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OP-142 Evaluation of children with acute scrotum: a multidisciplinary diagnostic approach with the collaboration of pediatrics and pediatric surgery
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  1. Hakan Aldemir1,
  2. Ebru Atike Ongun2
  1. 1University of Health Sciences Antalya Training and Research Hospital, Department of Pediatric Surgery, Antalya, Turkey
  2. 2University of Health Sciences Antalya Training and Research Hospital, Department of Pediatrics, Antalya, Turkey

Abstract

Aim To analyze the diagnosis and follow-up of children with scrotal swelling and/or pain

Material and Method Patient demographics, clinical/radiological findings, and treatment strategies of children with acute scrotum between Dec-2021 and Dec-2023 were retrospectively evaluated at the Pediatrics and Pediatric Surgery Clinics of Antalya Training and Research Hospital. Data analysis was conducted using the SPSS-21 statistical program.

Results The mean ages of 194 children were 10.98±2.40 years. Scrotal pain (testicular, inguinal, lower-quadrant pain), swelling, and redness were the common cause of complaints. Acute epididymitis (36.1%), epididymo-orchitis (8.8%), orchitis (2.1%), testicular torsion (21.6%), hydrocele (4.6%), epididymal cyst (1.6%), varicocele (1.6%), strangulated hernia (1.6%), appendiceal testicular torsion (0.5%), blunt scrotal trauma (1%), testicular tumor (0.5%), undescended testicle (0.5%) were identified as the underlying pathologies. Infection was complicated by scrotal abscess in two, and pyelonephritis in four children with epididymitis, epididymo-orchitis, and orchitis. No abnormality was found in 33 (22.1%) cases. Testicular torsion occurred in 42 children (mean age: 13.4±2.6 years) (three cases were excluded from the study). Left testicle was the common region in 64.3% of children. False-negative sonographic findings were observed in seven (16.6%) patients. No statistical significance was observed regarding torsion localization (right testicle: 13.4±2.5 years, left testicle: 12.8±3.2 years; p>0.005) (figure 1). Urgent orchiectomy was performed in four (10.3%) children, surgical detorsion/fixation in 19 (48.7%) children (n=13 for left testicle: n=6 for right testicle), and manual detorsion maneuvers in 16 children (n=11 for left testicle, n=5 for right testicle). Organ malfunction/testicle loss occurred in 12 (30.7%) patients (in eight children following acute detorsion, and in four children after orchiectomy).

Abstract OP-142 Figure 1

Clinical presentation of right testiculartorsion in a 14-year-old male

Conclusions Acute scrotum is an important pediatric health-care problem that requires early recognition and timely intervention of the underlying etiology. The ultimate goal is to prevent organ loss and infertility. Detailed evaluation of patients with the collaboration of health-care providers in pediatrics and pediatric surgery is crucial.

  • acute scrotum
  • scrotal swelling
  • testicular torsion
  • surgical intervention
  • scrotal pain

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