Four Years' Retrospective Look For Acute Scrotal Pathologies

INTRODUCTION: A group of diseases in the scrotum setting forth by the sudden swelling, and redness, and pain consist of acute scrotal pathologies. The most common causes of acute scrotum in children are epididymitis / epididymoorchitis / orchitis, testicular torsion, torsion of the appendix testis, incarcerated inguinal hernia, traumatic hydro / hematocele. In this study; we aim that to evaulate of patients with acut scrotal pathologies which interned to our department.
METHODS: All hospital datas of cases which interned at our deparment due to acute scrotum in between June 2010-June 2014 were evaluated retrospectively. Cases with incarcerated inguinal herni were excluded in this study
RESULTS: In 4-year period 114 cases were interned to our department with acute scrotum. Mean age was 7,6±4,577years (min: 1m-max: 18yrs). Doppler US was performed in 112 patients to evaluate the blood flow while in 2 patients applied on-Call without Doppler US. Two patients were operated under circumstance emergency surgical intervention. Diagnosis was made in 83 cases (%72,8) with epididymitis/ epididymoorchitis/ orchitis, and in 24 cases (%21,1) with testicular torsion, and in 2 cases (%1,8) with torsion of the appendix testis and in 5 cases (%4,4) with traumatic hydrocele/ hematocele. While detorsion was made in 18 cases (%75) with testicular torsion, orchiectomy was performed in 6cases (%25). Histopathological evaluation of orchiectomy specimens were revealed hemorrhagic necrosis and hemorrhagic infarction or ischemic changes. Normal testicular size and vascularity were detected in 11cases (%61,1) with the detorsioned testis by follow-up Doppler US; late orchiectomy was performed in 7cases (%38,9) with complete atrophy due to lack of blood supply.
DISCUSSION AND CONCLUSION: Although Doppler US is very helpful for differential diagnosis of patients with acute scrotum who applied early period; If Doppler US will lead to a waste of time, direct surgery to be done would be reduced the loss of the testicles.

Akut Skrotal Patolojilere 4 Yýllýk Retrospektif Bakýþ

GÝRÝÞ ve AMAÇ: Skrotumda ani geliþen þiþlik, kýzarýklýk ve aðrý ile ortaya çýkan bir grup hastalýk akut skrotum patolojilerini oluþturmaktadýr. Çocuklarda akut skrotumun en sýk nedenleri epididimit/epididimoorþit/orþit, testis torsiyonu, appendiks testis torsiyonu, boðulmuþ kasýk fýtýðý, travmatik hidro/hematosel’dir. Bu çalýþmada; kliniðimizde boðulmuþ kasýk fýtýðý dýþýndaki akut skrotum nedeniyle interne edilen olgularýn deðerlendirmesi amaçlandý.
YÖNTEM ve GEREÇLER: Haziran 2010- Haziran 2014 tarihleri arasýnda akut skrotum nedeniyle interne edilen hastalarýn tüm özellikleri geriyedönük olarak deðerlendirildi. Boðulmuþ kasýk fýtýðý tanýlý hastalar çalýþma dýþýnda býrakýldý.
BULGULAR: 4 yýllýk süreçte akut skrotum nedeniyle interne edilen 114 olgunun yaþ ortalamasý 7,6± 4,577 yaþ (min: 1ay-max: 18yaþ) idi. Doppler US ile kan akýmý deðerlendirilmesi 112 olguda yapýlýrken, 2 hastada mesai dýþý müracaat nedeniyle Doppler US yaptýrýlmadan acil cerrahi müdahale yapýldý. Hastalarýn 83’ü (%72,8) epididimoorþit, 24’ü (%21,1) testis torsiyonu, 2’si (% 1,8) appendiks testis torsiyonu, 5’i (%4,4 ) ise travmaya sekonder kontüzyon, hidro/hematosel tanýsý almýþtý. Testis torsiyonu tanýsý alan 18 hastada (%75) detorsiyon yapýlýrken, 6 hastada (%25) orþiektomi yapýldý. Orþiektomi olgularýnýn histopatolojik deðerlendirmelerinde; hemorajik nekroz, hemorajik infarktüs ve iskemik deðiþiklikler saaptandý. Detorsiyone edilen testislerin kontrol Doppler US’lerinde 11 olgunun (%61,1) testis boyutlarý ve kanlanmalarý normal bulundu. Kanlanmasý olmayan ve tamamen atrofiye giden 7 olguda ( %38,9) geç orþiektomi yapýldý.
TARTIÞMA ve SONUÇ: Erken müracaat eden akut skrotum olgularýnda Doppler US ayýrýcý taný için çok yararlý olmakla beraber, Doppler US yaptýrmak zaman kaybýna yol açacak ise hastanýn doðrudan ameliyata alýnmasý testis kaybýný azaltabilir.