title: Confirmed testicular torsion in a 67 year old.
abstract: Torsion amongst the elderly population is rarely described. This case presents the oldest surgically confirmed case of testicular torsion, in a 67-year-old male, within the UK. Presenting to the emergency department with a 10-day history of left-sided testicular pain, initially treated with antibiotics. There was no pyrexia or urinary symptoms and negative urine dipstick. In adults above the age of 40, likely diagnoses include epididymo-orchitis, epididymitis, neoplasm or hydrocele. Clinical differentiation with epididymo-orchitis can be difficult in any age range. Clinical signs such as fever, elevated C-reactive protein and positive urine dipstick test are suggestive of epididymo-orchitis/orchitis. This case study demonstrates that testicular torsion can occur at any age, and clinical suspicion should always be high in patients presenting with testicular pain and a negative urine dipstick, regardless of age. Although risk in this subgroup is low, the identification of a potentially reversible testicular abnormality should be of high priority.
authors.affiliation: Urology Department, Royal Liverpool University Hospital, Liverpool, UK nicola.farrington@googlemail.com.
authors.forename: Nicola L
authors.initials: NL
authors.lastname: Farrington
authors.affiliation: Urology Department, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Lucky
authors.affiliation: Urology Department, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Barnes
authors.affiliation: Urology Department, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Calvert