If there is twisting or compression of the spermatic cord or vessels, the compression will lead to occlusion of veins. However the arterial supply to the testis remains patent, and vascular engorgement of the testis results. This condition may arise at any age, but is most common in adolescents following physical trauma. If unrelived, there is ischemia and hemorrhagic infarction of the testis. The condition is extremely painful, and scrotal swelling usually occurs.
Surgical orchiopexy is required to prevent recurrence.
Note the engorged, hemorrhagic appearance of the cut surface of this torsed testis.