Management
ACUTE SCROTUM TORSION TESTIS
Acute scrotal conditions are common in infants and children. The causes are torsion of the testis (TT), torsion of the testicular appendix (TTA), epididymo- orchitis (EO) and strangulated inguinoscrotal hernia (SIH). It is generally considered that EO is rare in children and is associated with structural anomalies of the urinary tract. Presentation: Evaluation: strangulated inguinoscrotal hernia should be kept in mind if a newborn patient presents symptoms compatible with acute scrotum. Testicular torsion is an urgent condition which requires prompt surgical treatment. In addition to duration, the degree of rotation has been attributed in the clinical outcome. Ischemia can occur as soon as 4 hours after torsion and is almost certain after 24 hours. Some patients with a prolonged period of symptoms may have had intermittent torsion or a partial torsion and testis may be salvageable. So surgery should never be delayed on the assumption of nonviability based on duration of torsion. Torsion of the testicular appendix is one of the most frequent causes of acute scrotum. Although it is a benign condition and the necrotic tissue is reabsorbed without any sequelae in almost all cases, Another rare cause of acute scrotum in children is torsion of an epididymal cyst.
