Incarcerated Inguinal Hernia: A Cause of Testicular Ischemia Without the ‘Twist’

Introduction: Acute scrotal pain is a common complaint encountered in the emergency room. Besides testicular torsion, incarcerated inguinal hernia is another important cause that requires urgent exclusion as it warrants emergency surgery. Case Report: Here we present a case of acute painful scrotal swelling in a young man owing to an incarcerated inguinal hernia that caused testicular ischemia. Ultrasound evaluation revealed the presence of bowel and omentum in the scrotum and normal echotexture of the testis. However, color Doppler revealed the absence of testicular blood flow. The patient underwent emergency surgery. The bowel and testis were salvaged by reducing the hernia. Conclusion: This case report illustrates the occurrence of testicular ischemia owing to compressed vascular supply by an incarcerated inguinal hernia. It also shows that testicular ischemia can occur in the absence of a twisted spermatic cord, thereby underscoring the requirement for evaluating the testis in the setting of an incarcerated inguinal hernia. Cite this article as: Singh D, Kaur L, Khanduja N. Incarcerated Inguinal Hernia: A Cause of Testicular Ischemia Without the ‘Twist’. J Emerg Med Case Rep 2017; 8: 80-1.