[Clinical study of acute scrotum]

Acute scrotum is a clinical syndrome which includes various disorders. Differential diagnosis of these disorders is not always easy. We reviewed cases experienced in our hospital, focusing on diagnostic procedures. Final diagnosis in 39 cases were acute epididymitis in 23 cases, torsion of the testis in 13 cases, torsion of appendix epididymis in 2 cases and torsion of appendix testis in 1 case. It became clear ultrasonography was a useful diagnostic procedure; if the torsed portion is delineated, torsion of the testis can be diagnosed. Heterogenous echoes from the interior of the testis indicate the necrosis of the testis. Inspection was also useful; if the blue dot sign is detected, torsion of the appendix testis/epididymis is indicated. However, Doppler ultrasound did not always provide a correct diagnosis of torsion of the testis. If torsion of the spermatic cord cannot be completely ruled out, early surgical intervention and treatment are considered essential.