Rev. Med. Chir. Soc. Med. Nat., Iaşi – 2016 – vol. 120, no. 1 INTERNAL MEDICINE - PEDIATRICS ORIGINAL PAPERS 90 THE ACUTE SCROTUM IN CHILDREN Elena Ţarcă, Geanina Irina Crişcov*, B. Savu, S.G. Aprodu University of Medicine and Pharmacy, “Grigore T. Popa” -Iasi Faculty of Medicine Department of Mother and Child Medicine *Corresponding author. E-mail: irinacriscov@yahoo.com THE ACUTE SCROTUM IN CHILDREN (Abstract): The acute scrotum syndrome is a med- ical-surgical emergency and the recognition of this condition by both healthcare profession- als and the general population may result into the patients’ coming in earlier for medical e x- amination and into the preservation of the gonad in case of torsion. The purpose of this ret- rospective analytical research is to point out specific epidemiological aspects in pediatric pa- tients suffering from acute scrotum, and to review the existing diagnosis and treatment op- tions. The study included 208 patients, of whom 16 with vanishing testis and 192 with acute scrotum (torsion of testis 25.5%, torsion of the hydatid of Morgagni 68.2%, epididymo- orchitis 5.2%). The torsion of the hydatid of Morgagni occurs in boys with a mean age of 10 years and it involves both testes equally, whereas the torsion of testis usually occurs around the age of 13 and is twice more common in the left gonad. Another significant difference be- tween the two conditions is the inflammatory syndrome, which occurs in 45.4% of the chil- dren with torsion of testis versus only 18.2% in the torsion of hydatid. Only one out of six testes torted during the neonatal period could be saved (16.6%); the gonad preservation rate was as high as 68.2% in the group of patients with testis torsion occurring outside the neona- tal period. These alarming data are accounted for by the non-recognition of the severity of the condition and by the delayed surgical therapy, which occurs on the average 20 hours af- ter the testis torsion has set in. If the asepsis and antisepsis standards are observed, patients with torsion of the hydatid of Morgagni or torsion of testis require neither fluid sampling from the tunica vaginalis for culture, nor antibiotic therapy. Keywords: ACUTE SCRO- TUM, TESTICULAR TORSION, TESTICULAR APPENDAGE, EPIDIDYMO-ORCHITIS. The acute scrotum syndrome refers to the sudden onset of pain, swelling and other inflammatory phenomena in a hem- iscrotum, which may be caused by condi- tions such as orchiepididymitis, torsion of testis or appendix testis, testicular hemato- ma due to local injury or hematocele due to adrenal hemorrhage during the perinatal period, testicular tumor, strangulated in- guinal or scrotal hernia, acute scrotal ede- ma, Henoch-Schönlein purpura. Strangula t- ed inguinal hernia and testis torsion are surgical emergencies, whereas orchiepidi- dymitis may only require medical therapy. Scrotal injury with hematoma or incarcer- ated hernia may be diagnosed according to anamnesis, whereas Doppler ultrasound scanning may differentiate the inflammato- ry phenomena due to orchiepididymitis from the absence of blood flow due to tes- tis torsion (1). A detailed history, through physical examination of the genitalia and