Acute scrotum in children and young adults; clinical profile and management

Testicular torsion is a surgical emergency. Early diagnosis and timely intervention salvages the testis. Methods; 50 patients of acute scrotum were admitted in general surgery department who were ≤25 years of age. After Detailed history, thorough examination, relevant investigations and Doppler ultrasound, patients were divided into two groups. Group A included patients who required immediate surgical intervention and Group B included patients who were managed conservatively. Type of surgical procedure, Postoperative period, hospital stay and follow up findings were noted. Results: Youngest patient was 10 months old and eldest was 24 years old. Most common presentation was scrotal pain seen in 49 patients followed by scrotal swelling in 48 patients. All patients underwent baseline investigations and Doppler untrasound scrotum. Group A pncluded 27 patients; 23 testicular torsion, epididymo-orchitis 1 patient, torsion of testicular appendage 1 patient, incarcerated inguinal hernia 1 patient and traumatic haematocele 1 patient. Average Hospital stay in this group was 4 days. On follow up at 3 weeks all patients were symptom free and wound was healthy. Group B included 20 patients of epididymo-orchitis, 2 patients of torsion of testicular appendage and one patient of idiopathic scrotal edema. They were provided rest, antibiotics, antnflamatory drugs and proteolytic enzymes. All patients in group B resolved by conservative management and were discharged at average of 3 days. At follow up all patients were settled and symptom free. Conclusion; Early diagnosis and timely intervention prevents gangrene and hence loss of testis.