Sushanta Kumar Das1 , Sanjeeb Kumar Pradhan2 , Santoshi Prasad Adhikari3
BACKGROUND Acute scrotal swellings are common in both children and adults. It is a medical emergency which warrants immediate attention. Though these swellings are frequently encountered, many a times correct diagnosis is not made or delayed, and testis needs to be sacrificed. METHODS In this study 60 cases of acute scrotal swelling were studied from to evaluate the possible aetiological factors and common presentations in patients presenting with acute scrotal swelling. Cases were evaluated based on history, signs, symptoms, and clinical examination. RESULTS The most common cause of scrotal swelling is epididymo-orchitis (41.67 %); the second most common is pyocele (18.33 %). The maximum incidence of scrotal swelling occurred in the age group of 31 - 40 years (45.00 %), followed by 21 - 30 (23.33 %) years age group. All cases had swelling of scrotum, and were associated with pain. Out of 60 cases, 56.67 % cases were given conservative treatment and 43.33 % cases were treated surgically. There was no mortality in our study and all cases showed good recovery in six month follow up. CONCLUSIONS Most common cause of scrotal swelling is epididymo-orchitis. Second most common is pyocele, followed by haematocele. Presence of scrotal swelling with pain is seen in all cases along with fever in some cases, but not in all. Patients with Fournier's gangrene can present with septicaemia with shock. Most common predisposing factor is idiopathic. Earliest presentation was recorded in case of haematoma followed by scrotal trauma, followed by Fournier’s gangrene. Presence of urinary symptoms, with similar complaints in the past, is an important predisposing factor for acute scrotum. Involvement of right side is more common than left side, particularly in epididymo-orchitis.
