Acute Scrotum

Abstract

The great majority of cases of acute scrotum are due to one of three causes: trauma, torsion or epididymo-orchitis. Differential diagnosis also includes a few rare conditions: strangulated hernia, testicular tumour, haematocele and idiopathic scrotal oedema, Henoch-Schönlein purpura and scrotal fat necrosis. In younger subjects, testicular or appendiceal torsions account for over half of cases of acute scrotum, with an additional third due to epididymo-orchitis. The latter is the most frequent cause in adults, followed by trauma. Acute scrotum syndrome, whether of traumatic, ischaemic or inflammatory origin, always merits immediate evaluation as early intervention is very likely to preserve testicular function, whereas a delay will almost invariably lead to chronic irreversible complications.