An evaluation of the role of ultrasonography in acute scrotum in children

The use of enteral nutrition over parenteral nutrition is recommended in the case of patients undergoing major gastrointestinal surgery for cancer, as it reduces sepsis related morbidity. In this study we compared our experience of nasojejunal tube feeding with feeding jejunostomy. In children, due to difficulty in diagnosing torsion of testis (TT), a high rate of negative scrotal explorations is seen worldwide. To assess the possibility of utilising ultrasound scan of scrotum (USS-S) to minimise this rate at the Royal Manchester Children's hospital, a prospective audit of USS-S findings when diagnosis of TT became doubtful was performed.

Of the 61 children with acute scrotum admitted to emergency department (studied over 6 months), diagnosis was doubtful in 11 and hence had preoperative USS-S: 7 urgent and 4 early. Twenty three underwent exploration without ultrasonography.

Of 7 early presenters, 3 were diagnosed as TT clinically, ultrasonically and at surgery.

One with clinically suspected but ultrasonically excluded TT had TT at exploration. Two clinically suspected torted appendages (TA) with sonographic finding of acute epididymoorchitis (AE) had AE at surgery.

One with clinically doubtful diagnosis of TT/TA with USS-S finding of AE had TA at surgery.

In all 4 late presenters, TT was diagnosed clinically, ultrasonographically and at surgery.

USS-S was helpful in the diagnosis of early and late acute scrotum.

DOI: http://dx.doi.org/10.4038/sljs.v32i2.7354

The Sri Lanka Journal of Surgery 2014; 32(2): 32-34