16/M with severe lower abdominal pain.

Case Presentation

A 16-year-old boy is brought from school with sudden severe lower abdominal pain, worse toward the left groin, and two episodes of vomiting. He has no fever, dysuria, urethral discharge, or diarrhoea. He had been receiving first aid for bruises after a fight with a classmate, but the pain remained severe despite analgesia. On examination, he is uncomfortable, with mild left iliac fossa guarding and marked left groin tenderness. No obvious groin swelling is seen. The patient's symptoms have been ongoing for several hours, and he has been unable to urinate since the onset of pain.