WOFAPS 2025 8th World Congress of Pediatric Surgery

Oğuz Mehmet Çevik, Sevim Ecem Ünlü Ballı, İbrahim Yıldırım, Gökhan Berktuğ Bahadır, İlhami Sürer

Department of Pediatric Surgery, Health Sciences University Gulhane Medical Faculty

Introduction: Testicular torsion is one of the most common causes of acute scrotum in children. Early diagnosis is important because it can result in organ loss within hours. Conservative treatment is the mainstay of treatment for epididymo-orchitis.

The Systemic Inflammatory Index (SII: Neutrophils × Platelets / Lymphocytes) has been utilised in recent years to evaluate colorectal malignancies and hepatic steatosis. The aim was to evaluate the inflammatory response in cases of acute scrotum using complete blood count data to facilitate differential diagnosis.

Materials and Methods: All patients who presented with acute scrotum between January 2020 and December 2024 were included in the sample and retrospectively reviewed. Sixty-seven patients who presented with testicular torsion, 61 patients who presented with epididymo-orchitis, and 60 patients diagnosed with uncomplicated inguinal hernia were included in the study as the control group.

The mean SII of patients who presented with testicular torsion was 1181 (91-4499), the mean SII of patients who presented with epididymo-orchitis was 936 (144-3385), and the mean SII of the control group, who underwent elective surgery for inguinal hernia, was 443 (104-1927). The mean SII value for patients with testicular torsion was higher than that for the epididymo-orchitis group, and the mean SII value for the epididymo-orchitis group was higher than that for the control group (p<0.001).

Conclusion: The SII value is a simple blood test that can be performed at any healthcare center. We believe that this value will enable the differentiation of testicular torsion from acute scrotum in patients presenting with acute scrotum through a blood test.