创伤性睾丸脱位4例

创伤性睾丸脱位临床少见 ,易漏诊、误诊 ,我们1 995年 8月～ 2 0 0 2年 7月共收治 4例 ,现报告如下。1　临床资料例 1　 78岁。因不慎从 2m高处坠下 ,右侧阴囊破裂伴流血 ,40h入院。体检 :体温 38℃ ,脉搏88次 /min ,呼吸 2 0次 /min ,血压 1 5 0 /90mmHg( 1mmHg =0 .1 33kPa)。心肺腹未见异常 ,阴茎包皮无异常 ,右侧阴囊前方可见一约 3cm的纵形皮肤裂口 ,少许淡黄色渗液 ,右阴囊空虚 ,于右侧腹股沟中部扪及右侧睾丸 ,约 3cm× 3cm× 3cm大小 ,触痛 ,左侧正常。血常规 :WBC 1 2× 1 0 9/L ,N 0 .82 ;尿常规正常。拟诊 :右侧阴囊皮肤裂伤…     

创伤性睾丸脱位2例报告

在外界暴力作用下睾丸脱离阴囊至其它部位，称为创伤性睾丸脱位。本病较少见，也易漏诊而延误治疗。我们曾于2002年和2003年分别收诊2例，报告如下。     

外伤性睾丸脱位4例报告

外伤性睾丸脱位是指睾丸在外力作用下被挤压到阴囊以外的部位。临床少见 ,也常因漏诊而延误治疗。我院自 1990年 8月～ 1999年 2月收治 4例 ,报告如下。病历介绍例 1　 32岁。 1年前被汽车撞伤 ,在我院神经外科诊断为脑挫裂伤 ,行开颅清除血肿脑室分流手术。术后神志不清持续两个月。 1月前病人感左腹股沟区疼痛 ,同时发现左侧阴囊内无睾丸 ,遂来我院就诊。查体发现左侧阴囊空虚 ,左腹股沟区可触及4ｃｍ× 3ｃｍ× 3ｃｍ大小肿物 ,有触痛 ,活动 ,但不能推入阴囊。诊断 :外伤性睾丸脱位 (左 )。在硬膜外麻醉下行左睾丸松解固定术。术中见睾丸…     

创伤性睾丸脱位4例报告

创伤性睾丸脱位临床上少见,易延误诊治。我们自1996-2006年收治了4例(其中1例为作者在外院手术会诊所遇),本文报告其临床资料并结合文献探讨创伤性睾丸脱位的诊断和治疗。病例介绍例1患者,7岁,因右腹股沟区不适1月余入院。查体:左侧阴囊、睾丸、附睾和精索正常,右侧阴囊空虚,右腹股沟中部可触及一约1．5cm×1．0cm大小的肿块,比较固定。询问病史,2年前曾     

睾丸脱位2例报告并文献复习

例 1　男 ,4 7岁 ,5年前因车祸致骨盆骨折 ,左侧阴囊巨大血肿。经治疗后 ,症状改善 ,局部血肿消退后发现左侧阴囊空虚 (车祸前阴囊体检正常 ) ,因无明显不适感 ,未行进一步诊治。半年来 ,自觉阴茎举而不坚 ,难以性交而于 1997年 5月入院。体检 :右侧睾丸正常 ,左侧阴囊空虚 ,右腹股沟处未及睾丸。实验室检查 :血睾酮 (Ｔ)正常 ,Ｂ超示左下腹探及睾丸 ,约 4 .5ｃｍ× 3.6ｃｍ× 3.2ｃｍ大小 ,包膜完整。手术探查 ,术中于左下腹腔内探及睾丸 ,较右侧稍小 ,质地偏软 ,附睾及精索无明显异常 ,睾丸鞘膜积液约 80ｍｌ。予以精索高位结扎后行该侧睾…     

创伤性睾丸脱位

创伤性睾丸脱位是泌尿生殖系罕见的损伤 ,易漏诊而延误治疗。我院自 1995年 5月以来共收治 2例 ,报告如下。1　临床资料例 1,男性 ,13岁 ,因双侧阴囊空虚 2个月 ,于1995年 5月入院 ,该例原患双侧腹股沟斜疝。 2个月前因双侧斜疝嵌顿在当地医院行手法复位。此后出现双侧阴囊空虚 ,自觉下腹部胀痛不适。体格检查 :阴茎、阴囊发育正常 ,双侧阴囊空虚。于双侧腹股沟管外环处触及睾丸 ,活动度差。实验室检查 :血、尿常规无殊 ,血睾酮正常。拟诊双侧睾丸脱位 ,行手法复位失败后 ,次日改行手术探查 ,术中示双侧睾丸均位于腹股沟管内 ,被疝囊包裹 ,…     

