Emergency Medicine

Acute scrotum is a urological emergency characterized by sudden onset of scrotal pain, swelling, and tenderness. It encompasses a spectrum of conditions affecting the testis, epididymis, and surrounding structures. Testicular torsion is the most critical cause of acute scrotum and requires immediate surgical intervention. Other common etiologies include epididymitis, orchitis, torsion of the testicular appendages, and scrotal trauma. Rapid and accurate differential diagnosis is essential to preserve testicular viability. Clinical evaluation includes detailed history taking and focused physical examination. Color Doppler ultrasonography is the imaging modality of choice for assessment of testicular perfusion. Laboratory investigations may assist in identifying infectious or inflammatory causes. Delayed diagnosis or management can result in testicular infarction and loss of reproductive function. Prompt recognition and appropriate treatment are crucial to achieve favorable clinical outcomes in patients with acute scrotum.

Renal colic is a severe, acute pain syndrome most commonly caused by obstruction of the urinary tract by urolithiasis. The pain typically originates in the flank and may radiate to the lower abdomen, groin, or genital region. Renal colic results from increased intraluminal pressure and ureteral smooth muscle spasm proximal to the obstruction. Nausea, vomiting, and haematuria are frequently associated symptoms. Non-contrast computed tomography is considered the imaging modality of choice for the diagnosis of renal colic. Ultrasonography may be used as an initial imaging tool, particularly in pregnant patients or those requiring radiation avoidance. Laboratory evaluation includes urinalysis to detect haematuria and blood tests to assess renal function and infection. Differential diagnosis includes other causes of acute abdominal or flank pain. Initial management focuses on pain control, hydration, and exclusion of complications such as infection or renal impairment. Definitive treatment depends on stone size, location, composition, and patient-related factors.

Virtual scenarios for emergency medicine are developed and improved within projects’ activities of the authors and their primary aim is to foster development of critical thinking in students of medical and healthcare disciplines. Individual patient simulations contribute to the case-based learning approach that is learning style close to the needs of practice. Furthermore, we expect their better preparation for bedside teaching.

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