Do all Children with an Acute Scrotum Require Exploration?

Abstract

No AccessJournal of Urology1 Aug 1993Do all Children with an Acute Scrotum Require Exploration? Evan J. Kass, Kevin T. Stone, Alexander A. Cacciarelli, and Brent Mitchell Evan J. KassEvan J. Kass , Kevin T. StoneKevin T. Stone , Alexander A. CacciarelliAlexander A. Cacciarelli , and Brent MitchellBrent Mitchell View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)35579-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A total of 77 consecutive children ranging in age from 1 day to 17 years was evaluated for an acute scrotum by a single examiner (E.J. K.). In 10 children a definite diagnosis of acute spermatic cord torsion was made based upon the history and physical examination. No imaging studies were performed and torsion was confirmed at surgery in 9 children. The diagnosis of testis torsion was not as clear-cut in the remaining 67 children and, therefore, a color Doppler ultrasound was performed before any surgical intervention. The study demonstrated normal or increased blood flow in 55 of these children and none proved to have testicular torsion, although other scrotal pathology requiring surgery was noted in 5 children. Twelve children did not demonstrate evidence of testicular blood flow on the color Doppler ultrasound and all had surgical confirmation of testis torsion. We conclude that in our experience the majority (71%) of children with an acute scrotum did not require immediate surgical exploration. Color Doppler ultrasound can reliably identify those children with an acute scrotum who require exploration and spare the majority needless surgery. Routine scrotal exploration is no longer necessary for all children with an acute scrotum. © 1993 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRedshaw J, Tran T, Wallis M and deVries C (2014) Epididymitis: A 21-Year Retrospective Review of Presentations to an Outpatient Urology ClinicJournal of Urology, VOL. 192, NO. 4, (1203-1207), Online publication date: 1-Oct-2014.BENTLEY D, RICCHIUTI D, NASRALLAH P and McMAHON D (2018) SPERMATIC CORD TORSION WITH PRESERVED TESTIS PERFUSION: INITIAL ANATOMICAL OBSERVATIONSJournal of Urology, VOL. 172, NO. 6 Part 1, (2373-2376), Online publication date: 1-Dec-2004.KALFA N, VEYRAC C, BAUD C, COUTURE A, AVEROUS M and GALIFER R (2018) ULTRASONOGRAPHY OF THE SPERMATIC CORD IN CHILDREN WITH TESTICULAR TORSION: IMPACT ON THE SURGICAL STRATEGYJournal of Urology, VOL. 172, NO. 4 Part 2, (1692-1695), Online publication date: 1-Oct-2004.Allen T and Elder J (2018) Shortcomings of Color Doppler Sonography in Diagnosis of Testicular TorsionJournal of Urology, VOL. 154, NO. 4, (1508-1510), Online publication date: 1-Oct-1995.Stone K and Kass E (2018) Re: Testicular Torsion: Pitfalls of Color Doppler Sonography, by G. F. Steinhardt, S. Boyarsky and R. Mackey, J. Urol., 150: 461–462, 1993Journal of Urology, VOL. 152, NO. 1, (172-172), Online publication date: 1-Jul-1994. Volume 150Issue 2 Part 2August 1993Page: 667-669 Advertisement Copyright & Permissions© 1993 by The American Urological Association Education and Research, Inc.Keywordsultrasonographyscrotumspermatic cord torsionMetrics Author Information Evan J. Kass More articles by this author Kevin T. Stone More articles by this author Alexander A. Cacciarelli More articles by this author Brent Mitchell More articles by this author Expand All Advertisement PDF downloadLoading ...