创伤性睾丸脱位的诊断和治疗

在外界暴力作用下睾丸脱离阴囊至其他部位，称为创伤性睾丸脱位。本病较少见，也易漏诊而延误治疗。我们于1999年1月-2004年3月收治5例，报告如下。     

外伤性睾丸脱位诊治体会

外伤性睾丸脱位是指睾丸在外力作用下被挤压到阴囊以外的部位。临床少见，也是因漏诊而延误治疗。本组对１５年来６例外伤性睾丸脱位收治情况，报告如下。临床资料１．一般资料：明确诊断时间，２例及时诊断，另４例在伤后３～６个月诊断。左侧４例，右侧２例。合并伤，６例均合并耻骨枝骨折，下腹部广泛淤血，阴囊血肿２例合并膀胱破裂。２．B超检查：２例作阴囊B超检查，均为阴囊空虚，其中１例为阴囊内血肿，１例睾丸位于耻骨处，１例位于腹股沟。３．治疗：１例即行手法复位，１例在阴囊血肿多刀切开时复位，另４例以手术方法复位。讨…     

睾丸扭转的诊治(附59例报告)

目的 探讨睾丸扭转的诊治。方法 回顾性分析59例睾丸扭转患者的临床资料。结果 1例为腹腔内恶变隐睾扭转，余58例（59次）发病时中位年龄18．5岁，均无发热，50例次在夜间或剧烈运动后发病。4例手法复位成功。1例手法复位后再次扭转，拒行手术致睾丸萎缩。2例明确睾丸已坏死未手术治疗，患睾逐渐萎缩。接受手术探查的52例中有15例睾 丸存活，其中发病超过24d的1例，不到10h11例。结论 青少年夜间或运动后突发急性睾丸痛应该警惕扭转的可能，必要时紧急手术探查，手法复位可尝试应用。     

睾丸扭转的诊断与治疗(附11例报告)

目的提高临床医师对睾丸扭转的诊断和治疗水平。方法总结分析11例睾丸扭转的临床资料及彩色多普勒常规检查情况。结果11例均手术治疗,术前彩色多普勒检查确诊8例。结论仔细查体结合多普勒检查术前多可确诊,为手术治疗赢得时间。     

Traumatic manubriosternal dislocation

Manubriosternal dislocation is an extremely rare occurrence, especially as the result of an indirect compression injury. Manubriosternal dislocations are divided into two types: In a Type I dislocation, the body of the sternum is displaced in a dorsal direction; in Type II dislocation, the body is displaced to the ventral side of the manubrium. A manubriosternal dislocation may be caused by direct or indirect trauma. Direct injury is generally a collision injury occurring in the context of a road accident. Resulting may be in either a Type I or Type II dislocation. Indirect trauma always leads to a Type II dislocation due to a flexion-compression mechanism in the region of the spine. Rheumatic arthritis and obvious kyphosis are predisposing factors in manubriosternal dislocation due to the indirect compression injury. Non-operative treatments after reduction, e.g. correction tape or plaster bandage, symptomatic pain treatment, application of ice, and several weeks without sports, are associated with a not inconsiderable rate of subluxations or reluxations, especially due to insufficient patient compliance. These disorders can lead to chronic pain, periarticular calcification with ankylosis, and progressive deformity. It has not been possible to establish an optimal, standardized operative procedure so far because of the small number of cases. We have achieved very good, postoperative long-term outcomes after plate osteosynthesis of manubriosternal dislocations in two patients.     

Traumatic atlantoaxial dislocation

In our series of traumatic atlantoaxial injuries we found a 21% incidence of dislocation without an associated fracture of the odontoid process (7 of 33 cases). Clinically these patients initially exhibited associated cranial trauma (5 cases), cervical pain and headache (5 cases), subjective neurological complaints (5 cases), and objective neurological abnormalities (4 cases); in 4 patients, diagnosis was delayed because diastasis of the atlantoaxial joint was not recognized on lateral cervical radiograms. The wide spectrum of clinical presentations is partially accounted for by the varying degrees of injury to the transverse atlantal ligament and other associated ligamentous injuries. The findings in this series emphasize the need for awareness of this disorder, which may represent a significant number of the injuries to the region.     

外伤性睾丸破裂16例诊治体会

目的 探讨睾丸破裂的诊治及预后.方法 睾丸破裂16例,通过病史、体检,11例通过彩超确诊,3例彩超检查后可疑破裂进一步行CT扫描确诊,另有两例通过手术探查确诊.全部予以手术治疗,13例行睾丸修补,3例行睾丸切除.结果 无严重并发症及死亡病例发生,随访10个月～4年,其中有2例单侧损伤病人行睾丸修补后出现双侧睾丸萎缩,一例单侧切除后对侧发生萎缩,一例双侧严重损伤的病人生殖功能明显下降,但所有病人雄激素水平基本正常.结论 彩超及CT检查是判断睾丸损伤程度及病情变化的重要方法,积极早期手术探查可最大限度保留睾丸组织,减少并发痖发生.     

