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Three Cases of Acute Scrotal Disorders in the Neonate

Journal of the Korean Pediatric Society 2001;44(7):841-846.
Published online July 15, 2001.
Three Cases of Acute Scrotal Disorders in the Neonate
Ja Yun Yun1, Min Kyoung Kwon1, Mi Ran Kim1, Kon Hee Lee1, Kwang Nam Kim1, Ho Hyun Jeong2
1Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
2Department of Urology, College of Medicine, Hallym University, Seoul, Korea
신생아 급성 음낭증 3례
윤자윤1, 권민경1, 김미란1, 이건희1, 김광남1, 정호현2
1한림대학교 의과대학 소아과학교실
2한림대학교 의과대학 비뇨기과학교실
Acute scrotal disorders(ASD) in neonates-especially the torsion of testes- are rare, and the clinical presentations are quite different from those of adolescents or adults. The neonates with ASD are generally afebrile and do not show typical symptoms. Early diagnosis and proper treatment of ASD are very important but the differentiation of torsion and orchitis is not easy in neonates. The enlargement, color changes, induration and loss of transillumination of the scrotum and the absence of cremasteric reflex are clinical indicators of neonatal testicular torsion. But the correct diagnosis of testicular torsion is often delayed until the detection of a symptomatic, irreducible scrotal swelling which doesn't display transillumination. Doppler ultrasonography and testicular scans are important ways to improve the preoperative differential diagnosis of ASD. However, these examinations in neonates are often technically unsatisfactory due to the small size of the testicles. Sometimes immediate surgical exploration is needed for the diagnosis and treatment of neonatal testicular torsion. Here we report three cases of neonatal ASD, which include one case of testicular torsion and two cases of acute orchitis. For instance, a one-day old newborn underwent a surgical procedure. The testicular mass was diagnosed as testicular torsion and a subsequent right orchitectomy was performed. Similarly, right scrotal mass was detected in a 22-day old newborn. The patient underwent emergency exploration and was diagnosed with orchitis. Similarly, testicular torsion was suspected in a one-day old newborn with both testicular swelling of both testicles via ultrasound scanning examination. However, the patient improved following antibiotic therapy, suggesting orchitis. In conclusion, emergency exploration was performed in these two cases, and one case of orchitis was improved after the antibiotic therapy only.
Key Words: Acute scrotal disorders, Torsion of testis, Orchitis, Neonates

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