Vol 8, No 3 (2006)
Published online: 2006-08-02
Acute scrotum - a still relevant clinical problem
Chirurgia Polska 2006;8(3):191-197.
Abstract
Background: The complaints caused by the acute scrotum syndrome (ASS) are among the most frequent
indications for emergency surgical intervention in boys of different ages. The most dangerous type
of ASS, from the point of view of possible complications, is torsion of testicle.
Material and methods: A retrospective analysis of the causes of ASS, as well as the methods of treatment used on 153 boys with this condition, was the focus of this study. The boys were aged from 5 days to 16 years and underwent treatment at the Department of Pediatric Surgery of University Children’s Hospital No. 4 in Łódź from1998 to 2004.
Results: Of 140 patients who underwent revision of the scrotum, torsion of the appendix of the testicle was found in 103 (67%), torsion of the testicle itself in 20 (21%) and epididymitis in 18 boys (12%). The most severe symptoms (pain) were observed in patients with torsion of the testicle while they also presented themselves to the hospital fastest.
Conclusions: The observations of the authors of this study show, among other things, that:
- the borderline beyond which the ischaemic changes in the tortuous testicle were irreversible, lay between the 4th and 5th hour since the onset of disease;
- it is possible that ASS symptoms could have regressed spontaneously without surgical intervention in a number of boys residing in the countryside. If US-Doppler is not available, symptoms of ASS are still, in the authors’ opinion, an indication for operative revision of the scrotum.
Material and methods: A retrospective analysis of the causes of ASS, as well as the methods of treatment used on 153 boys with this condition, was the focus of this study. The boys were aged from 5 days to 16 years and underwent treatment at the Department of Pediatric Surgery of University Children’s Hospital No. 4 in Łódź from1998 to 2004.
Results: Of 140 patients who underwent revision of the scrotum, torsion of the appendix of the testicle was found in 103 (67%), torsion of the testicle itself in 20 (21%) and epididymitis in 18 boys (12%). The most severe symptoms (pain) were observed in patients with torsion of the testicle while they also presented themselves to the hospital fastest.
Conclusions: The observations of the authors of this study show, among other things, that:
- the borderline beyond which the ischaemic changes in the tortuous testicle were irreversible, lay between the 4th and 5th hour since the onset of disease;
- it is possible that ASS symptoms could have regressed spontaneously without surgical intervention in a number of boys residing in the countryside. If US-Doppler is not available, symptoms of ASS are still, in the authors’ opinion, an indication for operative revision of the scrotum.
Keywords: acute scrotum syndromeboystorsion of the testicletorsion of the appendix of the testicleepididymitis
