title: Acute scrotum caused by vasitis with abscess formation in children with lower urological anomalies.
abstract: OBJECTIVE
  The major causes of acute scrotum include testicular torsion, torsion of an appendix testis, and epididymo-orchitis. Recently, we experienced rare cases of acute scrotum caused by vasitis. Such a condition has not been previously reported in the literature so we summarize our patients with acute scrotum and discuss the pathogenesis of these rare cases.
  
  
  METHODS
  Thirty-two pediatric patients were admitted to our institutions with a diagnosis of acute scrotum between 1997 and 2008. The average age of the patients was 7.1 years. We summarize and review the clinical and pathologic features of 2 patients with vasitis with abscess formation.
  
  
  RESULTS
  The causes of acute scrotum included epididymitis, testicular torsion, and vasitis, among others. Testicular torsion was initially suspected in 23 of the patients. Twenty-three patients underwent emergency surgery, among whom 9 received orchidectomies. The initial diagnosis differed from the final diagnosis in 20 patients (62.5%). Two patients were diagnosed with vasitis. Both underwent emergency operations under a putative diagnosis of testicular torsion, and both were found to have hard tumorlike lesions in the scrotal portion during the surgery. These same 2 cases also suffered from lower urological anomalies, namely, hypospadias, posterior urethral valve, and Müllerian duct remnant.
  
  
  CONCLUSIONS
  Based on our experience, we propose that lower urological anomalies predispose children to vasitis and subsequent abscess formation. Pathologic conditions of this type have to be considered as potential causes of acute scrotum.
authors.affiliation: Department of Surgery, Nagasaki University, Graduate School of Medical Sciences, Nagasaki, Japan. fendikun_izuchan@yahoo.co.jp
authors.forename: Izumi
authors.initials: I
authors.lastname: Muraoka
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Ohno
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
authors.forename: Tomayoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Akira
authors.initials: A
authors.lastname: Satomi
mesh_terms: D000038:Abscess / Q000150:complications*; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005832:Genital Diseases, Male / Q000150:complications* / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D012611:Scrotum; D014521:Urethra / Q000002:abnormalities; D014649:Vas Deferens; D055815:Young Adult