Torsion in an Ectopic Testis: A Case Report

Torsion of an ectopic testis represents a rare but clinically significant condition, often complicated by its atypical anatomical location and the resulting diagnostic uncertainty. Because the testis lies outside the normal scrotal position, classical signs of testicular torsion may be absent or misleading, contributing to delay in recognition and definitive management. We describe the case of an adolescent male who presented to the emergency department with a four-day history of progressively worsening right inguinal pain and swelling, accompanied by a known history of an empty right hemiscrotum since birth. This case underscores the importance of considering torsion of an ectopic or undescended testis in the differential diagnosis of acute inguinal or lower abdominal pain, especially in pediatric and adolescent patients with an empty hemiscrotum. Failure to recognise this possibility can result in irreversible testicular damage and subsequent loss. Moreover, the report highlights the critical value of Doppler ultrasonography as a non-invasive, rapid, and accessible diagnostic tool that can provide essential information regarding testicular perfusion and guide urgent surgical decision-making. Enhanced awareness of this uncommon presentation may contribute to earlier detection, timely management, and improved clinical outcomes in similar cases.