The acute scrotum in children

The acute scrotum is a common referral to paediatric emergency departments. The term covers a wide range of diagnoses, with variable severity. The most important diagnosis is testicular torsion, and this should be ruled out in all cases due to the risk of gonadal loss. History and examination may give some indication of the underlying cause of pain; however, surgical exploration of the scrotum is often required as an emergency procedure. This article describes the presentation, differential diagnosis and acute management of this common condition, as well as touching on some areas of debate.