
• Department of Emergency Medicine, Chungnam National University Hospital, Daejeon, South Korea.
• J Emerg Med. 2022 Apr 1; 62 (4): e88-e90.

BackgroundUltrasonography is an effective diagnostic tool for testicular torsion (TT), which is typically characterized by the absence of blood flow in the affected testicle on color Doppler mode. However, there are a few reported cases of TT with symmetrical preserved flow. We report a case of TT with the preserved intratesticular flow on color Doppler ultrasound.Case ReportA 14-year-old boy was admitted due to sudden-onset right scrotal pain. Point-of-care ultrasound (POCUS) revealed that the right testicle was larger than the left. The intratesticular flow in both testicles was preserved. Radiology-performed ultrasound confirmed the preserved intratesticular flow observed on POCUS, but also demonstrated a whirlpool sign of the right spermatic cord. TT was confirmed surgically. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should investigate the presence of intratesticular blood flow and the whirlpool sign of the spermatic cord or other ultrasound features suggestive of TT, even if testicular blood flow is preserved. Suspicion of TT from POCUS findings warrants further evaluation to preserve the patient's fertility.Copyright © 2021. Published by Elsevier Inc.

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