Testicular Examination for Children presenting with Abdominal Pain

Author

Mumin Mohamed

While oncall we noticed multiple instances when a child who presented to ED with abdominal pain hadn’ t had a groin/perineal examination. Are boys (0-15 years old) presenting to a paediatric ED with abdominal pain receiving the appropriate clinical examination?

Excerpt from GIRFT Children and Young People: Testicular Torsion Pathway, v2 October 2025

According to GIRFT Recommendations on Testicular Torsion. All children presenting to Emergency services with abdominal pain should

always have a testicular examination.

Excerpt from GIRFT Children and Young People: Testicular Torsion Pathway, v2 October 2025

100% of boys (of all ages) presenting with abdominal pain should have a testicular examination performed as part of an appropriate clinical examination

  • We used Slicer Dicer to obtain all MRNs for boys coming to ED with Abdominal pain and/or Constipation And/or groin pain as a ‘presenting complaint’ on EPIC system.

  • Within Month of July

  • 198 patients were obtained

    • of which 50 where sent to Urgent care and therefore had no Documentation on EPIC

    • 18 Didn’t have abdominal pain listed as a presenting complain in the initial clerking and were excluded.

  • Left with 130 boys

  • The initial clerking note was reviewed to get information like : Age, ED Doctor Grade, Testicular Examination, Surgical Doctor Grade if reviewed by one

TLDR ;

We are not achieving the target.

Summary statistics for age for our patients :

Median   Mean   Max. 
     7      7     15

ED Doctors Examination of Various Systems in Comparison with Testicular Examination

  • Overall Examinations of Testicles for boys with Abdominal pain is not adequate

  • Surgical St3+ dont always examine the testes as part of routine examination for abdominal pain

  • Non-Surgical St3+/SHO dont always examine the testes other systems more frequently than testes

  • We are preferentially not examining testes for obscure diagnosis(

  • Re-Audit in a months time to asses change

  • Audit other parts of GIRFT