肾损伤450例的诊断和治疗

目的　提高肾损伤的诊疗水平。方法　对450例肾损伤进行了回顾性分析。结果　闭合性损伤423例,开放性损伤27例, 合并伤227例。B超阳性率68.2%,双倍剂量IVU阳性率47.9%,CT阳性率100%。根据病情分别选择手术与保守治疗,非手 术治愈365例,超选择性肾动脉栓塞4例,手术治愈67例,死亡14例。结论　B超检查快捷安全,应作为肾损伤首选检查方法, 在诊断中主要起到筛选作用。CT扫描为肾损伤程度分类和选择治疗方案提供可靠依据,应作为重度肾损伤和术前常规检查方 法。治疗取决于伤情,保守治疗是重要的治疗方法,严格掌握手术和非手术治疗指征是处理肾损伤的关键。     

肾上腺髓性脂肪瘤5例报告

目的提高对肾上腺髓性脂肪瘤的认识和诊治水平。方法对1992年12月~2003年11月收治的5例肾上腺髓性脂肪瘤患者的临床资料进行回顾性分析。结果4例为右侧偶发瘤,1例出现右腰痛就诊。3例术前行内分泌学检查无异常,4例经CT或MRI均确诊为肾上腺髓性脂肪瘤,1例CT误诊为右肾错构瘤。均行手术切除肿瘤,术后病理报告均为肾上腺髓性脂肪瘤。术后随访0.5~11.5年,均未见肿瘤复发。结论肾上腺髓性脂肪瘤多数无症状,术前通过CT或MRI等影像学技术多能确诊。对瘤体直径<3.5cm的无症状偶发瘤可密切随访,对有症状者或瘤体直径>3.5cm者宜行手术切除。     

闭合性肾损伤的诊断与治疗（附86例报告）

目的探讨闭合性肾损伤的诊断和治疗。方法对86例（1990年3月至2005年12月）闭合性肾损伤患者的临床资料进行回顾性分析。结果行B超、CT、静脉尿路造影（intravenous urography，IVU）检查分别是80例（93％）、32例（37．2％）和8例（9．3％）；保守治疗65例（75．5％），手术治疗21例（24．5％），其中保肾手术16例（76．2％）；治愈83例（96．5％），死亡3例（3．5％）。结论B超和CT检查可诊断并评估肾损伤程度，有利于制订合理保肾治疗方案。     

Traumatic recurrent distal radioulnar joint dislocation: a case report

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury (Garrigues and Aldridge III in J Bone Joint Surg Am 89:1594–1597, 2007]. Reports of isolated DRUJ luxations, volair or dorsal, are often case reports and rarely a series of cases [Dameron Jr in Clin Orthop Relat Res 83:55–63, 1972]. We present a case of an acute traumatic dorsal DRUJ dislocation treated with cast immobilization with recurrence of the dislocation after a new trauma some months later. At follow-up, 17 months after the first dislocation and 9 months after the second, he experienced no pain and had no restrictions in work or sports-related activities.     

Traumatic testicular dislocation: A rare occurrence of blunt scrotal injury

We report a motorcyclist who presented with a right empty hemiscrotum with ecchymosis and swelling after sustaining straddle injuries in a motorcycle collision. A tender soft mass was palpable in the right groin on physical examination. The ultrasound image revealed a right dislocated testis within the inguinal canal; it had a normal size and echotexture. Manual reduction was unsuccessful. The patient underwent surgical exploration and reduction. He recovered well after undergoing orchidopexy. Two weeks later, the follow-up physical examination at the outpatient clinic was normal. Traumatic testicular dislocation is a rare occurrence after blunt scrotal trauma and is easily overlooked. Manual reduction of a dislocated testis has a low success rate and may overlook coexisting injuries. Early surgical exploration and testicular repositioning are necessary to preserve the testis and avoid coexisting injuries.     

Traumatic lumbosacral lateral dislocation without fracture

Study design  A unique case of lumbosacral lateral dislocation without fracture is reported. Objective  To report on the diagnosis and treatment of a traumatic L5-S1 lateral dislocation in a polytrauma 34-year-old male with L5 nerve root paralysis. Method  Interbody fusion following decompression, posterior reduction and interbody grafting combined with posterior plating was performed. Results  At an early stage the patient was able to return to work and walk without supports. At the 12-month follow-up evaluation no back pain was referred and fusion was achieved. Conclusions  Lateral pure dislocation of the lumbosacral joint is very rare and can be easily misdiagnosed. A careful evaluation of the AP standard X-ray can lead to diagnosis and can be confirmed by CT scan. Prompt reduction and fusion is the treatment of choice to allow a quick functional recovery.