Hepatic Artery Rupture in a Young Man with Abdominal Pain and a Testicular Mass

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• 作者：Kevin S. Barlotta ; MD ; David Page ; MD
• 关键词：abdominal pain ; testicular cancer ; hepatic artery rupture
• 刊名：The Journal of Emergency Medicine
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：52
• 期：2
• 页码：e33-e36
• 全文大小：347 K
• 卷排序：52

文摘

Male patients presenting to the emergency department (ED) with abdominal pain accompanied by a testicular mass should be evaluated for the presence of hernia, epididymitis, orchitis, and testicular torsion. When a patient presents with an asymptomatic testicular nodule or mass, the emergency physician should consider testicular carcinoma, a diagnosis that typically warrants no more than prompt urologic outpatient referral.Case ReportWe present a case involving a young male whose presenting complaint was abdominal pain. Despite his reluctance to initially discuss any genitourinary (GU) complaints, careful questioning and thorough examination revealed a large left testicular mass. Despite having a benign abdomen, the patient experienced a rapid clinical deterioration in the ED after a previously undiagnosed metastatic lesion to his liver eroded into his hepatic artery.Why Should an Emergency Physician Be Aware of This?This case highlights the importance of performing a GU examination in all patients presenting with abdominal pain and discusses a rare presentation of a relatively common male condition. We also discuss the prioritization of emergent interventions and diagnostic studies specific to this case.