Until proven otherwise (UPO)

Question 1

Acute painful/swollen testis/scrotum in a boy/adolescent

• Ix?
• Rx?

Answer 1

Testicular torsion.

- Ix:

Question 2

Acute abdomen in women of childbearing age

• Ix?
• Rx?

Answer 2

Ectopic pregnancy.

• Ix: pregnancy test, transvaginal U/S, hCG levels 48 hours apart
• Rx: Conservative (if hCG levels falling and patient clinically well), Methotrexate, or laparoscopic salpingectomy (surgery if…Significant pain. Adnexal mass ≥35 mm. Fetal heartbeat visible on scan. Serum hCG level ≥5000 IU/L. Rupture.)