Nonscrotal Causes of Acute Scrotum

J Ultrasound Med. 2021 Mar;40(3):597-605. doi: 10.1002/jum.15431. Epub 2020 Aug 13.


Acute scrotum is characterized by intense acute scrotal pain, which may be associated with other symptoms and signs such as abdominal pain, inflammation, and fever. Many pathologic conditions can present in this way, most which involve the scrotal contents. Nonscrotal conditions, however, can rarely present clinically only as acute scrotum: among them, renal colic, aneurysm rupture or other causes of retroperitoneal hemorrhage, primary abdominal or pelvic tumors and metastases, pancreatitis, pelvic inflammation, and muscle injuries. The pathophysiologic characteristics of the clinical presentation, clues for diagnosis, and imaging features of a series of nonscrotal lesions presenting clinically with acute scrotal pain are herein reported and illustrated. In patients presenting with acute scrotal symptoms and normal scrotal ultrasound findings, nonscrotal causes of acute scrotal pain should be considered in the differential diagnosis. Therefore, an ultrasound investigation of the abdomen, groin, and thighs is indicated.

Keywords: acute scrotum; diagnosis; acute scrotum; differential diagnosis; acute scrotum; innervation; nonscrotal causes; scrotum.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Diagnosis, Differential
  • Genital Diseases, Male* / diagnostic imaging
  • Hemorrhage
  • Humans
  • Male
  • Scrotum* / diagnostic imaging
  • Ultrasonography