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Movable discoloration in the scrotum with attendant pain
  1. Takateru Ihara1,
  2. Satoshi Arino1,
  3. Osamu Nomura2
  1. 1 Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan
  2. 2 Department of Emergency and Disaster Medicine, Hirosaki University, Hirosaki, Japan
  1. Correspondence to Takateru Ihara, Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Fuchu, Tokyo, Japan; ihara.er{at}gmail.com

https://doi.org/10.1136/emermed-2020-210269

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    Clinical introduction

    A 10-year-old man presented with acute right scrotal pain of 20 hours’ duration. He denied fever, vomiting and history of trauma. The scrotum showed no swelling or erythema, and the cremasteric reflex was normal. Both testes demonstrated normal vertical lie and softness on palpation. A tender area of subtle, blue discoloration was observed near the upper pole of the right testis that moved when the testis was manipulated (figure 1, online supplementary video). Both testes and the epididymal blood flow were normal on ultrasound.

    Supplementary video

    [emermed-2020-210269supp001.mov]
    Figure 1

    Subtle blue discoloration can be seen at the upper pole …

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    Footnotes

    • Handling editor Ellen J Weber

    • Twitter @takateru_ihara

    • Collaborators Shun Iwasa.

    • Contributors SA supervised patient care. TI and SA conceptualised the report. TI interpreted the data and wrote the first draft of the manuscript. SA and ON supervised the manuscript. All the authors reviewed and approved the final manuscript as submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.