Clinical score for surgical treatment of acute scrotum in pediatric age

Abstract

Acute scrotum is a set of signs and symptoms that should lead the patient to go to a first aid center. There are different causes of these signs and symptoms, but testicular torsion is identified as the main ones and can be suspected thanks to a careful history, physical examination and testicular ultrasound. It is important to quickly differentiate the various conditions associated with acute scrotum in order to optimize surgery times and preserve testicular vitality. Often the radiological study is essential to identify the causes of acute scrotum, in particular the testicular Doppler ultrasound is sensitive and specific for testicular torsion, infact it is considered the gold standard for diagnosis. However, the radiological study can delay surgical treatment and reduce testicular vitality. So TWIST score was proposed. It is based on the identification of signs and symptoms that can lead at clinical diagnosis of testicular torsion. Our narrative of literature review analyzes TWIST score validity and shows the utility of an adequate clinical examination obtaining a diagnosis of torsion cord, reducing the costs and the time of surgical treatment resulting in a higher likelihood of preserving testicular vitality

Keywords

• acute scrotum, testicular torsion, twist score, doppler ultrasound, children, pediatric patients