Q: My 14 years old son got sudden pain in the left testicular region associated with abdominal pain and vomiting. What are the causes? How can it be managed?

A:Sudden testicular pain and vomiting in a child is an emergency, and should be examined and investigated in an emergency room. First diagnosis is testicular torsion, unless and until proved otherwise. Testicle hangs on the structures carrying its blood supply like a bell on a rope. Torsion of the hanging structures may stop blood flow to testis causing permanent damage. Immediate surgery is required to untwist the testis, and fix it to prevent future torsions. Other causes of such pain and vomiting could be traumatic or inflammatory, like epididymoorchitis or mumps orchitis, with treatment being predominantly medical.