Sudden-onset Severe Left Scrotal in Surgery — 16yo Child | Urology | SMLE Q#19033

SMLE Question #19033

Surgery Urology

Objective: OBJ-124

Last updated: March 2026
A 16-year-old boy presents to the emergency department with sudden-onset severe left scrotal pain that started 3 hours ago while resting. He has nausea and scrotal swelling. He denies dysuria, urethral discharge, fever, or trauma. Examination shows a swollen, erythematous, very tender left hemiscrotum; the testis is difficult to palpate due to pain. The left cremasteric reflex is absent, and the swelling does not transilluminate. What is the most likely diagnosis?

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