Moderator True Anomaly Posted March 12, 2013 Moderator Share Posted March 12, 2013 Had a 32 year old come in for a painful, swollen L testicle that started about 2 hours prior to arrival. No prior history of the same. No hematuria, no discharge, no rashes or lesions, no N/V. Afebrile. On exam, absent cremaster reflex, and his epididymis felt like it was now completely anterior. I "open the book", twist it back posteriorally, and call urology and order the ultrasound. Urology resident came right down, came out and put him on call to the OR, and ultrasound confirmed the torsion. He went up to the OR, had flow restored, and they sent him home later on in the afternoon. Total save. A little context- our main hospital ER is kind of a strange hybrid mix of an academic and community setting, so while we're pushing to see 300+ patients a day at a rapid pace, the other services aren't exactly "johnny on the spot" with consults. Urology is one of the worst offenders of this. Thankfully, that wasn't the case here, and the system worked like it's ideally supposed to. Had a NSTEMI and an appy later on in the shift, but I was most proud of that. Anyway, just wanted to share. And for students- if you've got someone who comes in with a textbook presentation....you better not miss it! Link to comment Share on other sites More sharing options...
rcdavis Posted March 12, 2013 Share Posted March 12, 2013 Very nice. I think urology understands the severe consequences of late response to your timed documented consult in a torsion gone bad. Btw have you ever unspun one? I did, pt would get transient relief and would spin again.. Needed the pexy to stay unspun, but was cool to do... Link to comment Share on other sites More sharing options...
CAdamsPAC Posted March 12, 2013 Share Posted March 12, 2013 Very nice. I think urology understands the severe consequences of late response to your timed documented consult in a torsion gone bad. Btw have you ever unspun one? I did, pt would get transient relief and would spin again.. Needed the pexy to stay unspun, but was cool to do... Did his heart and mind follow you anywhere? :-) The old vets out there know the story! Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 12, 2013 Author Moderator Share Posted March 12, 2013 Very nice. I think urology understands the severe consequences of late response to your timed documented consult in a torsion gone bad. Btw have you ever unspun one? I did, pt would get transient relief and would spin again.. Needed the pexy to stay unspun, but was cool to do... I'd like to think so, but in the world of overworked residents 'tis unfortunately not always the case. I'll caveat that as this is purely anecdotal evidence, though. And nope, never unspun before. Like you, my guy got a little relief, but it didn't re-spin for me. Link to comment Share on other sites More sharing options...
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