Evaluation of Acute Scrotal Pathologies in Pediatric Emergency Settings: A Retrospective Analysis of Etiologies, Clinical Presentations, and Management Timelines

Objective: Acute scrotal pathologies are conditions characterized by sudden pain, swelling, and redness in the scrotum, commonly seen in boys presenting to emergency departments. Prompt diagnosis and treatment are crucial. This study aims to evaluate the etiology, clinical presentation, sociodemographic characteristics, and timelines for presentation, diagnosis, and treatment in boys with acute scrotum. Study Design: This retrospective study reviewed files of boys under 18 years admitted to our pediatric emergency department between July 2019 and July 2024 with acute scrotum. Data collected included sociodemographic characteristics, causes of acute scrotum, presenting complaints, physical examination findings, time from symptom onset to presentation, imaging, and surgical consultation. Results: A total of 151 cases were identified, with ages ranging from 0 to 17 years. Etiologies included epididymitis (n=43), torsion of the appendix of the testis (n=33), testicular torsion (n=28), scrotal cellulitis (n=23), incarcerated/strangulated inguinal hernia (n=15), trauma (n=8), and Henoch-Schönlein purpura (n=1). Swelling (n=39, 30.7%) and pain (n=36, 28.3%) were the most common presenting complaints. While the time to presentation and imaging were similar across cases, surgical consultation was significantly faster for testicular torsion patients. Conclusion: Acute scrotum requires careful evaluation in pediatric emergency settings. Early diagnosis and timely intervention are essential to prevent complications, such as testicular loss, and to maintain the patient’s quality of life.