ABC of General Surgery in Children: ACUTE PROBLEMS OF THE SCROTUM

~~~~' An "acute scrotum" is a common Iniec of commonpresentation in infants and children with several possible causes, some of which require ~~~~~~~~~~~~~~~immediate corrective surgery while others may The likeliestca ineed only reassurance.It is helpful to consider the ossibilities by the age of the child, as knowledge of this can lead in many cases to heriamathe most likely diagnosis.Incidence of common causes of acute scrotal problems in infants and children. Acute problems in newborn infantsThe likeliest cause in a newbor infant is testicular torsion or trauma, usually due to a breech delivery.In infants an irreducible inguinal hernia may mimic an acute scrotal problem Testicular torsionA testicular torsion in newborn infants differs anatomically from that in older boys because it is a twist of the whole spermatic cord, and presumably occurs because of the unfixed nature of the newly .... ... ...... .fdescended testis.Almost all of such torsions present late-at the stage * s . . . . .-. .: ; : of overt testicular necrosis.Pain and tenderness are not prominent features in newborn infants.The scrotum is usually red and swollen