The use of systemic immune-inflammation index in the differential diagnosis of acute scrotum in children

Abstract

Background & Objectives: Acute scrotum is an emergency condition characterized by scrotal pain, swelling, and erythema . While testicular torsion requires emergency surgery, epididymo-orchitis requires medical treatment. In our study, we investigated the utility of the systemic immune-inflammation index in the differential diagnosis of acute scrotum in children. Can we use SII in the differential diagnosis of epididymal orchitis and testicular torsion by comparing retrospective data of patients diagnosed with acute scrotum who applied to our pediatric emergency clinic?

Methodology: In our study, we retrospectively reviewed the medical records of patients who presented to our emergency department (Konya City Hospital / Turkiye) with complaints such as testicular pain, swelling, and redness between December 2012 to December 2022.Testicular torsion (TT) and epididymo-orchitis (EO) groups were formed among the patients admitted to our pediatric emergency outpatient clinic with complaints of the acute scrotum and treated. Scrotal doppler ultrasonography (DUSG), C-reactive protein (CRP), white blood cell (WBC), neutrophil (NE), lymphocyte (LY), monocyte (MO), and platelet (PLT) values of patients were recorded.

Results: No statistically significant difference was found between TT and EO groups in terms of age, DUSG, WBC, NEU, LY, MO, and PLT. There was a significant difference between the groups in terms of CRP. CRP was found to be significantly higher in the EO group compared to the TT group (P<0.001). TT group was analyzed within itself and scrotal DUSG was found to be valuable in diagnosis. There was no significant difference between the groups in terms of SII value.

Conclusion: Parameters such as CRP and scrotal DUSG, which are commonly used in the differential diagnosis of AS, are still valuable. More studies are needed to determine the use of SII in the differential diagnosis of AS.