Unusual presentation of testicular ischemia as a consequence of pressure caused by inguinal hernia

Background: The incidence of indirect inguinal hernia in young children ranges from 0.8% to 4.4%. Infants are at a high risk of testicular ischemia from indirect inguinal hernia due to their delicate vascular supply. Case report: A 5-year-old patient presented with a rare case of acute testicular ischemia secondary to an incarcerated inguinal hernia. He underwent surgery that successfully salvaged his testicle. Conclusion: Emergency medicine providers need to clinically suspect for testicular ischemia even in the presence of examination findings suggestive of an alternative diagnosis, such as inguinal hernia.