Rosh Pediatrics Practice Exam

Which clinical manifestation may be seen in an 11-year-old boy with suspected testicular torsion?

1. Dysuria

2. Fever

3. Nausea and vomiting

4. Scrotal pain relieved by recumbency

The correct answer is: Nausea and vomiting

In cases of suspected testicular torsion, nausea and vomiting are commonly observed clinical manifestations, especially in pediatric patients. Testicular torsion occurs when the spermatic cord becomes twisted, compromising blood flow to the affected testicle. This acute condition is characterized by severe scrotal pain, which can lead to a sympathetic response in the body, including gastrointestinal symptoms such as nausea and vomiting. The presence of nausea and vomiting can signify the body's response to acute pain and the stress of the condition, making it a critical indicator to monitor in young patients. Recognizing these symptoms, alongside the primary symptom of scrotal pain, is crucial for timely diagnosis and intervention, as testicular torsion requires urgent surgical treatment to prevent irreversible damage to the testicle. While other symptoms like dysuria and fever could be associated with different conditions affecting the genitourinary system or infections, they are not typical manifestations of testicular torsion. Scrotal pain relieved by recumbency is more characteristic of conditions like epididymitis rather than torsion. Thus, experiencing nausea and vomiting strongly supports the suspicion of testicular torsion in this scenario.