# Acute Aortic Dissection Masquerading as Testicular Torsion: A Case Report

## TL;DR

A case of aortic dissection initially mistaken for testicular torsion is reported, highlighting the importance of considering rare conditions in atypical presentations.

## Contribution

This case report adds to the literature on atypical presentations of acute aortic dissection.

## Key findings

- The patient's initial symptoms mimicked testicular torsion, leading to a delayed diagnosis of aortic dissection.
- Computed tomography confirmed an acute type A aortic dissection extending to the iliac arteries.
- The patient underwent surgical repair and was discharged after 12 days.

## Abstract

Aortic dissection is a rare but life-threatening condition with a high mortality rate if diagnosis is delayed. Aortic dissection classically presents with sudden-onset, sharp pain in the chest or back. However, atypical presentations can also occur, which could lead to a delay in diagnosis.

A patient initially presented to the emergency department (ED) with left testicular pain ongoing for several hours. On examination, he had tenderness in the left lower quadrant abdomen and left testicle. A testicular ultrasound revealed decreased blood flow to the left testicle, raising concern for testicular torsion. The patient was taken to the operating room, where no torsion was found, and he was subsequently discharged home. Several days later, the patient returned to the ED with worsening pain radiating to the back. A computed tomography revealed an acute type A aortic dissection extending to the iliac arteries. He was transferred for surgical repair and discharged 12 days later.

While acute aortic dissection (AAD) typically presents with chest or back pain, atypical presentations can occur. When initial findings do not fully explain a patient’s symptoms, AAD should remain on the differential. This case highlights an uncommon presentation of AAD initially mimicking a testicular torsion.