Acute Scrotum : A Prospective Study of the clinical presentation,differential diagnosis, and management

Abstract

Background :Many acute scrotal conditions can present in similar way, Testicular torsion is a true surgical emergency because,the likelihood of testicular salvage decreases,as the duration of torsion increases. Other conditions that present in similar way to testiculartorsion include,torsion of appendix testis,epididymo-orchitis,traumato testis, haematocele, strangulated inguinal hernia.Aim: To study the clinical presentation,differential diagnosis, and management of acute scrotum.Methods :This is a prospective study conducted for a period of 12 months and 100 patients satisfying the inclusion criteria were included in the study.Results :In present study,the most common condition is epididymo orchitis(35%) followed by Fournier’s gangrene (30%), pyocele (16%), haematoma (10%), torsion (8%) and scrotal wall abscess(1%). Doppler vascularity was absent in all case of torsion (100%) and increased in all cases of epididymo-orchitis (100%). All cases of epididymo-orchitis were treated conservatively. All cases of Fournier's gangrene underwent debridement. 8 cases of pyocele underwent unilateral orchidectomy and 8 cases were treated by incision and drainage. 8 cases of hematoma were treated by exploration and evacuation and 2 cases were treated by orchidectomy. 6 cases of testicular torsion underwent unilateral orchidectomy and contralateral orchidopexy. 2 cases underwent bilateral orchidopexy. Scrotal wall abscess was treated by incision and drainage.Conclusion :The most common cause of acute scrotum was epididymo-orchitis. Early exploration is the gold standard treatment for torsion.