The acute scrotum: A review of 40 cases

被引:18
作者
Abul, F
Al-Sayer, H
Arun, N
机构
[1] AL Amiri Hosp, Dept Surg, Urol Unit, Safat 13041, Kuwait
[2] Kuwait Univ, Fac Med, Dept Surg, Safat 13060, Kuwait
关键词
acute scrotum; testis; epididymitis; torsion; testicular appendage;
D O I
10.1159/000084636
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. Copyright (C) 2005 S. Karger AG, Basel.
引用
收藏
页码:177 / 181
页数:5
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