{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T23:53:02Z","timestamp":1773273182853,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T00:00:00Z","timestamp":1632873600000},"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":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute scrotal pain is a common emergency presentation in paediatric surgery. Torsion of the testicular appendage (TTA) is the most common cause for pain, with testicular torsion (TT) being the sinister pathology to exclude. Outcomes are time dependent, and a delayed scrotal exploration could result in testicular loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a review on a large retrospective cohort of 449 surgical scrotal explorations at a large referral paediatric surgical centre over three years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only about a quarter of children with testicular pain presented within 4 h. TT is commonly associated with nausea and an abnormal lie. Two children with a classical \u2018blue dot\u2019 sign were later found to have a testicular torsion. 19% of all children with a TTA were also seen to have Bell clapper anomaly (BCA). Recurrent testicular pain was associated with 84.7% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) of BCA. Intra\u2010operative diagnosis of TTA correlated with histopathology in 84.6% (p=0.021). The sensitivity of intraoperative diagnosis was 90.9% with a specificity of 75.3%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Routine histopathology for a classic TTA may not be required especially in resource poor situations. All children presenting with recurrent episodes of testicular pain must be considered for surgical scrotal exploration. And in view of the incidence of BCA in this cohort, all scrotal explorations for acute scrotal pain should include an assessment for BCA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17231","type":"journal-article","created":{"date-parts":[[2021,9,29]],"date-time":"2021-09-29T12:49:43Z","timestamp":1632919783000},"page":"2514-2517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical management of the acute paediatric scrotum: a three\u2010year single centre experience"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-3853","authenticated-orcid":false,"given":"Janarthan Sainath","family":"Muraliharan","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery Children's Hospital at Westmead  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun John K.","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"Department of Paediatric Surgery Christian Medical College  Vellore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7763-9772","authenticated-orcid":false,"given":"Bapesh Krishna","family":"Bollu","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery Children's Hospital at Westmead  Sydney New South Wales Australia"},{"name":"School of Medicine University of Sydney  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Graf","sequence":"additional","affiliation":[{"name":"School of Medicine University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Pathology Children's Hospital Westmead  Sydney New South Wales 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