A clinical study of acute scrotum
Journal Title: Medpulse International Journal of Surgery - Year 2017, Vol 4, Issue 1
Abstract
Background and Objectives: Acute scrotal swellings are one of the common swellings affecting both children and adults. Aim of this study was to describe the clinical presentation, pathophysiology, differential diagnosis and management of acute scrotum. Methodology: The present one and a half year study was done in the Department of Surgery, GMCH Miraj, PVPGH Sangli. All the patients with complaints of acute pain and swelling in the scrotum irrespective of age were included in the study. Results: Acute epididymo-orchitis (44%) was the commonest cause for acute scrotal pathology followed by Fourneir's gangrene (30%). 47% of the affected patients belonged to the age group between 21 - 40 years. All cases had swelling of scrotum, associated with pain. 60 patients had history of fever, while 45 patients had history of burning micturiton. Surgical treatment was given for all cases of Fournier,s Gangrene, testicular torsion, pyocele and Testicular Abscess. Out of four cases of torsion of testis orchidectomy was performed in three cases and orchidopexy in one. All 30 cases of Fournier's gangrene, were treated by debridement and daily dressings. Orchidectomy was required in one case of testicular abscess. Conclusion: The primary objective of management of acute scrotum is to avoid testicular loss. Surgical exploration undertaken without delay maximizes chances of testicular salvage. Acute scrotal swellings are common in younger and middle age individuals with variable symptomatology. The commonest cause for acute scrotum in our study is epididymo-orchitis followed by Fournier's gangrene. Presence of scrotal swelling with pain is the most common feature followed by fever. Special investigations like USG, Doppler are not always very much conclusive to the final diagnosis but are supportive to clinical diagnosis. Conservative treatment with rest, scrotal support, antibiotics and analgesics is more effective in case of epididymo-orchitis. Emergency surgical exploration proved to be the best in case of Torsion testis, Fournier's gangrene, pyocele and Hematocele.
Authors and Affiliations
A V Ingale, P D Gurav, N N Hombalkar, P Dhandore, Srikant Pai
Keywords
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