Acute scrotum

Abstract A boy presenting with an acutely inflamed and tender scrotum is a common and potentially challenging scenario. It is crucial to identify and treat possible testicular torsion in a timely fashion, as this has a significant impact on the likelihood of salvaging the testis. Alternative diagnoses should be considered in order to avoid unnecessary and potentially harmful surgical intervention. These may include epididymitis, a torted hydatid of Morgagni, or idiopathic scrotal oedema, all of which may benefit from non-surgical management. Although clinical examination is the mainstay of diagnosis, in certain scenarios, investigations may aid in the diagnosis. Perinatal testicular torsion results from a different pathological process, the management of which is debated.