[##]-year-old male with history and
exam consistent with [right-sided/left-sided] testicular torsion.
Initial considerations in this
patient included testicular torsion, epididymitis, orchitis, hematocele,
hydrocele, spermatocele, hernias, scrotal abscess, sexually transmitted
infections, urinary tract infection (UTI), scrotal abscess and cellulitis, and
Fournier gangrene among others.
Patient presented with report of [right-sided/left-sided
testicular/scrotal] pain with report of onset of pain [## minutes/hours] prior
to presentation concerning for torsion. Patient [reported/denied] preceding trauma [describe]. Urology was consulted early
in the course of care due to strong suspicion for testicular torsion [based on
TWIST score greater than 5/with recommendation for emergent testicular
ultrasound/evaluation in the ED]. A testicular
ultrasound was obtained with evidence of torsion of the [right/left] testicle
[as noted above]. A urinalysis was obtained and [noted to be
unremarkable/notable for evidence of abnormal findings].
[Manual detorsion was considered/performed in this patient as a temporizing measure due to urologist not being immediately available. The patient was given parenteral analgesic and the affected right/left testicle was twisted outward and laterally ("open the book") 180° with noted improvement in pain (if pain improves consider 2-3 rotations/if pain worsens consider twisting in opposite direction).]
[Manual detorsion was considered/performed in this patient as a temporizing measure due to urologist not being immediately available. The patient was given parenteral analgesic and the affected right/left testicle was twisted outward and laterally ("open the book") 180° with noted improvement in pain (if pain improves consider 2-3 rotations/if pain worsens consider twisting in opposite direction).]
Patient evaluated in the ED by Dr.
[Name] of [Pediatric] Urology with plan for [admission to the OR for operative
management/admission for serial examinations and likely operative management]. Patient reported [some/minimal/significant] improvement
in pain after treatment with [analgesic] in the ED. We discussed planned admission and treatment
plan with the [patient/patient’s mother/father/parents], and they demonstrated
understanding and agreement with this plan.
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