成人双侧睾丸扭转病例分析并文献复习

目的:报告3例成人双侧睾丸扭转并复习文献。方法:回顾性分析3例双侧睾丸扭转因误诊致睾丸坏死的病例,结合国内外文献对睾丸扭转发病原因、解剖分类、临床表现、超声诊断和治疗方案进行复习和讨论。结果:3例因误诊后致双侧睾丸坏死,后均经双侧睾丸彩色多普勒超声确诊后行双侧睾丸切除术。结论:发病后及时就诊,首诊医师的高度重视、准确诊断、正确处置是挽救睾丸的关键;彩色多普勒超声检查仍然是确认阴囊急症的首选辅助检查;对疑为睾丸扭转者,应急诊手术探查。     

外伤性睾丸扭转2例并文献复习

阴囊闭合性外伤可引起睾丸扭转,易误诊为单纯性睾丸炎或睾丸外伤.延误手术时机会引起睾丸坏死导致严重后果,尽早手术探查可以明确诊断和手术复位以挽救患侧睾丸.2000年9月至2010年1月笔者共收治2例,结合文献复习报告如下.     

成人双侧睾丸同时扭转1例报告并文献复习

<正>睾丸扭转为男性人群最重要急症之一,也是急诊科常见阴囊急症[1]。25岁以下男性发病率为1/4000,成人罕见[2]。成人双侧睾丸同时扭转临床更为罕见,我院收治1例,现结合文献复习报告如下。     

睾丸扭转3例报告及文献复习

为探讨睾丸扭转的临床诊治情况，报告睾丸扭转３例，结合文献讨论了睾丸扭转的病因、临床表现、诊断和治疗。重点描述了彩色多普勒流动显像（ＣＤＦＩ）的影像学变化和诊断价值，提出对阴囊内急症应常规行ＣＤＦＩ检查，如诊断明确或不能排除睾丸扭转，应及早手术探查以期最大程度的保留睾丸功能。     

睾丸扭转反复误诊致坏死1例并文献复习

目的:提高临床医生对睾丸扭转的诊断能力。方法:报道1例睾丸扭转因延迟就诊和2次误诊致坏死。结合文献,对其解剖、临床表现、超声诊断及误诊原因进行复习与分析。结果:1例表现为下腹痛的睾丸扭转患者,2次分别被误诊为肠痉挛和输尿管结石。术中探查证实睾丸扭转,睾丸已经坏死并切除。术后病理证实为睾丸坏死并弥漫性出血。结论:发病后及时就诊、准确诊断和正确治疗是避免睾丸丢失的关键。彩色多普勒超声检查为明确本病的一种理想影像学检查方法,并对手术有指导作用。     

儿童隐睾扭转1例并文献复习

隐睾是指一侧或双侧睾丸停止于下降途中,未进入同侧阴囊内,多发生于婴幼儿,其发病原因及机制尚不完全清楚.睾丸扭转是指一种睾丸急性缺血、坏死的病变,表现为睾丸所在位置剧烈疼痛,常发生于青少年,需要积极手法复位或急诊手术,如不积极治疗将给患者生理和心理带来不可逆转伤害.隐睾扭转相关报道较少[1].我院收治1例,现结合文献报告...     

睾丸扭转31例报告

1978年至 2 0 0 1年我院收治睾丸扭转 31例 ,现报告如下。材料与方法　本组 31例 ,其中 30例年龄 7～ 32岁 ,平均 17.3岁 ;1例 4 5岁。多在安静 (14例 )或睡眠 (8例 )中发病。 3例发病 6h内经我院诊治 ;2 8例初诊时误诊 ,转至我科时发病 15h～ 2 8d ,平均 2～ 4d ,其中误诊为附睾睾丸炎 2 2例、阑尾炎 2例、鞘膜积液出血 2例、睾丸肿瘤出血 1例、绞窄性疝 1例。发病 <6h者临床表现睾丸骤痛 ,位置上移、肿大、压痛、提睾反射消失 ,透光试验阴性 ,Prehn征阴性 (疼痛加剧 ) ,多伴消化道症状 ,少有发热 ;发病 2～ 7d者疼痛渐缓 ,睾丸渐软 ,以阴…     

睾丸扭转10例报告

本文报告10例睾丸扭转,其中7例在8小时内手术探查,复位后挽救睾丸,3例因睾丸坏死而手术切除。作者就睾丸扭转的诊断及手术治疗进行讨论,认为应高度重视睾丸扭转的诊断,并尽早手术探查,以提高睾丸挽救率。     

