Acute_Scrotal_Disorders_in_Children_Flashcards

Question 1

What is essential to exclude in a child with an acute scrotal presentation?

Answer 1

It is essential to exclude testicular torsion in a child with an acute scrotal presentation.

Question 2

Why is it crucial to exclude testicular torsion in a child with an acute scrotal presentation?

Answer 2

Immediate surgery is required for testicular torsion, making it crucial to exclude.

Question 3

What is the most common age group for testicular torsion?

Answer 3

Testicular torsion is most common around puberty.

Question 4

What is the most common age group for an irreducible inguinal hernia?

Answer 4

An irreducible inguinal hernia is most common in children under 2 years old.

Question 5

How common is epididymitis in prepubescent children?

Answer 5

Epididymitis is rare in prepubescent children.

Question 6

SUMMARISE TESTICULAR TORSION

Answer 6

Acute scrotal disorders in children

It is essential to look for and exclude testicular torsion in a child with an acute scrotal presentation as immediate surgery is required

The table below lists the possible differential diagnoses in a child with an acute scrotal problem

Question 7

A 16-year-old boy presents to the emergency room with a history of groin pain for the past three hours. He has associated nausea and has vomited three times. He reports that he recently had unprotected vaginal sex. On examination there is tenderness and swelling of the scrotum and left testicle, with absence of the cremaster reflex on the left side. Elevation of the affected testicle causes increased pain.

What is the most likely diagnosis?

Torsion of the hydatid of Morgagni
Strangulated inguinal hernia
Epididymitis
Testicular torsion
Hydrocoele

Answer 7

Testicular torsion

Testicular torsion occurs when the testis turns on the remnant of the processus vaginalis thereby restricting blood flow. It usually presents with acutely severe testicular pain often with associated nausea and vomiting. There may be swelling of the testis with overlying erythema. The cremaster reflex may also be absent on the affected side. Elevation of the testicle often results in worsening of the pain.

Although this patient recently had unprotected sex, the history is less suggestive of epididymitis. With epididymitis we would expect urinary symptoms. In addition, elevation of the testes often relieves the pain (Prehn’s sign positive).