PMC9035904_01
Color Doppler image: Two testicles were lying in the left hemi-scrotum. The lower testicle (A) is smaller than the higher testicle (C) and has normal blood flow (B). There is no visible vascular flow in the higher testicle (D).
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F1
The higher mass, measuring 3.1 x 2.0 cm, did not have visible vascular flow inside on color Doppler examination (Figures 1C,D); the lower mass, measuring 1.9 x 1.5 cm, had visible vascular flow (Figures 1A,B).
Emergency scrotal exploration was performed; the upper left testicle was black and twisted 360  clockwise. The lower left testicle was normal in its color.
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F2
On gross examination, the two testicles share the same vas and two separate epididymites (Figure 2).