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.
