The Acute Scrotum

The presentation of a child with a scrotal mass is frequently accompanied by significant distress regarding the potential medicolegal implications of the misdiag-nosis of an acute surgically correctible lesion, namely testicular torsion. However, a rational, thoughtful approach to the child with an acutely symptomatic scrotum will aid in the rapid diagnosis and treatment of this commonly encountered entity. The history will determine the age of the patient, associated symptoms, and the presence or absence of pain. Pertinent physical findings and appropriate investigations will help clari-

Fig. 8.42. Newborn boy with an enlarged, nontender, discolored left hemiscrotum at the time of newborn examination. Neonatal torsion was diagnosed and the patient underwent or-chidectomy and contralateral orchiopexy at 2 weeks of age fy the diagnosis and enable treatment in a timely fashion.

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