临床少见的阴囊淋巴管瘤术前漏诊分析

目的分析阴囊淋巴管瘤的误诊原因,以提高术前诊断率。方法回顾分析1例阴囊淋巴管瘤的临床资料。结果患者以阴囊肿胀为主要表现,超声和CT检查提示阴囊占位性病变,右侧附睾增大。术前诊断为睾丸鞘膜积液、附睾炎,行右侧阴囊探查术,术中见右侧睾丸鞘膜及精索段积液,右侧睾丸下方阴囊皮下可见多房性囊肿。完整切除精索段睾丸鞘膜,将睾丸下方的囊性组织完整游离并切除。术后病理诊断为右侧阴囊淋巴管瘤。结论少部分淋巴管瘤可发生于阴囊,应注意与睾丸鞘膜积液、附睾炎鉴别,及时手术探查明确诊断。     

高频彩色多普勒超声在阴囊、睾丸疾病中的诊断价值

目的探讨高频彩色多普勒超声在阴囊、睾丸疾病中的诊断价值。方法对151例经手术及病理证实的阴囊、睾丸疾病声像图和彩色血流进行回顾性分析。结果151例中包括:睾丸肿瘤6例(其中精原细胞瘤3例、胚胎细胞癌1例、畸胎瘤1例、恶性淋巴瘤1例);睾丸囊肿1例;睾丸微石症4例;睾丸炎5例;睾丸结核4例;睾丸扭转5例;睾丸创伤10例;附睾肿块35例(其中附睾囊肿21例、附睾炎性结节11例、附睾结核3例);鞘膜积液39例(其中睾丸鞘膜积液27例、精索鞘膜积液4例、精索睾丸鞘膜积液6例、交通性鞘膜积液2例);隐睾6例(均为腹股沟型);精索静脉曲张36例(其中21例为左侧、7例为右侧、8例为双侧);均经手术及病理证实。结论高频彩色多普勒超声能显示各种阴囊、睾丸疾病的声像图和血供特点,为临床诊断提供了重要价值。     

精索囊肿的高频超声表现

目的探讨精索囊肿的高频超声声像图特征。方法31例男性,年龄1~81岁,临床以及超声检查为无痛性阴囊或腹股沟区肿块,所有病例均经手术及病理证实。结果精索囊肿29例,其中位于阴囊内有14例,位于腹股沟管内5例,其余10例位于阴囊上方以及阴囊内。囊肿均为单侧,其中右侧15例,左侧14例。囊肿为单房26例,多房3例,囊肿透声好,形状为卵圆形或梭形,彩色多普勒观察囊肿内未见明显彩流信号。2例误诊。结论精索囊肿又称精索鞘膜积液,是鞘膜积液的4种类型之一,高频超声作为一种无创性检查方法,对诊断精索囊肿有很高的特异性。     

阴囊壁病变的高频超声表现及其病理结果

目的探讨高频超声对阴囊壁病变的诊断意义。方法回顾性分析115例阴囊壁病变的声像图表现,并与手术病理对照。结果本组115例中,阴囊壁闭合性外伤46例（挫伤32例、血肿14例）,鞘膜积液42例（精索鞘膜积液13例、睾丸鞘膜积液29例）,阴囊壁炎性病变16例（结核14例、非特异性炎变伴脓肿2例）,阴囊壁肿块11例（血管瘤3例、淋巴管瘤3例、纤维脂肪肉瘤2例、平滑肌瘤1例、恶性间皮瘤1例、表皮囊肿1例）。阴囊壁病变的共同声像图特点为阴囊壁局限性增厚,层次结构不清楚,并有异常回声出现。并因其病理类型不同而超声表现亦各有特点。结论高频超声能显示阴囊壁病变的回声改变,结合病史,能对病变进行一定程度的鉴别,可作为检查阴囊壁病变的有效手段。     

精索鞘膜腔积液的超声诊断

目的 评价超声在精索鞘膜腔积液(spermatic cord hydrpcele SCH)的诊断及鉴别诊断中的价值。方法 对55例超声诊断为精索鞘膜腔积液患进行回顾性分析。结果 55例患均被外科手术及临床证实，超声诊断符合率达到100％。其中44例为局限性精索鞘膜腔积液(topical hydrocele TH)，11例为交通性精索鞘膜腔积液(commumicating hydrocle CH)。6例患囊肿内见分隔光带回声，9例内见光点漂浮，均为局限性精索鞘膜腔积液。1例囊壁厚3mm，术后诊断为合并感染。结论 超声在精索鞘膜腔积液的诊断和鉴别诊断中是一种非常敏感和准确的方法。     

