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Child with a non-painful red scrotum
  1. Paola Pascolo1,
  2. Andrea Magnolato2,
  3. Lorenzo Calligaris1,
  4. Daniela Sanabor3,
  5. Egidio Barbi2,4,
  6. Giorgio Cozzi1
  1. 1 Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
  2. 2 Pediatric Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
  3. 3 Department of Radiology, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
  4. 4 Department of Medical, Surgical, and Health Sciences, University of Trieste, Trieste, Italy
  1. Correspondence to Dr Paola Pascolo, Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste 34100, Italy; paolapascolo{at}gmail.com

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Clinical case

An 8-year-old boy was admitted to our emergency department because of scrotal swelling and redness, starting a few hours earlier. No fever, vomiting, abdominal pain, dysuria or local trauma were reported. At examination, he was well, afebrile and complaining of mild scrotal pain evoked at palpation. A thickened and hyperaemic skin of the left scrotal sac extended to groin and perianal region was noted (figure 1). On palpation, testis had a normal volume for the child’s age, and no pain was elicited. Cremasteric reflex was bilaterally valid. The clinical examination was otherwise unremarkable.

Figure 1

Thickened and hyperaemic skin of the scrotal sac extended to groin.

Question 1

Which of the following is the most likely diagnosis in this patient?

  1. Testicular torsion.

  2. Henoch-Schonlein purpura.

  3. Inguinal hernia.

  4. Acute idiopathic scrotal oedema.

  5. Epididymitis.

Question 2

Which is the most helpful exam?

  1. Protein C reaction.

  2. Scrotal ultrasound.

  3. Urinalysis.

  4. Surgical exploration.

  5. Blood exams. …

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