Acute Scrotal Swelling in Children
1. What is acute scrotal swelling in children?
Acute scrotal swelling can be largely classified into painless scrotal swelling and painful scrotal swelling.
If the scrotal swelling is associated pain, you should seek URGENT medical attention, even at non-office hours (including midnight!) – as delay in the treatment of certain problems e.g. testicular torsion would result in irreversible damage to the testis/ testes.
If the scrotal swelling is not associated with pain, then you can seek medical attention in an elective setting (by appointment).
2. What are the possible cause of painful acute scrotal swelling?
Acute scrotal pain (with or without swelling) is a SURGICAL EMERGENCY!!! Possible causes include:
a) testicular torsion
b) torsion of the appendix testis or appendix epididymis
c) epididymitis or orchitis
d) trauma/ injury
e) irreducible/ strangulated inguinal hernia
f) immunoglobuin A vasculitis (Henoch-Schönlein purpura)
g) referred pain
3. What are the possible causes of painless scrotal swelling?
Painless scrotal swelling can have acute or insidious onset. Possible causes include:
a) hydrocele
b) inguinal hernia
c) varicocele
d) spermatocele
e) testicular tumour
4. What is the treatment for scrotal swelling?
It depends on the clinical presentation. You should inform the paediatric surgeon if your child has any history of recurrent urinary tract infections, scrotal trauma, systemic symptoms or past urological operations.