Introduction: The acute scrotum has signs of local inflammation such as scrotal swelling, heat, redness, and pain. The acute scrotum has four most common cause including appendix testis torsion (ATT), epididymitis, orchitis, and testicular torsion. An established treatment strategy is the immediate exploration of the scrotum in acute scrotum patient to prevent testicular loss, whereas other authors recommend a therapeutic approach based on the findings of scrotal Doppler ultrasound (DUS) .
Case Report: We describe a 10-year-old boy, student, and physical examination revealed tenderness of left swelling & reddish scrotum (figure 1 &2), because of suspected acute scrotum, and followed scrotal Doppler ultrasound that increased blood flow of left scrotum was noticed in comparison with the contralateral testicle. (figure 3 &4) Because of epididymitis, then he received the treatment of antibiotics, and the symptom subsided.
Discussion: The acute scrotum is common condition in emergency department, and we must be careful to diagnose between surgical and non-surgical condition. It is important that adequate treatment prevent testicular loss. Since the early 1990s, there has been an increased use of DUS in the diagnosis of acute scrotum. Children with normal or increased testicular blood flow should not undergo primary surgical exploration, and decreased or missing testicular perfusion or unclear DUS indicates immediate surgical exploration. In children with persistent symptoms, despite conservative treatment, elective scrotal exploration should be considered. A comparison of the blood flow with the contralateral testicle may have prevented misdiagnosis in these cases.