What Are the Causes of Acute Scrotum in Boys?

Acute scrotum is pain and inflammation of the boy's testicle. Learn about the most frequent causes and how to distinguish them in the following article.
What Are the Causes of Acute Scrotum in Boys?

Last update: 09 November, 2021

We know acute scrotum as a condition in baby boys or children that appears as inflammation and pain in this part of their body. It may be caused by different illnesses or injuries, some of which may be medical emergencies and require quick action. Here, we’ll tell you about the most common causes of acute scrotum.

Acute scrotum due to testicular torsion

In testicular torsion, what happens is that the spermatic cord, which supplies blood to the testicles, coils on itself. It’s the most common cause of acute scrotum, especially in older boys and pre-adolescents.

It presents itself as a sudden, severe pain radiating into the boy’s groin. In addition, the testicle may be swollen and red. If we try to lift the affected testicle, the pain increases.

What Are the Causes of Acute Scrotum in Boys?

What happens is that the longer this condition goes undiagnosed and untreated, the longer the testicle will go without receiving blood. Because of this, the testicle may suffer necrosis and need to be removed if treatment is delayed.

Therefore, it’s important to know how to interpret the symptoms and to visit a specialist as soon as possible. The professional will make a clinical diagnosis and, perhaps, an ultrasound scan. In case of confirmation, the child may need to go to the operating room to correct the problem as soon as possible.

Hydatid torsion

Hydatid torsions, also known as testicular appendages, are embryonic structures that can remain in different parts of the testicle. We most commonly find them in the upper part of the testicle.

When this appendage coils in on itself, it produces a gradual pain that’s usually less intense than in testicular torsion. Moreover, this pain, instead of being spread throughout the testicle, is usually localized in the upper part. Apart from this localized pain, a bluish spot may appear at this painful point.

This usually occurs in childhood, especially between the ages of 2 and 11 years. Contrary to testicular torsion, this is a less serious condition and isn’t urgent. Treatment usually consists simply of rest and, if necessary, analgesics and anti-inflammatory drugs. With or without treatment, it usually resolves on its own. Just the same, the child should see a doctor in order to obtain a proper diagnosis and rule out other more serious issues.


The epididymis is the part of the testicle where sperm mature and are stored. Epididymitis is the inflammation of this part of the testicle. It usually occurs because urine with bacteria gets into this part of the testicle and becomes infected.

What Are the Causes of Acute Scrotum in Boys?

Epididymitis manifests itself as increasing pain. In this case, the child will also experience general malaise, painful urination, and fever. Diagnosis will be based on symptoms and imaging tests.

For example, doctors may perform an ultrasound or a urine culture to confirm the presence of bacteria. The treatment will involve analgesics and antibiotics directed against the bacteria that produce the infection.

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What you should know about acute scrotum

We must keep in mind that pain and inflammation in a boy’s testicle can be caused by different diseases or injuries. The most important thing is to visit a specialist as soon as we observe any symptoms. As we’ve mentioned, some of them can be a real medical emergency.

The specialist will be the one who, through the patient’s symptoms and some complementary tests, if necessary, will establish the diagnosis. From here, they’ll propose the most appropriate treatment. In most cases, the condition resolves itself and the child won’t have any consequences after that.

As always, it’s important to keep up to date with check-ups with your child’s pediatrician. In case you observe any symptoms in your child, you should remain calm and follow the pediatrician’s advice.


All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Pons M, Barani C, Gelas T, Demede D, Mure PY. (2018). Urgencias en urología pediátrica. EMC – Pediatría. 2018 Mar 1;53(1):1–7
  • Tekgül S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, et al. (2010). Guía clínica sobre urología pediátrica.
  • Manual de urgencias pediátricas – Hirsch, Tamara, Concha, Ida – Google Libros [Internet]. [cited 2020 May 12]. Available from: https://books.google.es/books?hl=es&lr=&id=kt2NCgAAQBAJ&oi=fnd&pg=PT278&dq=escroto+agudo+pediatria&ots=yjsc4CW72C&sig=Qqh19-IZMyi3MjFOkCZnDfHr68Q&redir_esc=y#v=onepage&q&f=false

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.