Outcomes of routine surgical exploration in children who admitted to the emergency service with acute scrotum

Year 2017, Volume: 3 Issue: 2, 152 - 156, 04.07.2017

Serpil Sancar , Esra Ozcakir , Mete Kaya

https://doi.org/10.18621/eurj.269349

Abstract

Objectives. The acute scrotum
frequently presents a diagnostic and therapeutic challenge. In cases where the testicular
torsion cannot be excluded, a surgical exploration is recommended. The aim of
the study was to present the results of our management in the patients with acute
scrotum. Methods. We reviewed the medical records of 33 patients
suffering from acute scrotal pain underwent scrotal exploration between 2011
and 2016. Anamnestic data (age of patient, duration of anamnesis prior to
admission and the side that was involved), scrotal color Doppler ultrasound
(SCDUS) results, intraoperative findings, mode of operative treatment, and the
clinical outcomes were analyzed. Results. Patients aged from several
hours up to 17 years of age (average 11.9 years). The duration of symptoms
prior to admission ranged from 3 h to 4 days, (average 32 h). Acute scrotum was
found 18 in right side, 15 in left side. SCDUS was diagnostic for testicular
pathologies in 19 (51%) of 30 patients. In patients who underwent scrotal
exploration, 18 (54%) had a testicular torsion, 11 (33%) had a torsion of the appendix
testis, and 4 (12%) had an orchio-epididymitis. Three patients who found testicular
torsion required an orchidectomy immediately because of necrosis. The rest had
detorsion and ipsilateral fixation of testis. Three patients underwent second
look, and orchiectomy was performed in 2 of them. In 2 of detorsioned testes,
two testicular atrophies developed on follow-up period. Conclusion. Regardless of
the etiology, the management of the patients with acute scrotum by urgent
surgical intervention allows the salvage of a possible testicular torsion. 

Keywords

Acute scrotal pain, testicular torsion, torsion of appendix testis, orchio-epididymitis

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