title: Idiopathic scrotal hematoma simulating a testicular torsion, in association with cryptorchidism: US findings.
abstract: BACKGROUND
  An acute scrotum concerns endoscrotal organs (testicles, spermatic cord, tunica vaginalis) and is characterized by pain, swelling and hyperemia of the hemi-scrotum. It represents one of the most common surgical emergencies in children often caused by testicular torsion; the diagnosis is mostly clinical but must be supported by ultrasonographic examination of the scrotal region in association with a colour Doppler study of the spermatic cord vessels and glandular parenchyma. An idiopathic scrotal hematoma is a very rare condition that can simulate it.
  
  
  METHODS
  A 3-day-old full-term baby, otherwise in good health, showed swelling and pain of the left inguinal-scrotal region. A testicular torsion was suspected, so the baby underwent an ultrasound examination of the testis and spermatic cord that showed a left scrotal hematoma with superior displacement of the didymus; the right testicle was located in the internal inguinal canal. Surgical intervention confirmed the sonographic diagnosis of left testicular hematoma and of the right cryptorchidism.
  
  
  CONCLUSIONS
  Although testicular torsion is the most frequent cause of acute scrotum, the possibility of a persistent idiopathic scrotal haematoma and/or haematoma secondary to a trauma of the inguino-scrotal region, must be always taken into account. US diagnosis can avoid unnecessary emergency surgical treatment, required in case of testicular torsion.
authors: Department of Biomorphological and Functional Sciences, Section of Radiology, University Hospital Federico II, Naples, Italy.
authors: Vincenzina
authors: V
authors: Crisci
authors: Department of Tanslational Medical Sciences, "Federico II" University of Naples, Naples, Italy.
authors: Ciro
authors: C
authors: Esposito
authors: Department of Tanslational Medical Sciences, "Federico II" University of Naples, Naples, Italy.
authors: Ida
authors: I
authors: Giurin
authors: Department of Biomorphological and Functional Sciences, Section of Radiology, University Hospital Federico II, Naples, Italy.
authors: Valerio
authors: V
authors: Vitale
authors: Department of Biomorphological and Functional Sciences, Division of Pediatric Diagnostics, University Federico II of Naples, Naples, Italy.
authors: Gianfranco
authors: G
authors: Vallone
keywords: Cryptorchidism; Spermatic Cord Torsion; Ultrasonography, Doppler, Color