小儿睾丸卵黄囊瘤误诊分析

目的　减少小儿睾丸卵黄囊瘤的误诊。方法　回顾一组 2 8例小儿睾丸卵黄囊瘤病例 ,分析其误诊情况。结果　 1 9例曾误诊为睾丸炎、鞘膜积液、腹股沟斜疝、睾丸附睾结核等疾病 ,部分病例行睾丸肿块穿刺及按鞘膜积液行手术治疗。结论　为减少误诊必须提高对小儿睾丸卵黄囊瘤的认识 ,细致的体格检查 ,血清甲胎蛋白 (AFP)测定和超声检查对诊断有重要价值 ,但不可仅依据透光实验和 AFP结果就排除本病 ,必要时可手术探查 ;对睾丸肿块未排除肿瘤者不宜行诊断性穿刺     

高频超声诊断小儿精索囊肿

目的　探讨高频超声在小儿精索囊肿中的诊断价值。方法　 2 6例均为男孩 ,临床及超声检查为无痛性阴囊或腹股沟区肿块。所有病例均经手术及随访证实。结果　囊肿发生于单侧 2 5例 ,双侧 1例。大小 6 .8cm× 3.0 cm～ 1.5 cm× 0 .8cm。囊肿为单房 2 5例 ,双房 1例。 3例囊肿内见光点及光带反射 ,余透声好。形状为椭圆形或梭形 2 1例 ,类三角形 5例 (尖端指向腹股沟 )。位于腹股沟 10例 ,位于阴囊 16例。合并同侧及双侧睾丸鞘膜积液各 1例。彩色多普勒观察囊肿内未见明显血流信号。结论　精索囊肿又称精索鞘膜积液 ,是鞘膜积液的4种类型之一。高频超声做为一种无创伤性检查方法 ,对诊断精索囊肿有很高的特异性 ,为临床诊断及治疗提供较可靠的信息。     

小儿睾丸良性畸胎瘤误诊11例分析

目的：探讨小儿睾丸良性畸胎瘤的临床特点及误诊原因。方法：对11例误诊的小儿睾丸良性畸胎瘤临床资料及治疗方法进行回顾性分析。结果：本组经手术将肿物切除后,常规病理检查诊断睾丸良性肿瘤,术后7d拆线。全部病例均痊愈出院,经过随访结果无复发。结论：以睾丸鞘膜的积液为主要临床表现的小儿睾丸畸胎瘤易误诊为小儿睾丸鞘膜积液。对该疾病的警惕性不高,病史采集及体检不细致,不重视,没有进行必要的辅助检查是导致该疾病误诊的主要原因。     

横纹肌肉瘤超声误诊1例分析

对横纹肌肉瘤超声误诊1例分析如下。 1病历摘要 男，41岁。0．5a前发现右阴囊鸡卵大小的包块呈椭圆形，无疼痛不适感。0．5a来包块逐渐增大，平卧及运动后包块体积均无明显变化。因包块太大影响行走而来诊。以右精索鞘膜积液收入院。右阴囊见一成人拳头大小，椭圆形包块，表面光滑，边界清楚，透光实验（-）。     

微创手术治疗小儿腹股沟区斜疝鞘膜积液320例分析

目的探讨微创手术治疗小儿腹股沟区斜疝、鞘膜积液的疗效。方法回顾性分析2005-05-2010-02微创手术治疗320例小儿腹股沟区斜疝和（或）精索、睾丸鞘膜积液患儿的临床资料。结果 320例手术均获成功,随访1～5 a,除1例女孩术后复发外,其余均无复发及相关并发症发生。结论小儿腹股沟区斜疝,鞘膜积液是常见病,多发病,多需手术治疗,微创手术切实可行,安全有效,易于推广。     

Role of Doppler sonography in the diagnosis of cystic lymphangioma of the scrotum

Cystic lymphangioma is a congenital lymphatic malformation that is a rare cause of extratesticular scrotal masses in children; it is frequently misdiagnosed preoperatively. Complete excision is curative, but recurrence may result from incomplete excision. We report a case of cystic lymphangioma of the scrotum in a 3-year-old boy, which had been previously diagnosed as a hydrocele. Gray-scale sonography showed a multicystic extratesticular lesion; color Doppler sonography further characterized the lesion by showing blood flow within the septa. CT scanning ruled out extrascrotal involvement. The cystic mass was surgically resected. The appearance of the lesion both macroscopically and microscopically was consistent with a diagnosis of cystic lymphangioma. The child recovered uneventfully and was discharged on the third day after surgery; no evidence of recurrence was found in 6 months of follow-up. In such cases of scrotal masses in children, gray-scale and color Doppler sonography, followed by CT or MRI, are useful in diagnosing cystic lymphangioma, differentiating it from other lesions, and defining its extent, thus allowing proper surgical planning.     

