CLINICAL, BIOCHEMICALAND RADIOLOGICAL STUDY OF ACUTE SCROTAL SWELLINGS

Background:Acute scrotum is a common urological emergency condition requiring rapid evaluation and urgent surgical intervention and specic medical therapy if required, due to the time dependency of certain morbid but reversible conditions, such as torsion testis. Although these swellings are frequently encountered, many a time testis could not be salvaged due to late or incorrect diagnosis. Objective: Assessment of different acute scrotal conditions in terms of clinical ndings (signs and symptoms), Relative incidence of different etiological factors, Assessment of various biochemical ndings. Methodology: This is a prospective study of 80 patients of acute scrotum carried out in Department of General surgery, Patna Medical College and Hospital, Patna from September 2020 to July 2023. Result: Out of 80 patients included in the study, 35 patients had right side, 25 patients had left side and 19 patients had bilateral involvement of acute scrotal swellings. The mean age of study population was years. Acute epididymo-orchitis was found to be the commonest cause of acute scrotum followed by Fournier's gangrene and hematocele. It was more common among younger and middle-aged individuals and those involved in strenuous works. The maximum incidence of acute scrotal swellings was found to be present in 41-50 years age group. The most common predisposing factors of acute scrotum was found to be idiopathic. Scrotal swelling with pain was the commonest presenting symptom. All the patients of acute epididymo-orchitis were managed by conservative approach while rest all the patients were managed surgically. Post-operative complications were hematoma (2.5%), seroma (6.25%), surgical site infections (6.25%), induration (5%) and chronic groin pain (2.5%). USG scrotum was not done in patients of Fournier's gangrene and scrotal wall abscess and found to be conclusive in rest all the patients of acute scrotum except 10 cases of acute epididymo-orchitis. E. coli was the commonest organism found in urine culture. Swab culture of all the patients of Fournier's gangrene yielded polymicrobial growth (Proteus, klebsiella etc.) in 31.57% and monomicrobial growth in 68.43% cases. Conclusion:Any patient presenting with acute scrotum, torsion testis must be considered and evaluated. All the patients must be subjected to USG doppler of the scrotum. In patients with torsion testis presenting within 6 hours of onset of symptoms, testis can be savaged.