Acute scrotal syndrome

Acute Scrotum refers to a set of symptoms and signs involving sudden pain, swelling, and sometimes erythema in the scrotal area, which requires urgent medical evaluation. This condition can occur in children, adolescents, or adults and is generally considered a medical emergency because it may be caused by conditions that can impair blood flow to the testicles.

Causes of Acute Scrotum

1. Testicular torsion: This occurs when the testicle twists around the spermatic cord, cutting off blood supply. It is a surgical emergency and must be treated quickly to avoid irreversible damage to the testicle.
2. Epididymitis: Inflammation of the epididymis (the tube that carries sperm from the testicles), usually caused by an infection. It can lead to pain and swelling, although symptoms are typically less severe than in testicular torsion.
3. Orchitis: Inflammation of the testicles, usually due to a viral (e.g., mumps) or bacterial infection.
4. Scrotal trauma: Injury to the scrotum can cause pain, swelling, and inflammation, and also requires prompt medical attention.
5. Strangulated inguinal hernia: Inguinal hernias can descend into the scrotum, and if strangulated, may cut off blood flow and cause acute pain.

Symptoms of Acute Scrotum

• Sudden and severe scrotal pain
• Scrotal swelling
• Erythema or tenderness
• Nausea or vomiting (especially in cases of testicular torsion)

Management and Treatment

Immediate medical evaluation is essential to determine the exact cause of acute scrotum. Typically, the following are required:

• Scrotal Doppler ultrasound to assess blood flow to the testicle
• Emergency surgery (in the case of testicular torsion) to save the affected testicle
• Antibiotics in cases of epididymitis or bacterial orchitis

Prompt treatment is crucial, especially in cases of testicular torsion, to prevent long-term complications such as loss of testicular function.