Scrotal enlargement in boys with a history of scrotal trauma: two unusual findings

The presentation of a boy with an acutely painful scrotum is often associated with a history of trauma. Two recent patients with a history of scrotal trauma and an enlarged hemiscrotum were found on surgical exploration to have unusual causes for the scrotal enlargement. In the first case, there was bleeding from omentum in an incarcerated inguinal hernia, and in the second, there was bleeding into a scrotal cystic lymphangioma. Fewer than 40 cases of scrotal lymphangioma have been reported.     

可视穿刺肾镜在成人睾丸鞘膜积液治疗中的初步应用

目的 探讨可视穿刺肾镜睾丸鞘膜切除术治疗成人睾丸鞘膜积液的应用价值.方法 回顾性分析2018年10月-2020年10月该院行可视穿刺肾镜睾丸鞘膜切除术的23例成人睾丸鞘膜积液患者的病例资料.观察患者手术时间、出血量、住院时间、术后并发症和复发情况.结果 22例患者顺利完成手术,1例因阴囊粘连严重中转开放手术.22例患者...     

睾丸动脉舒张期反向血流的临床意义

目的探讨阴囊急症中睾丸动脉舒张期反向血流的形成及其临床应用价值。方法回顾124例阴囊急症高频彩色多普勒超声检查结果,重点分析精索内动脉及其分支的多普勒频谱形态变化,并与治疗结果对照。结果在124例中共检出10例动脉舒张期反向血流,包括睾丸不全扭转7例,急性睾丸附睾炎2例,鞘膜积液伴急性感染1例。检出舒张期反向血流的血管为精索内动脉末段及包膜动脉和(或)睾丸穿隔动脉。8例施行手术均发现睾丸存在不同程度供血障碍。结论精索内动脉及其分支舒张期反向血流可作为睾丸急性血运障碍的评判指标,其临床应用值得进一步研究。     

Inguinal approach in adult hydrocele surgery: Preliminary randomized study

This prospective study compared the effects of scrotal and inguinal approaches in hydrocele repair. Thirty-two adult patients, enrolled between January 1994 and May 2000, were randomly assigned to an inguinal (n=17) or a scrotal (n=15) approach. Scrotal size (at the surgical site) was measured preoperatively and postoperatively. Edema, infection, and hematoma formation were evaluated on the first, second, and third days after operation. Hematoma occurred in 4 patients in the scrotal approach group and in 1 patient in the inguinal approach group. Scrotal size was significantly smaller in the scrotal approach group on all postoperative evaluation days. Three months after surgery, all patients in both groups were free of hydrocele. The inguinal approach is a feasible option in the surgical treatment of adults with hydrocele; it results in less edema than is noted with the scrotal approach. Larger studies are needed to confirm these results.     

Sonographic findings in a case of scrotal lymphangioma in a 68‐year‐old male

Lymphangiomas are benign tumors resulting from a congenital lymphatic malformation in infant and children. Most common sites are head, neck and axilla, and scrotal lymphangioma is very rare. Lymphangiomas are classified as capillary, cavernous, and cystic type and cystic type is most common. Complete surgical excision is definitive treatment and incomplete excision leads to local recurrence. We report a case of scrotal lymphangioma in 68‐year‐old male patient. Gray‐scale sonography revealed multiseptated, hypoechoic mass abutting the upper pole of the normal right testis. Color Doppler sonography showed no remarkable blood flow in the mass. MRI demonstrated multispetated extratesticular and extraepididymal mass in the right scrotum. Surgical excision was performed and the histopathologic diagnosis was a cystic lymphangioma. In conclusion when multiseptated cystic scrotal mass was discovered in an elderly patient, scrotal lymphangioma should be included in differential diagnosis. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009     

急性附睾、睾丸炎的B超诊断

对38例急性附睾睾丸炎的声像图表现作了观察分析.结果表明:阴囊壁增厚、鞘膜积液、附睾和睾丸增大、附睾和睾丸局限性或弥漫性回声减低为本病的声像图改变,但这些征象并无特异性,应结合临床,与睾丸扭转的亚急性期等加以鉴别.