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Treatment of acute scrotum in children: 5 years' experience
Volkan Sarper Erikci1, Münevver Hoşgör, Nail Aksoy
1Department of Pediatric Surgery, Dr. Behçet Uz Children Training and Research Hospital, İzmir, Turkey. verikci@yahoo.com
Insights
Orchitis/epididymo-orchitis is the most common cause of acute scrotum in children. Prompt surgical intervention is crucial for conditions like strangulated inguinal hernia and testicular torsion, while urological anomalies require investigation in orchitis/epididymo-orchitis cases.
Area of Science:
- Pediatric Urology
- Surgical Management
- Diagnostic Imaging
Background:
- Acute scrotum is a common pediatric surgical emergency.
- Determining the incidence and etiology of acute scrotum is vital for effective management.
- Retrospective reviews aid in understanding disease patterns and outcomes.
Purpose of the Study:
- To determine the incidence of various causes of acute scrotum in children.
- To evaluate the outcomes of different management strategies for acute scrotum.
- To identify associated urological anomalies in patients presenting with acute scrotum.
Main Methods:
- Retrospective review of 50 pediatric patients diagnosed with acute scrotum (2007-2012).
- Data collected included age, presentation, associated anomalies, and treatment outcomes.
- Diagnosis confirmed via physical examination, Doppler ultrasound, and biochemical tests.
Main Results:
- Orchitis/epididymo-orchitis (O/EO) was the most frequent cause (n=22), followed by strangulated inguinal hernia (SIH) (n=16), testicular torsion (TT) (n=11), and torsion of testicular appendage (TTA) (n=1).
- Average age was 7.5 years; common presentation was sudden inguinoscrotal swelling and pain.
- Five patients with O/EO had associated urological anomalies. Medical management for O/EO, surgical for SIH, TT, and TTA.
Conclusions:
- Orchitis/epididymo-orchitis is the leading cause of acute scrotum in the pediatric population.
- Urgent surgical intervention is recommended for SIH, TT, and TTA.
- Investigation for associated urological anomalies is essential in cases of O/EO.
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.
