Acute scrotum in the pediatric emergency room: A single center retrospective study

Abstract

(Objective) The objective of this study was to survey cases of acute scrotum examined at the pediatric emergency room (ER). (Subjects and methods) All patients examined for acute scrotum at the emergency outpatient unit between March 2010 and March 2014 were designated subjects of the study. Medical records were used to retrospectively investigate the final diagnoses including testicular torsion (TT), torsion of the testicular appendage, epididymitis, orchitis, incarcerated inguinal hernia, idiopathic scrotal edema, Schonlein-Henoch purpura, hydrocele, external trauma, as well as those with no confirmed diagnosis. (Results) A total of 257 patients presented with acute scrotum at the emergency outpatient unit. The patients had an average age of 6.7 years, with symptoms present on the right side in 120 cases (47%), left side in 108 cases (42%), and both sides in 29 cases (11%). Observing the frequency of each condition, TT was present in 33 cases (13%), torsion of the testicular appendage in eight cases (3%), epididymitis in 85 cases (33%), orchitis in four cases (2%), incarcerated inguinal hernia in 59 cases (23%), idiopathic scrotal edema in six cases (2%), Schonlein-Henoch purpura in nine cases (4%), hydrocele in 10 patients (4%), external trauma in 12 patients (5%), and unconfirmed diagnosis in 31 cases (12%). Average time between onset and presentation at the ER was 0.6 days for TT, with patients having previously been examined at other hospitals before coming to this institution in 12 cases (36%). Emergency urological surgery was performed in 31 cases (12%), with TT comprising 28 cases (90%), and orchiectomy performed in six cases (21%). (Conclusion) Of all patients examined for acute scrotum, epididymitis were high and TT in 13% at the pediatric ER. Average time for TT patients from symptom onset to ER presentation were longer, we must ensure that patients present at earliest possible opportunity requires educating the general population.