{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:31:13Z","timestamp":1786321873541,"version":"build-2736575974"},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:00:00Z","timestamp":1568160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute scrotal pain is a common paediatric surgical presentation. Delays in treatment can result in testicular loss from torsion. It is unclear where delays occur. We aimed to investigate presentations with an acute scrotum to identify any potential areas of delay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective study (April 2017\u2013November 2018) of paediatric patients (&lt;18\u2009years) presenting with acute scrotal pain. Data collected included: patient demographics, history\/examination findings, mode of presentation, clinical timeline details and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 107 acute scrotum presentations were identified: 58 (54.2%) testicular appendage torsion, 23 (21.5%) testicular torsion, 6 (5.6%) epididymo\u2010orchidits and 20 (18.7%) other diagnoses. Median age at presentation was 11\u2009years (4 months\u201316\u2009years). Fifty\u2010seven (53.3%) underwent emergency surgery, of whom 23 (40.4%) had testicular torsion, with 2 requiring orchidectomy. Median time from onset of symptoms to seeking medical opinion was 5.5 (0\u2013135) h. Once assessed by a medical professional, the route to paediatric surgical review via general practitioner (GP) and local emergency department (ED) to paediatric ED was 4.84 (1.67\u201324.5) h; via GP to paediatric ED was 2.58 (0.75\u201325.5) h; via local ED to paediatric ED was 2.25 (1\u20137.75) h; and directly to paediatric ED was 0.45 (0\u20131.42) h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Delays in assessment and treatment of acute scrotal pain occur from the time parents are aware of symptoms to seeking medical opinion. Education to increase awareness may reduce time delays. GPs should refer patients directly to a paediatric ED. Local EDs should manage paediatric cases as per the local surgeons' skill base.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.15399","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T10:05:12Z","timestamp":1568196312000},"page":"1615-1619","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical state of the paediatric acute scrotum in south\u2010eastern Victoria"],"prefix":"10.1111","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4504-4969","authenticated-orcid":false,"given":"Sharman P.","family":"Tan Tanny","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Wijekoon","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Pacilli","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics Monash University  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh M.","family":"Nataraja","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.5505\/tjtes.2013.82783"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(95)90574-X"},{"key":"e_1_2_7_4_1","volume-title":"Acute Scrotum Pain","author":"Boniface MP","year":"2019"},{"key":"e_1_2_7_5_1","first-page":"90","article-title":"The acute scrotum in children","volume":"120","author":"Tarca E","year":"2016","journal-title":"Rev. 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