Scrotal Pain

Question 1

Features of testicular torsion

Answer 1

• sudden onset testicular pain and swelling
• a/w N + V
• pain may be in iliac fossa and a/w sports activity
• exquisitely tender and swollen testis
• high riding testes
• absent cremasteric reflex

Question 2

Mx of testicular torsion

Answer 2

1) urgent surgical exploration and detorsion needed

Keep NBM

Question 3

Features of torsion of appendix of testes

Answer 3

• more gradual onset of testicular pain
• blue dot sign- necrotic appendix seen through scrotal skin
• focal tenderness at upper pole

Question 4

Mx for torted testes appendix

Answer 4

• analgesia and rest
• pain usually resolves in 2-12 days, improved in 2 days
• often requires surgical exploration

Question 5

Features of HSP

Answer 5

• painful scrotal pedamma with purpuric rash over scrotum
• may have associated vasculature rash of buttocks and LL
• arthritis
• abdo pain
• GIT bleeding abdo pain
• nephritis

Question 6

Features of incarcerated hernia

Answer 6

• Hx of intermittent inguinoscrotal bulge
• irritability
• firm tender and irreducible inguinoscrotal scrotal swelling

Question 7

Mx of incarcerated hernia

Answer 7

Must be reduced or contents of hernia can become gangrenous

Question 8

Features of hydrocele

Answer 8

swollen hemiscrotum in well, settled baby

Soft, non tender swelling adjacent to testis
Transilluminates brightly

Mx: will often resort and tunica vaginalis will close spontaneously in 1st year