Role of C - reactive protein for Assessment for Exploration of Acute Scrotum in Children: A Study was done in a Tertiary Care Hospital

Background: Acute scrotum comprises a long list of differential diagnosis. The patient suffering from an acute scrotal condition requires urgent medical care. It must be evaluated promptly and accurately to make a management plan especially to save the testis from necrosis in torsion. Decision making regarding the plan for exploration is more important than reaching an exact diagnosis. Objectives: To differentiate emergency surgical acute scrotal conditions from non-surgical cases. To establish an early diagnosis of acute scrotum in children. To avoid negative exploration of acute scrotum in many cases. Methods: Sixty four patients of different age groups ranging from neonate to 12 years were underwent surgical exploration under general anesthesia (GA) between January 2016 to December 2019. The study was conducted in the Faculty of Paediatric Surgery in Bangladesh Shishu Hospital & Institute (BSH&I). A total of 72 patients were admitted with acute scrotal pain and/or swelling and evaluated by taking detailed history of presenting complaints, careful physical examinations, different laboratory investigations including serum c-reactive protein (CRP) level and radiology & imaging studies whenever appropriate and available. Results: Out of 72 cases admitted for acute scrotum, serum C - reactive protein (CRP) level estimation was done in all cases and surgical exploration was done in 64 cases. Total sample size was 64. In age incidence majority of patients were >1 year-6 years (37.5%) and >6 years-12 years (34.37%). Majority of patients came with scrotal swelling (100%), pain (93.77%) and fever (65.62%). Majority of patients came after 48 hours of onset of symptoms and exploration was performed within 6 hours to 12 hours. Blood collection was done >48 hours since complaints in majority cases (59.38%). Serum CRP level was negative in majority cases of Torsion testis (TT) and Torsion appendix testis (TAT). Total count of WBC was raised in majority of inflammatory cases ...