Identifying data

PL, 19 yr old male Scrotal pain

3/19/12

History of Present Illness Chief complaint:

scrotal pain

15 hours (8AM) PTC upon waking up, patient

had a sudden onset of left scrotal pain with left inguinal pain

3/19/12

History of Present Illness Chief complaint:

scrotal pain

15 hours (8AM) PTC upon waking up, patient had a sudden

onset of left scrotal pain with left inguinal pain

No No No No

vomiting trauma inguinal mass scrotal swelling

3/19/12

History of Present Illness Chief complaint:

scrotal pain

15 hours (8AM) PTC upon waking up, patient had a sudden

onset of left scrotal pain with left inguinal pain

No vomiting No trauma No inguinal mass No scrotal swelling

Consult done in another institution Doppler ultrasound scan showed absence of blood flow in the left testicle compared to the right Surgery was advised

3/19/12

Review of Systems
General. No fever, no weight loss Skin. No rashes, lesions HEENT. No head injuries, no tinnitus, no hearing loss, no colds, Neck. No masses, no enlarging neck veins Respiratory. No hemoptysis, no cough Cardiovascular. No chest pain, no easy fatigability Gastrointestinal. No changes in bowel movement, No diarrhea Urinary. No dysuria, no increased frequency in urination, no changes in color of urine, no incontinence Genital: No lesions or ulcers Peripheral vascular. No varicosities, no leg pain Musculoskeletal. No tremors, no muscle rigidity Psychiatric. No changes in personality Neurologic. No increased drowsiness, no loss of consciousness Hematologic. No easy bruisability Endocrine. No heat/cold intolerance

3/19/12

Past Medical History

No history of mumps No history of trauma No history of past surgeries Past illness: Dengue, 2011

3/19/12

Family History
No family history of the following: - diabetes - cancer - stroke - asthma - allergies

3/19/12

Personal and Social History

Non smoker Non alcoholic drinker 2nd year college student

3/19/12

Physical Examination
Awake, ambulatory, not in cardiorespiratory distress BP: 100/60 (normotensive) HR: 88 (normal) RR: 20 (normal) Temp: 37.0C (afebrile)

3/19/12

Physical Examination HEEN

Anicteric sclerae Pink conjunctivae No TPC, No CLAD Neck veins not dilated Intact tympanic membrane No ptosis Pupils 3mm equal brisk reactive to light Midline septum, no discharge No neck rigidity Dry lips, moist buccal mucosa Nonhyperemic pharynx

NT

3/19/12

Physical Examination
Chest/Lu ngs Symmetrical chest
expansion Resonant on percussion Equal tactile and vocal fremiti No retractions No rales No wheezes

3/19/12

Physical Examination
Hea rt Adynamic precordium
No heaves or thrills Apex beat is at 5th ICS MCL Normal rate, regular rhythm No murmurs

3/19/12

Physical Examination

Abdom en Flat, soft abdomen

No tenderness No organomegaly No masses Normoactive bowel sounds

3/19/12

Physical Examination

Extremi ties Full pulses

No edema, no cyanosis Good turgor No rashes, no lesions Equally distributed hair No clubbing CRT <2sec
3/19/12

Physical Examination
Genit als No inguinal mass
left scrotum is firm, tender, retracted superiorly Scrotum is slightly erythematous No scrotal swelling (-) Prehns sign (-) Cremasteric reflex

3/19/12

Salient Features
19 year old female Sudden onset of unilateral scrotal pain No fever No swelling No inguinal mass No dysuria No hematuria No penile lesions Left scrotum is firm, tender, retracted superiorly Scrotum is slightly erythematous (-) Prehns sign (-) Cremasteric reflex Doppler ultrasound noted absent blood flow in the affected testicle

3/19/12