Treatment of acute scrotum in children: 5 years’ experience

Background: A retrospective review was carried out to determine the incidence of various causes and outcome of management in patients with acute scrotum.
Methods: Fifty children had a diagnosis of acute scrotum between 1st January 2007 and 15th May 2012. Age, mode of presentation, associated anomalies, and results of treatment were studied. Diagnosis of acute scrotum was confirmed by physical examination, Doppler ultrasound and biochemical investigations.
Results: Clinical presentation consisted of sudden swelling and pain in the inguinoscrotal region. The average age was 7.5 years (2 months-14 years). Causes of acute scrotum were orchitis/epididymo-orchitis (O/EO) in 22, strangulated inguinal hernia (SIH) in 16, testicular torsion (TT) in 11, and torsion of testicular appendage (TTA) in 1. Associated urological anomalies were found in 5 patients with O/EO. Medical treatment was applied to patients with O/EO, and surgical treatment was performed in patients with SIH, TT and TTA.
Conclusion: In this series, O/EO was found to rank first as the cause of acute scrotum. Immediate surgical treatment in acute scrotum patients, except those with O/EO, is necessary. Associated urological anomalies should be investigated in patients with O/EO.

Çocukluk çaðý akut skrotum olgularýnda tedavi yaklaþýmý: 5 yýllýk deneyim

Amaç: Akut skrotum tanýsý ile tedavi edilen olgular altta yatan deðiþik nedenlerin insidansý ve bu olgulardaki tedavi sonuçlarýnýn belirlenmesi amacý ile geriye dönük olarak incelendi.
Gereç Ve Yöntem: 1 Ocak 2007 ile 15 Mayýs 2012 tarihleri arasýnda 50 akut skrotum olgusu tedavi edildi. Yaþ, klinik yansýma, ek anomaliler, týbbi ve cerrahi tedavi sonuçlarý araþtýrýldý. Tüm olgularda taný, fiziksel inceleme, ultrasonografi ve/veya Doppler ultrasonografi ve biyokimyasal incelemelere dayanýlarak konuldu.
Bulgular: Klinik görünüm inguinoskrotal bölgesinde ani þiþlik ve aðrý oluþumuydu. Ortalama hasta yaþý 7,5 yýldý (2 ay-14 yaþ). Olgularýn 22’sinde orþit/epididimo-orþit (O/EO), 16’sýnda strangüle herni (SH), 11’inde testis torsiyonu (TT), bir olguda da appendiks testis torsiyonu (ATT) saptandý. O/EO olgularýnýn 5’inde eþlik eden ürolojik anomaliler saptandý. O/EO olgularý konservatif olarak, SH, TT ve ATT olgularý ise cerrahi olarak tedavi edildi.
Sonuç: Bu çalýþmada E/EO akut skrotum nedeni olarak ilk sýrada bulunmuþtur. O/EO olanlar hariç akut skrotum hastalarda acil cerrahi tedavi gereklidir. Ayrýca E/EO tanýlý olgular ek ürolojik anomaliler açýsýndan ele alýnmalýdýr.