Causes of scrotal swelling in children:
1. Inguinoscrotal hernia
2. Congenital hydrocele
3. Acute epididymo-orchitis
4. Testicular torsion
5. Obsructed hernia
6. Testicular tumor
7. Lymphoma of testis
8. Haematocele
9.Trauma
10. Cellulitis of scrotum
11. Scrotal abscess
Out of these, Testicular torsion & obstructed inguinoscrotal hernia are surgical emergencies. In case of congenital hydrocele, there is possibility of spontaneous resolution till 1 year of age. Inguinoscrotal hernia & testicular tumor are surgical semiemergencies while lymphoma is an oncological emergency. In case of acute epididymo-orchitis, one should rule out testicular torsion & then start on antibiotics. Similarly cellulitis, trauma & haematocele can be treated conservatively. The child who progressed to scrotal abscess (rare) will need incision & drainage (again a surgical emergency).
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