This case involves a 37-year-old male who underwent a vasectomy. The surgeon noted there was a prominent blood vessel in close approximation to the vas deferens that took extra time to control. The day after the operation, the patient presented to emergency department of the hospital with significant swelling and severe pain radiating from his left groin. An ultrasound appeared to show compromised blood flow. The radiology impression determined his testicle was inflamed and he was discharged with antibiotics. The patient continued to feel excruciating pain and the next day, he was taken to emergency deparment of a local hospital where he underwent an exploratory surgery. The spermatic cord was found to have a significantly large hematoma. The surgeon attempted to treat the hematoma, but clotting was so severe that she had to perform a orchiectomy.
Question(s) For Expert Witness
- 1. If a patient presents to the ER with compromised blood flow and vascular insufficiency, what steps should be taken?
- 2. Have you ever reviewed a similar case? If yes, please elaborate.
Expert Witness Response E-065721
If a patient presents to the ER with compromised blood flow and vascular insufficiency, they should immediately be evaluated by urology services. If this is not possible, they should be transferred to a hospital where urology services are available immediately.
Expert Witness Response E-001278
If a patient presents to the ER with compromised blood flow and vascular insufficiency, emergency ultrasound of the scrotum to determine blood flow to the testicle should be done immediately.