Abstract
The great majority of cases of acute scrotum are due to one of three causes: trauma, torsion or epididymo-orchitis. Differential diagnosis also includes a few rare conditions: strangulated hernia, testicular tumour, haematocele and idiopathic scrotal oedema, Henoch-Schönlein purpura and scrotal fat necrosis. In younger subjects, testicular or appendiceal torsions account for over half of cases of acute scrotum, with an additional third due to epididymo-orchitis. The latter is the most frequent cause in adults, followed by trauma. Acute scrotum syndrome, whether of traumatic, ischaemic or inflammatory origin, always merits immediate evaluation as early intervention is very likely to preserve testicular function, whereas a delay will almost invariably lead to chronic irreversible complications.
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References
Muttarak M, Lojanapiwat B. The painful scrotum: an ultrasonographical approach to diagnosis. Singapore Med J. 2005;46:352–7.
Feld R, Middleton WD. Recent advances in sonography of the testis and scrotum. Radiol Clin N Am. 1992;30:1033–51.
Pavlica P, Barozzi L. Imaging of the acute scrotum. Eur Radiol. 2001;11:220–8.
Krone KD, Carroll BA. Scrotal ultrasound. Radiol Clin N Am. 1985;23:121–39.
Wittenberg AF, Tobias T, Rzeszotarski M, Minotti AJ. Sonography of the acute scrotum: the four T’s of testicular imaging. Curr Probl Diagn Radiol. 2006;35:12–21.
Hricak H, Lue T, Filly RA, Alpers CE, Zeineh SJ, Tanagho EA. Experimental study of the sonographic diagnosis of testicular torsion. J Ultrasound Med. 1983;2:349–56.
Stehr M, Boehm R. Critical validation of colour Doppler ultrasound in diagnostics of acute scrotum in children. Eur J Pediatr Surg. 2003;13:386–92.
Mernagh JR, Caco C, De Maria J. Testicular torsion revisited. Curr Probl Diagn Radiol. 2004;33:60–73.
Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology. 2003;227:18–36.
Coley BD, Frush DP, Babcock DS, O’Hara SM, Lewis AG, Gelfand MJ, Bove KE, Sheldon CA. Acute testicular torsion: comparison of unenhanced and contrast-enhanced power Doppler US, color Doppler US, and radionuclide imaging. Radiology. 1996;199:441–6.
Hesser U, Rosenborg M, Gierup J, Karpe B, Nystrom A, Hedenborg L. Gray-scale sonography in torsion of the testicular appendages. Pediatr Radiol. 1993;23:529–32.
Stewart VR, Sidhu PS. The testis: the unusual, the rare and the bizarre. Clin Radiol. 2007;62:289–302.
Yusuf GT, Sidhu PS. A review of ultrasound imaging in scrotal emergencies. J Ultrasound. 2013;16:171–8.
Jeffrey RB, Laing FC, Hricak H, McAninch JW. Sonography of testicular trauma. AJR Am J Roentgenol. 1983;141:993–5.
Lupetin AR, King W III, Rich PJ, Lederman RB. The traumatized scrotum. Ultrasound evaluation. Radiology. 1983;148:203–7.
Cohen HL, Shapiro ML, Haller JO, Glassberg K. Sonography of intrascrotal hematomas simulating testicular rupture in adolescents. Pediatr Radiol. 1992;22:296–7.
Shah J, Qureshi I, Ellis BW. Acute idiopathic scrotal oedema in an adult: a case report. Int J Clin Pract. 2004;58:1168–9.
Munden MM, Trautwein LM. Scrotal pathology in pediatrics with sonographic imaging. Curr Probl Diagn Radiol. 2000;29:185–205.
Thomas AC, Cain MP, Casale AJ, Rink RC. Ultrasound findings of acute idiopathic scrotal edema. ScientificWorldJournal. 2004;4(Suppl 1):9–10.
van Langen AM, Gal S, Hulsmann AR, De Nef JJ. Acute idiopathic scrotal oedema: four cases and a short review. Eur J Pediatr. 2001;160:455–6.
Morrison D, Blaivas M, Lyon M. Emergency diagnosis of Fournier’s gangrene with bedside ultrasound. Am J Emerg Med. 2005;23:544–7.
Aho T, Canal A, Neal DE. Fournier’s gangrene. Nat Clin Pract Urol. 2006;3:54–7.
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Isidori, A.M., Lenzi, A. (2017). Acute Scrotum. In: Ultrasound of the Testis for the Andrologist. Trends in Andrology and Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-51826-8_5
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DOI: https://doi.org/10.1007/978-3-319-51826-8_5
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