Lateral thinking

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1114
  1. Derek Chase, general practitioner
  1. Arrowe Park Hospital, Merseyside CH49 5PE

    A 13 year old boy presented to my surgery with an eight hour history of left iliac fossa pain. It was worse on some movements, gripping in nature, and present most of the time. He denied any other symptoms, and there was no recent injury. He was generally well, although he was small and taking growth hormone for hypopituitarism.

    My examination of the abdomen was unremarkable. Having loosened his tracksuit trousers, my drawing his pants down to examine his testicles evoked a …

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