Treatment of acute scrotum in children: 5 years' experience

BACKGROUND A retrospective review was carried out to determine the incidence of various causes and outcome of management in patients with acute scrotum. METHODS Fifty children had a diagnosis of acute scrotum between 1st January 2007 and 15th May 2012. Age, mode of presentation, associated anomalies, and results of treatment were studied. Diagnosis of acute scrotum was confirmed by physical examination, Doppler ultrasound and biochemical investigations. RESULTS Clinical presentation consisted of sudden swelling and pain in the inguinoscrotal region. The average age was 7.5 years (2 months-14 years). Causes of acute scrotum were orchitis/epididymo-orchitis (O/EO) in 22, strangulated inguinal hernia (SIH) in 16, testicular torsion (TT) in 11, and torsion of testicular appendage (TTA) in 1. Associated urological anomalies were found in 5 patients with O/EO. Medical treatment was applied to patients with O/EO, and surgical treatment was performed in patients with SIH, TT and TTA. CONCLUSION In this series, O/EO was found to rank first as the cause of acute scrotum. Immediate surgical treatment in acute scrotum patients, except those with O/EO, is necessary. Associated urological anomalies should be investigated in patients with O/EO.