Acute Scrotum: Validating the role of Color Doppler Ultrasonography in children and young adults

Abstract

Introduction: Acute scrotum is a surgical emergency and a rapid diagnosis is important to save testis from irreversible harm. Study was carried out to outline the etiology of acute scrotum in children and young adults to establish the role of Doppler Ultrasonography substantiating the role of clinical examination. Materials and Methods: In this study we examined reliability of color Doppler ultrasonography comparing operative finding and clinical course. 50 patients of less than 25 years of age with acute scrotum admitted or managed in OPD were included in the study. The patients were categorized into two groups. One group comprised of patients who needed immediate surgical exploration on the basis of history, physical examination and Doppler Ultrasonography (suggestive of testicular torsion).The second group, had patients who on the basis of history, physical examination and Doppler Ultrasonography (suggestive of epididymo-orchitis, etc) were managed conservatively. Results: Doppler ultrasonography in acute scrotum diagnosed the condition with torsion of testis, epididymo-orchitis and torsion of testicular appendages. Sensitivity and specificity of Color Doppler ultrasonography for testicular torsion was 86.93% and 92.6% respectively and for epididymo-orchitis was 95.3% and 100% respectively. Conclusion: Color Doppler Ultrasonography is highly sensitive, specific, very safe and a noninvasive method of evaluating acute scrotum in children and young adults. It is not only helpful in timely surgical intervention for testicular salvage but also helps in avoiding unnecessary surgical exploration.