title: Testicle ischemia resulting from an inguinal hernia.
abstract: BACKGROUND
  Scrotal pain in the emergency department (ED) should be evaluated rapidly for sources that may cause irreversible testicular ischemia.
  
  
  OBJECTIVE
  This case report discusses a patient presenting with a large inguinal hernia causing testicle ischemia.
  
  
  METHODS
  A 48-year-old man with a 1-year history of a large right-sided indirect inguinal hernia was transferred to the ED from the ultrasound laboratory after the patient experienced acute onset of severe right-sided testicular pain. The radiologist urgently called the attending emergency physician to notify him of ultrasound findings that showed compromised vascular flow to the right testicle. Urology and General Surgery were consulted immediately. The patient was placed in a supine position and reduction of the large hernia was attempted. After approximately 15 min of manual pressure, the herniated bowel was reduced back into the abdominal cavity and the patient experienced immediate relief of his symptoms.
  
  
  CONCLUSIONS
  Scrotal ultrasound was repeated, and vascular flow to his right testicle was found to be re-established. This case highlights a rare presentation of acute onset of testicular ischemia caused by vascular compression from a large indirect inguinal hernia in an adult male.
authors.affiliation: Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
authors.forename: Yagnesh
authors.initials: Y
authors.lastname: Desai
authors.forename: Brian
authors.initials: B
authors.lastname: Tollefson
authors.forename: Lindsey
authors.initials: L
authors.lastname: Mills
authors.forename: Robert
authors.initials: R
authors.lastname: Galli
mesh_terms: D006552:Hernia, Inguinal / Q000150:complications*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging; D012611:Scrotum / Q000000981:diagnostic imaging; D013737:Testis / Q000098:blood supply* / Q000000981:diagnostic imaging; D014463:Ultrasonography