Nonscrotal Causes of Acute Scrotum

Abstract

Acute scrotum is characterized by intense acute scrotal pain, which may be associated with other symptoms and signs such as abdominal pain, inflammation, and fever. Many pathologic conditions can present in this way, most which involve the scrotal contents. Nonscrotal conditions, however, can rarely present clinically only as acute scrotum: among them, renal colic, aneurysm rupture or other causes of retroperitoneal hemorrhage, primary abdominal or pelvic tumors and metastases, pancreatitis, pelvic inflammation, and muscle injuries. The pathophysiologic characteristics of the clinical presentation, clues for diagnosis, and imaging features of a series of nonscrotal lesions presenting clinically with acute scrotal pain are herein reported and illustrated. In patients presenting with acute scrotal symptoms and normal scrotal ultrasound findings, nonscrotal causes of acute scrotal pain should be considered in the differential diagnosis. Therefore, an ultrasound investigation of the abdomen, groin, and thighs is indicated.

A retroperitoneal mass presenting as acute scrotum: a rare presentation and review of the literature

“…The acute scrotum is characterized by intense acute scrotal pain that might be associated with other signs and symptoms such as abdominal pain, inflammation and fever [ 1 , 2 ]. Accurate and early diagnosis of the acute scrotum is of the utmost importance to avoid testicular loss and/or needless surgery [ 1 ].…”

“…Acute scrotal pain is defined as a sudden onset of pain, swelling, with or without tenderness of the intrascrotal contents. Patients may describe the onset of symptoms occurring within minutes up to 1–2 days, dependent on the etiology [ 1 , 2 ]. The differential diagnosis of the acute scrotum includes a wide variety of diseases.…”

“…Other causes of the acute scrotum are torsion of the testicular appendix, epididymitis, epididymo-orchitis, scrotal abscess and testicular cancer [ 1 ]. However, non-scrotal conditions are rarely present clinically only as acute scrotum such as renal colic, ruptured aneurysm or other causes of retroperitoneal pathologies [ 2 ]. Evaluating acute scrotum sometimes could be a diagnostic challenge and must be carefully evaluated with full patient history, physical examination, laboratory tests and imaging studies [ 1 , 2 ].…”

“…However, non-scrotal conditions are rarely present clinically only as acute scrotum such as renal colic, ruptured aneurysm or other causes of retroperitoneal pathologies [ 2 ]. Evaluating acute scrotum sometimes could be a diagnostic challenge and must be carefully evaluated with full patient history, physical examination, laboratory tests and imaging studies [ 1 , 2 ]. Doppler ultrasonography is the most appropriate imaging modality for acute scrotal evaluation, which has a sensitivity range between 96 and 100% and specificity between 84 and 95% when it does not delay definitive surgical consultation in cases of presumed torsion [ 1 ].…”

“…Doppler ultrasonography is the most appropriate imaging modality for acute scrotal evaluation, which has a sensitivity range between 96 and 100% and specificity between 84 and 95% when it does not delay definitive surgical consultation in cases of presumed torsion [ 1 ]. In cases of non-scrotal causes of acute scrotum, ultrasound extended to the abdomen, groin and thighs, and further imaging modalities are considered when needed [ 1 , 2 ].…”