Abstract
The acute scrotum is defined as a new-onset pain of the intrascrotal contents. The differential diagnosis of acute scrotum includes a variety of etiologies. We report a case of an 18 years old presented with acute scrotal pain with scrotal ultrasound suggestive of testicular torsion, underwent bilateral orchiopexy for suspected testicular torsion. The patient came later with persistent testicular pain. A computerized tomography (CT) scan of the abdomen and pelvis was done and showed a retroperitoneal mass. We suggest that patients with atypical presentation of the acute scrotum should undergo CT scan of the abdomen and pelvis to rule out retroperitoneal pathologies and referred pain.