Scrotal emergencies-Two case reports on scrotal exploration scenarios (original) (raw)
Related papers
Acute scrotum — Etiology and management
Indian Journal of Pediatrics, 2005
Objective: Acute scrotal pain is a common urological emergency. Urgent exploration is the standard means of management, since no investigation can confidently exclude torsion of testis from the differential diagnosis.Methods: A review of all boys presenting with acute scrotal pain who underwent emergency scrotal exploration between January 1983 and March 2003 was performed.Results: 195 boys were included in this study. They were divided into 3 groups: group 1–73 with epididymo-orchitis, group 2–63 with torsion of testicular appendages and group 3–57 with spermatic cord torsion. The patients in group 2 were older than group 1, also patients in group 1 were older than group 3. During neonatal period the most common pathology was spermatic cord torsion, whereas in prepubertal period torsion of appendages was more common. In all boys, mean duration of pain at presentation was 2.11 days. Epididymo-orchitis was diagnosed in 37% of patients, with torsion of the appendages being the next most common entity. Testicular torsion was diagnosed in 29% of patients. In the group with testicular torsion salvage rate of testis was 37% because of late admission. The perioperative morbidity and mortality was not seen in any of the groups.Conclusion: We believe that any boy with acute scrotal pain and any suspicion of testicular torsion in physical examination must be applied routine surgical exploration.
Rational Approach to Diagnosis and Management of Blunt Scrotal Trauma
Urology, 2007
To provide a rational approach to the diagnosis and management of blunt scrotal trauma to aid clinicians in the selection of patients for surgical exploration. We performed a retrospective evaluation of the medical records of 44 patients from two metropolitan tertiary referral hospitals. A total of 29 patients were recruited from July 1, 1993 to June 30, 2003 at one institution and an additional 15 patients from February 1, 1991 to January 31, 1999 at the second. Scrotal ultrasound scans were retrieved and reviewed by a uroradiologist unaware of the treatment regimen and outcome. The presence of both testicular swelling and tenderness suggested more significant testicular injury; however, testicular rupture was present in the absence of tenderness. Three patients with operatively confirmed testicular rupture had only swelling on clinical examination. Five patients with intratesticular hematoma were successfully treated conservatively with interval ultrasound scans recommended to assess for resolution. All patients with operatively confirmed testicular rupture had a combination of the following ultrasound features: the presence of hematocele, disruption of the tunica albuginea, and/or extrusion of the seminiferous tubules. Patients presenting after blunt scrotal trauma with clinical hematocele should progress directly to exploration. The remainder should undergo scrotal ultrasonography. Those with large hematoceles or suspected rupture on ultrasonography should also proceed to exploration. Those without hematocele, a clearly distinct tunica albuginea, and a lack of fracture planes within the testes are a subgroup that can be successfully treated conservatively.
Gezira Journal of Health Sciences, 2014
Objective : To evaluate the clinical presentation, causes, management and outcome of patients who presented with clinical aspect of acute scrotum. Material and methods: A total of 72 patients aged from one day to adulthood period hospitalized with acute scrotum were included in the study. Most of patients underwent surgical exploration of the scrotum, and the medical records were revised to obtain information regarding operative findings and post-operative complications. Results : The different common causes of acute scrotal pain were testicular torsion (27.8%), epididymo-orchitis (20.8%), and torsion of testicular appendix (19.4%). The most common age group affected by the disease is between 10 and 20 years (37.5%). Approximately two-thirds of patients presented late after 24 hours of onset of pain (61.1%), and (9.2%) developed post-operative complications. Conclusion: Generally, children and teenagers are more likely to be affected by scrotal conditions, and most patients presente...