A young male experiences acute abdominal pain with testicular swelling. What is the most likely diagnosis?

The scenario describes a young male with acute abdominal pain accompanied by testicular swelling, which is highly indicative of testicular torsion. Testicular torsion occurs when the spermatic cord becomes twisted, compromising blood flow to the testicle. This condition usually presents suddenly and causes severe pain and swelling of the affected testicle. It is often accompanied by nausea or vomiting and may have accompanying abdominal pain due to its acute nature.

The urgency of this diagnosis is underscored by the need for immediate surgical intervention to salvage the testicle; delay in treatment can lead to loss of the testicle due to necrosis from lack of blood supply.

In contrast, while testicular cancer could also present with a mass or swelling, it often does not present acutely with abdominal pain; rather, it may develop more insidiously over time. Appendicitis typically presents with right lower quadrant pain and may be associated with gastrointestinal symptoms, but it would not commonly include testicular swelling. Epididymitis can cause scrotal pain and swelling, often with a gradual onset and can be associated with urinary symptoms, but it is less likely to present with acute abdominal pain as prominently as testicular torsion. Thus, considering the acute nature of the symptoms and