Syed Muhammad Khalid, Al Faqeeh Ahmad A, Othman Alsayed, Hussein Ahmed A, Hussain Salman, Almas Talal, Alsufyani Reema, Alaeddin Hasan, Syed Saifullah, Syed Sabahat K
Pediatric Surgery, King Fahad Hospital, Al Baha, SAU.
Pediatric Surgery, Al-Azhar University - Assuit Branch, Assuit, EGY.
Cureus. 2020 Oct 16;12(10):e10984. doi: 10.7759/cureus.10984.
Background The term acute scrotum encompasses a plethora of testicular pathologies that are detrimental to the survival and sustenance of testes. The aim of the present study is to determine the spectrum of these testicular pathologies upon scrotal exploration performed in the aftermath of acute scrotal pain in the pediatric population. Methods This multicenter retrospective cross-sectional study was conducted at the department of pediatric surgery at two hospitals. During the study period, the clinical characteristics of the 76 patients that underwent scrotal exploration for acute scrotum were assessed. These included age, duration of symptoms on presentation, and identification of the etiology underlying scrotal pain. The data obtained was eventually analyzed using the Statistical Package for the Social Sciences (SPSS) 23.0 software (IBM Corp., Armonk, NY). Results A total of 76 scrotal exploration procedures were performed. The involvement of the left side of the scrotum was more common than the right side. Most of the patients who presented were older than five years of age. A majority of the patients presented after 24 hours of the commencement of their symptoms. Of the included participants, 36 patients (47.47%) were found to have an underlying torsion of appendix testes that was appropriately managed. Testicular torsion was observed in 15 patients, out of which eight viable testes were salvaged with a subsequent orchidopexy while seven torsions required orchiectomy owing to their non-viability. Other findings included epididymo-orchitis and infected hydrocele. A total of 19 testes appeared completely normal upon scrotal exploration. Conclusion Scrotal exploration should be considered as part of the medical and surgical workup and in the management of acute scrotum, as it divulges the specific underlying testicular pathology. Prompt scrotal exploration can aid in ascertaining the underlying etiology and is, therefore, pivotal in the apt management of the underlying pathology.
背景 “急性阴囊” 一词涵盖了众多对睾丸的存活和维持有害的睾丸病变。本研究的目的是确定在儿科人群急性阴囊疼痛后进行阴囊探查时这些睾丸病变的范围。方法 这项多中心回顾性横断面研究在两家医院的小儿外科进行。在研究期间，评估了76例因急性阴囊而接受阴囊探查的患者的临床特征。这些特征包括年龄、就诊时症状持续时间以及阴囊疼痛潜在病因的确定。最终使用社会科学统计软件包（SPSS）23.0软件（IBM公司，纽约州阿蒙克）对获得的数据进行分析。结果 总共进行了76例阴囊探查手术。阴囊左侧受累比右侧更常见。大多数就诊患者年龄超过5岁。大多数患者在症状开始24小时后就诊。在所纳入的参与者中，发现36例患者（47.47%）存在睾丸附件扭转，并得到了适当处理。观察到15例睾丸扭转，其中8例存活的睾丸通过随后的睾丸固定术得以挽救，而7例扭转因睾丸无法存活而需要进行睾丸切除术。其他发现包括附睾炎和感染性鞘膜积液。在阴囊探查时，共有19个睾丸外观完全正常。结论 阴囊探查应被视为急性阴囊医疗和外科检查及管理的一部分，因为它能揭示具体的潜在睾丸病变。及时进行阴囊探查有助于确定潜在病因，因此在恰当地处理潜在病变方面至关重要。
