Acute scrotum in children: Jordan university hospital experience

Introduction: Acute scrotum is one of the common surgical emergencies in pediatric age group. Although the differential diagnoses are many, most of the conditions are not urgent; of paramount importance is the prompt diagnosis and surgical treatment of torsion of the test is to avoid permanent ischemic damage. In this study we present our experience at University of Jordan Hospital in management of acute scrotum in children. Methods: A retrospective review of the pediatric patients who were admitted to the pediatric surgical unit at Jordan University Hospital with acute scrotum from March 2008 to March 2013. The characteristics of symptoms, clinical and imaging findings prior to operation, operative findings and type of management were recorded. Results: A total of 59 patients with acute scrotum were admitted and constituted the basis of this study. Operative exploration was performed in all of the 59 cases: Four patients (7%) had testicular torsion, 28patients (48%) had torsion of testicular appendix, 13 patients(22%), had epididymoorchitis, three patients had idiopathic scrotal edema; three patients (5%) had scrotal hematomas due to trauma; two patients(3%) had incarcerated inguinal hernias; two patients(3%) had hydroceles and four patients (7%) had normal findings. Conclusions: testicular torsion is a common surgical emergency in children which should be treated promptly with early scrotal exploration; since no diagnostic test in the pre-operative work up could differentiate between the different causes and excludes torsion testis which is the major concern. A prospective study to evaluate the diagnostic accuracy of Doppler ultrasonography is suggested based on the results of the predictive values seen in our study.