Acute Scrotum in Pediatric: Clinical Presentation and Management in Royal Medical Services Hospitals

Abstract

Objectives: Children with acute scrotum usually present with acute scrotal pain. To rule out testicular torsion with consequent ischemia, this complaint is considered a top emergency that should be treated quickly. The objective of this study was to assess the clinical presentation and treatment of the acute scrotum in pediatric surgery. Method: A prospective study, which included 107 patients, was conducted in Queen Rania Hospital, Jordan, in the period January 2016–April 2020. Patients above 14 years old and those under conservative treatment, such as IV antibiotics for epididymo-orchitis, were excluded. In addition to scrotal exploration, the diagnosis was made via Doppler ultrasonography (DUS). Results: The main results revealed that the causes of acute scrotum are testicular torsion (35.5%), epididymo-orchitis (20.5%), torted hydatid of Morgagni (28.9%), hematoma (4.6%), scrotal abscess (1.8%), and tumor (0.9%). The most common signs and symptoms were tenderness (86%), erythema (77.6%), and edema (71.9%). In patients with testicular torsion, the salvage rate was around 65.8% for surgeries performed in durations up to 48 h from symptom onset. Conclusion: Testicular torsion is the most significant diagnosis that leads to testicular loss.