Acute scrotum in children

Abstract

Acute scrotum in children is a time-critical surgical emergency, as testicular torsion may be present, and testicular loss may occur without urgent exploration. The differential diagnosis of children presenting with acute scrotum includes torsion of the testicular appendix, epididymo-orchitis, trauma, and idiopathic scrotal oedema. The incidence of testicular torsion in children is approximately 4 per 100,000. A bimodal distribution is seen, with peaks in the first month of life and in early adolescence. This pattern is likely due to a different aetiology of torsion in newborns compared to older children. This review focuses on the surgical approach to acute scrotum in children, from referral to follow-up, with particular attention to considerations for newborns, and a comparison to adult practice.