Pediatric emergency medicine trisk 1172 1172

FIGURE 61.1 Anatomy of the scrotal contents.

DIFFERENTIAL DIAGNOSIS
Table 61.1 lists the principal causes of acute scrotal swelling, and Table 61.2
provides the most common diagnoses by age.

CAUSES OF PAINFUL SCROTAL SWELLING
Torsion of the Testis
Testicular torsion or twisting of the spermatic cord and its contents threatens the
survival of the testis and is a true surgical emergency. Testicular torsion accounts
for 10% to 15% of cases of acute scrotal pain and has two peaks in incidence; a
small one in the newborn period, and a larger peak around puberty related to the
increasing mass of the testis.