Suppurative appendicitis presenting acute scrotal pain: a rare condition may confuse surgeons

Scrotal pain presentation has many differential diagnoses such as testicular torsion is surgical emergency. For this reason, it is necessary for surgeons to differentiate between diseases for choosing the best treatment approach. We have reported a rare condition of 19-year-old male case had an atypical scrotal pain presentation of appendicitis. He was admitted to emergency service with 4 days history of pain in abdomen and testis. In physical examination, there is tenderness in right lower quadrant, right inguinal region and scrotum. Testicular torsion and appendicitis were roll-out in sonography. Because of low sensitivity of sonography in diagnose of appendicitis and high suspicious of surgeons, the case was candidate for an open appendectomy surgery. Acute suppurative appendicitis that presenting testicular pain is rare for making the best diagnosis and prevents multiple surgeries in such cases, cooperation of urology, general surgery and radiology specialists with high index of suspicion is required.