The Journal of Clinical Pediatric Rheumatology
Online ISSN : 2434-608X
Print ISSN : 2435-1105
Orchiectomy for acute scrotum : A case report of a 4-year-old boy with IgA vasculitis
Itsumi KomoriKeitaro FukushimaYusuke AndoJunpei IshiiYuzuru YamazakiToshitaka UematsuYuumi TokuraTsunehito KanbaraShigeko KuwashimaYoshimasa NakazatoTakao KamaiShigemi Yoshihara
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2019 Volume 10 Issue 1 Pages 11-15

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Abstract
IgA vasculitis sometimes causes acute scrotum, but in many cases surgical treatment is not necessary. We report a case of unilateral orchiectomy because of acute scrotum due to IgA vasculitis. A 4-year-old boy was admitted to our hospital with a diagnosis of IgA vasculitis because he had abdominal pain, ankle pain, and purpura. These symptoms disappeared with administration of prednisolone( PSL). On the 8th day after onset while PSL was gradually being tapered, pain and swelling of the left scrotum suddenly appeared. His left testis became dark red and was diagnosed macroscopically as necrotic. Because we could not distinguish his symptoms from testicular torsion, an emergency orchiectomy was performed. On the 11th day, the patient experienced right scrotal pain. Since imaging findings showed normal blood flow to the right testis, the patient was treated conservatively. The scrotal symptoms disappeared, and the right testis was preserved. Pathological findings on the left testis showed vasculitis and hemorrhage without necrotizing changes. Many patients with acute scrotum associated with IgA vasculitis do not have damage to the testis, but in rare cases this disease causes serious vasculitis in the testis. Immediate examination by imaging and conservative treatment are important when acute scrotum develops during the course of IgA vasculitis, but surgical intervention should also be performed if the diagnosis is unclear.
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© 2019 Pediatric Rheumatology Association of Japan
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