Title: A Study of Acute Scrotum in Pediatric Patients
Authors: Dr Ajay M Naik, Dr Jeevan V Shinde
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.38
Abstract
Background: The diagnosis of Pediatric acute scrotal pain can be one of the most interesting and challenging aspects in medicine. Clinical signs may be inconsistent and investigations are not always definitive in establishing the diagnosis. We now review the different etiologies, differential diagnosis and management strategies of acute pediatric scrotum.
Methods: A retrospective review of all recorded cases of acute scrotal pain in patients aged 12 years or below admitted at SKN medical college hospital, Pune between January 2009 and October 2017.
Results: Out of 150 cases, Torsion of testis (46) was commonest cause of acute scrotum followed by incarcerated inguinal hernia (45), torsion of testicular appendage (40), epididymo-orchitis (10), idiopathic scrotal edema (6), hematocele (2) and pyocele (1). Most (36%) of the patients were in the first year of life. The commonest signs were pain and swelling (66%) followed by pain, swelling and redness (18%) and pain alone (14%). 118 patients consisting of 46 with torsion of testis, 15 with torsion of testicular appendage, 45 with incarcerated hernia, 9 with epididymo–orchitis, 2 with haematocele and one with pyocele underwent surgical exploration. 20 patients with torsion of testis had orchiectomy and orchiopexy of contra–lateral testis and the rest had detorsion and bilateral orchiopexy.
Conclusion: Regardless of the etiology, it is of great importance that the patient seeks medical assistance promptly. Early exploration of scrotum based on careful physical examination excludes the risk of misdiagnosis and unnecessary delay by diagnostic techniques.
Keywords: scrotal pain, Scrotal swelling, Testicular torsion
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