Acute scrotal swelling in children

Caldamone, Anthony A.; Valvo, John R.; Altebarmakian, Varoujan K.; Rabinowitz, Ronald

doi:10.1016/s0022-3468(84)80109-8

Cited by 62 publications

(19 citation statements)

References 18 publications

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“…The acute scrotum in children is often a diagnostic puzzle with the need to differentiate, promptly and accurately, cases of TT from those of a number of other non-surgical conditions [1]. Radiological studies, such as CDU and scintigraphy [3,4], have been suggested to be of use in order to spare unnecessary surgery, but no agreement has been reached about the ideal work up of these patients, and some authors still advise surgical exploration in every case [5].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of testicular viability in testicular torsion

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Castagnetti

et al. 2007

Journal of Pediatric Urology

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Aim: Testicular torsion (TT) requires prompt diagnosis and treatment to avoid testicular loss. Most studies have focused on the ideal work up to rule TT out in cases of acute scrotum. We attempted here to define objective criteria to select between orchidopexy and orchidectomy in patients undergoing surgery for TT. Patients and methods: Fifteen boys with a median age at presentation of 7.8 (range 6.4e12) years undergoing surgical treatment for TT underwent color-Doppler ultrasound (CDU) preoperatively, and a bleeding test intraoperatively. Duration of preoperative history, degree of torsion, CDU findings and degree of bleeding were analyzed. Results: Salvageability was independent of the degree of torsion. In patients with a history longer than 10 h, no flow on CDU and no bleeding, after orchidectomy all the testicles were necrotic on pathology. When all these variables were negative, all the testicles did well during follow up. In the group of patients with no agreement among the analyzed variables, the outcome was unpredictable. Five out of six underwent orchidopexy, but in two cases the testicle atrophied (in spite of flow on CDU in one). Conclusions: No predictive parameters were found for testicular salvageability. Taken as a whole, the parameters studied can be of help in treatment choice. In patients with no agreement among the parameters, orchidopexy seems the appropriate option, but parents should be informed of the risk of testicular atrophy during follow up.

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Section: Discussionmentioning

confidence: 99%

“…Testicular torsion (TT) accounts for only about 25% of all cases of acute scrotum in children [1], but requires prompt diagnosis and treatment in order to avoid ischemic necrosis of the testis. Misdiagnosis or delayed diagnosis of TT with subsequent testicular loss is a relatively common subject of litigation [2].…”

Section: Introductionmentioning

confidence: 99%

Predictors of testicular viability in testicular torsion

Cimador

Pace

Castagnetti

et al. 2007

Journal of Pediatric Urology

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“…In the same series, only 4 cases of HSP were found [21]. Several case series [10,13,20,[22][23][24][25][26] have reported a considerable variation in the frequency of scrotal swelling and pain in patients with HSP ( Table 2).…”

Section: Scrotal Symptomsmentioning

confidence: 97%

“…Obviously, torsion of the testis is the single most important condition to Although torsion of the testis occurs most commonly during puberty (mean age, 11-12 years) [21], the mean age of children with HSP and scrotal symptoms is 5 and 7 years, respectively [13,[22][23][24]. However, both entities show a considerable overlap, thus making age a poor diagnostic marker.…”

Section: Scrotal Symptomsmentioning

confidence: 99%