Acute scrotal pain in children: prospective study of diagnosis and management.
Forty-eight boys were assessed for an acutely painful scrotum. Thirty-six (75%) of them underwent radionuclide scanning of the scrotum; the average age of this group was 11 years. The scan revealed epididymitis in 19 cases, spermatic cord torsion in 9, appendix testis torsion in 7 and acute hernia-hydrocele in 1. The diagnosis was confirmed at operation in all nine cases of spermatic cord torsion. Boys who had epididymitis received antibiotics only; all were available for short-term follow-up, and 16 were also assessed at a mean of 6 months after infection. Only one boy had testicular atrophy; he had undergone repair of an inguinal hernia, which could not be ruled out as a cause. Bacteriuric epididymitis occurred in three boys; two had known predisposing genitourinary anomalies, the third had no abnormalities. Boys who had nonbacteriuric epididymitis were investigated by renal and pelvic ultrasonography or voiding cystourethrography; no important abnormalities were detected. This prospective study indicates that radionuclide scanning can reliably differentiate spermatic cord torsion from other acute scrotal disease.
Anderson
P A
PA
Department of Surgery, Izaak Walton Killam Hospital for Children, Dalhousie University, Halifax, NS.
Giacomantonio
J M
JM
Schwarz
R D
RD
D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004823:Epididymitis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012611:Scrotum / Q000000981:diagnostic imaging; D013086:Spermatic Cord Torsion / Q000000981:diagnostic imaging* / Q000601:surgery; D013733:Testicular Diseases / Q000000981:diagnostic imaging; D014102:Torsion Abnormality / Q000000981:diagnostic imaging
D000900:Anti-Bacterial Agents