Urgent surgical exploration of the scrotum of a child or teenager who presents with a painful and swollen scrotum is paramount if testicular torsion should not to be missed. It is extremely rare for a non-scrotal pathology to present with acute scrotal signs. Here we present such a rare case in an adult and emphasize the importance of being aware of this potential clinical pitfall. Abscess formation is a well-known complication of appendicular pathology and it may be intra-abdominal or pelvic. Acute scrotum following an appendicular abscess perforation is very rare.

NEED FOR STUDYThe present study is to use a simple bedside tool as a scoring system to assess the severity of acute pancreatitis and to predict its risks for morbidity and mortality. The main criteria of this study is to highlight the ease of using this tool to identify the severity of acute pancreatitis as early as possible in order to reduce the complications, risks and to improve the outcome and overall survival. MATERIALS AND METHODSOur study is a single centre, prospective observational study conducted at Rajarajeshwari Medical College Hospital, Bangalore, India from September 2014 to September 2015. Forty six patients, both males and females presenting within 24 hours of onset of symptoms diagnosed with acute pancreatitis were included in the study. Informed consents were obtained from all patients. Cases of chronic pancreatitis and acute on chronic pancreatitis were excluded. Pediatric patients of age less than 14 years and geriatric patients more than 70 years were excluded. RESULTSWe observed that biliary pancreatitis was the most common with male population more affected than females. Pain abdomen was the most common presentation in the entire study population. Necrotizing pancreatitis was most commonly associated with ICU admission and prolonged hospital stay. Patients with organ failure and BISAP score more than 3 were found to have prolonged hospital stay. SIRS was the most common component of BISAP scoring system seen in 91.3%. Elderly patients with age more than 60 years (6 pts.) had high BISAP score (5). All patients with shock had BISAP score of >3. A BISAP score of ≥3 was associated with higher morbidity than scores of <3. CONCLUSIONBISAP is a simple and a quick tool over other scoring systems and is similar to other scoring systems to predict the severity and prognosis of acute pancreatitis. In summary we have studied the ease of BISAP scoring system and its advantage in early recognition of acute pancreatitis, thus taking early steps to provide specific treatment to prevent complications, reduce the risks and to improve the overall survival.

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