Patient with antiphospholipid syndrome presenting with testicular torsion-like symptoms

Testicular torsion, a urological emergency, occurs due to absence of testicular blood supply secondary to a mechanical twist of the spermatic cord. The authors describe a 28-year-old male who presented with torsion symptoms, first in the left testicle and four months later in the right testicle. Doppler ultrasound and surgical exploration revealed disruption of blood flow but no evidence of spermatic cord twisting. Additionally, physical examination findings at the time of presentation were inconsistent with testicular torsion. Hematologic workup revealed triple positive antiphospholipid syndrome as the cause of testicular ischemia. The patient was successfully treated with aspirin and therapeutic heparin.