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Review Question - QID 213778

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QID 213778 (Type "213778" in App Search)
A 13-year-old boy presents to the emergency department with a 1-hour history of nausea and vomiting. He says that these symptoms came on with right lower quadrant abdominal pain as well as pain in the right scrotum. Physical exam reveals an erythematous and swollen right scrotum. He also has tenderness to deep palpation of the right lower quadrant without guarding or rebound. Stroking of the thigh does not elicit any response. Which of the following mechanisms is most likely responsible for this patient's symptoms?