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Published on: August 30, 2024
[Acute scrotum in children]
K Gnassingbe1, G K Akakpo-Numado, B Songne-G
1Service de Chirurgie Pédiatrique, CHU Tokoin BP 57 Lomé Togo. jeanpi_gnass2002@yahoo.fr
Insights
Acute scrotum in children is most commonly caused by incarcerated inguinal hernia, followed by spermatic cord torsion. Prompt diagnosis and treatment are crucial to prevent complications.
Area of Science:
- Pediatric Surgery
- Urology
- Emergency Medicine
Context:
- Acute scrotum is a common surgical emergency in children.
- Timely diagnosis and intervention are critical for preserving testicular function.
- Understanding the local epidemiology of acute scrotum is essential for effective management.
Purpose:
- To determine the incidence of acute scrotum in pediatric patients.
- To identify the primary causes of acute scrotum.
- To outline the treatment strategies for different etiologies of acute scrotum.
Summary:
- A study of 57 children with acute scrotum revealed an incidence of 5.80%.
- The most frequent causes were incarcerated inguino-scrotal hernia (49.12%), spermatic cord torsion (29.83%), and epididymo-orchitis (17.54%).
- Delayed treatment exceeding 72 hours occurred in nearly half of the cases, highlighting a need for prompt evaluation and management.
Impact:
- Highlights the significant proportion of incarcerated inguinal hernias presenting as acute scrotum.
- Emphasizes the importance of surgical intervention for torsion and trauma, and medical management for epididymo-orchitis.
- Underscores the necessity of early diagnosis and treatment to avoid potential long-term complications such as infertility.
Aims:
To evaluate the frequency, to identify the aetiologies of the acute scrotum and to describe their treatment in children.
Material And Method:
Fifty seven children treated for acute scrotum in the paediatric surgery department of the Tokoin teaching hospital (Lomé) between January 2003 to December 2007 were studied.
Results:
The frequency of acute scrotum was 5.80%. The average age was of 4.75 years (range: 7 days to 15 years). The aetiologies were: incarcerated inguino scrotal hernia (49.12%); spermatic cord torsion (29.83%); epididymo-orchitis (17.54%) and testicular trauma (3.51%). The delay of treatment was superior of 72 hours in 49.12%. The pain and the increase of the volume of the scrotum were present in all the patients. The emergency operation was performed in the spermatic cord torsion and the testicular trauma. The medical treatment was performed in the epididymo-orchitis cases. The patients presenting an incarcerated inguino-scrotal hernia benefited from a surgical cure in a delay of eight days after the acute episode. The operative continuations were in any cases simple.
Conclusion:
The diagnosis and the treatment must be precocious in the acute scrotum in order to avoid possible complications.
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