The Acute Scrotum: A Review of 40 Cases

Abstract

Objective: To determine the relative importance of clinical presentation, laboratory studies, and ultrasonography in the diagnosis of acute scrotum, and to suggest an effective method of management. Subjects and Methods: Forty patients who were hospitalized between January 2002 and December 2002 for acute scrotum were studied with respect to history, physical examination, blood tests, urine analysis including culture, and scrotal ultrasonography with color Doppler study. Results: Epididymitis (n = 24) was the commonest cause of acute scrotum followed by testicular torsion (n = 11), torsion of testicular appendages (n = 4), and idiopathic scrotal edema (n = 1). Both mean age (40.7 vs. 13.8 years), and average duration of pain at presentation (4.5 days vs. 19.1 h) were higher in patients with epididymitis than in torsion. Onset was usually insidious in epididymitis, sudden in testicular torsion, and variable in torsion of testicular appendages. The majority (87.5%) of patients with epididymitis were managed conservatively. The testis was salvaged in 81.8% of patients with testicular torsion. The accuracy of ultrasonography was only 72.7% in testicular torsion, but was good in epididymitis. Conclusion: Our results show that a careful clinical evaluation, by an experienced examiner, provides the correct diagnosis in acute scrotum rather than ultrasonography. It is of utmost importance to exclude testicular torsion in those who are younger than 16 years and whose pain duration is less than 24 h.

Acute idiopathic scrotal edema: ultrasonographic findings at an emergency unit

“…Pain in the scrotal wall is not characteristic, but a b c e d Fig. 1 has been reported in several studies [2,5,6]. Tenderness of the skin is another feature, but this tenderness does not extend to the testis or adnexa [7].…”

“…AISE is more commonly observed in children than in adults [1], and is the fourth most common cause of acute scrotum in patients aged below 20 years, following epididymitis, testicular torsion, and torsion of appendages [2]. Since AISE manifests characteristics similar to those of other surgically correctable acute scrotal disease, it is important to confirm diagnosis to avoid unnecessary surgery.…”

Etiology of acute scrotal pain in children and adolescent patients admitted in Ahvaz Educational Hospitals

“…In the study carried out by Abul et al [4] on patients aged 0-69 years, epididymitis was the most common cause of acute scrotum, followed by testicular torsion. In most reports, torsion of the appendix of testis was the most common diagnosis [5][6][7].…”

Rapid Differentiation of <b><i>Candida dubliniensis</i></b> from <b><i>Candida albicans</i></b> by Early <i>D</i>-Xylose Assimilation

“…All the isolates were further identified based on their carbohydrate assimilation pattern by API 20C AUX yeast identification system (bioMerieux, France). The identity of C. dubliniensis was confirmed by production of rough colonies with hyphal fringes and chlamydospores on simplified sunflower seed agar and by using seminested PCR amplification of internal transcribed spacer (ITS)-2 region of rDNA followed by direct DNA sequencing of the ITS region of rDNA as described previously [20]. …”