39例睾丸扭转的诊断与治疗并文献复习

目的 提高睾丸扭转的诊断与治疗水平.方法 回顾性分析2007年1月～ 2013年10月间39例睾丸扭转患者的住院病例资料.结果 30例患者早期被误诊为睾丸附睾炎.39例均行阴囊彩超检查,其中9例提示睾丸血供明显减少,30例提示睾丸血供消失.并急诊行阴囊探查术,术中发现30例患侧睾丸坏死,行患侧睾丸切除+对侧睾丸固定术;9例复位扭转睾丸后血供好转或者恢复,行睾丸复位固定术+对侧睾丸固定术.术后35例获随访,随访时间3 ～72个月,其中3例复位睾丸出现不同程度萎缩,所有患侧睾丸及健侧睾丸未再次发生扭转.结论 睾丸扭转早期容易误诊为睾丸、附睾炎,阴囊彩超有助于诊断.一旦明确或者高度怀疑睾丸扭转,应急诊行阴囊探查术,挽救扭转的睾丸.     

睾丸表皮样囊肿7例报告并文献复习

目的探讨睾丸表皮样囊肿的临床特点及诊治方案。方法回顾性分析2003年1月至2013年6月我院收治的7例睾丸表皮样囊肿的临床资料,结合文献复习进行讨论,其中6例采用肿瘤剜除术,1例采用睾丸切除术。结果术后随访6个月~10年,无肿瘤复发及转移。结论睾丸表皮样囊肿是少见的睾丸良性肿瘤,B超、CT、MRI检查对诊断本病有重要作用,推荐保留睾丸的单纯肿物剜除术作为主要的治疗方式。     

睾丸扭转18例报告

目的 总结睾丸扭转的诊治体会。方法 报告18例睾丸扭转的临床诊治资料。结果 5例扭转时间短或不全扭转才经手术复位后保留了睾丸。13例（70％）坏死睾丸予以切除。结论 彩色多普勒超声成像是诊断急性睾丸扭转的可靠方法,治疗上主张作预防性睾丸固定,以免扭转复发或再发。     

睾丸扭转的诊断与治疗(附42例报告)

目的总结睾丸扭转的早期诊断及治疗方法,提高睾丸扭转的诊治水平。方法回顾性分析我院1992年1月至2006年3月收治的42例睾丸扭转患者的临床资料。结果手法复位3例,其中2例术后再次出现睾丸扭转;手术治疗39例,11例予以保留睾丸,28例行睾丸切除。结论对本病应保持足够的警惕与认识,并通过详细地询问病史、细致地体格检查、适当地辅助检查和及时地手术探查来诊断本病;发现本病应及时手术治疗,尽量避免睾丸切除的发生。     

Gallbladder torsion: case report and review of 245 cases reported in the Japanese literature

We report here a case of torsion of the gallbladder in a 73-year-old woman. The patient was admitted to our hospital with right hypochondralgia. Ultrasonography and computed tomography demonstrated a distended gallbladder, with a multilayered wall, which contained no stones. Since the symptoms did not respond to antibiotics, laparotomy was performed. The gallbladder was found to be twisted around its pedicle and to be gangrenous. Cholecystectomy was performed, and the patient had an uneventful postoperative course. We also reviewed 245 cases reported in the Japanese literature. The clinical features of gallbladder torsion, which include low frequency of fever and jaundice, poor response to antibiotic therapy, and acute onset of abdominal pain, may be helpful in the differential diagnosis from acute cholecystitis. Moreover, a highly suggestive sign of gallbladder torsion observed by ultrasonography or computed tomography is a markedly enlarged "floating" gallbladder with a continuous hypoechoic line indicating edematous change in the wall. Received for publication on Feb. 8, 1999; accepted on April 21, 1999     

69例睾丸扭转诊断与治疗

目的提高睾丸扭转诊断及治疗水平。方法对69例睾丸扭转患者的临床资料进行回顾性分析。结果8例12h内手术者，睾丸均存活；6例12—24h手术者，3例睾丸存活；39例超过24h手术者仅7例睾丸存活。未手术者16例，随访7例扭转睾丸均发生不同程度萎缩，尚未发现生育能力受影响者。结论早期诊断、及时治疗是提高疗效的关键。睾丸移植是治疗双侧睾丸扭转后功能性无睾症的一种有效方法。     

Ovarian torsion in puerperium: A case report and review of the literature

INTRODUCTION

Ovarian torsion (OT) is a rare cause of acute abdominal pain that requires prompt recognition and treatment during puerperium. Diagnosis of OT can be challenging due to nonspecific clinical features and uncommon objective findings. The management of OT is often delayed because of diagnostic uncertainty. Early and timely recognition and prompt intervention are crucial to preserve ovarian function and to minimize morbidity.

PRESENTATION OF CASE

We report a 29-year-old postpartum woman who presented to the emergency department (ED) with severe right flank pain, nausea and anorexia initially considered as renal colic. After further investigation, OT caused by large mucinous cyst was diagnosed. Right-sided salpingo-oophorectomy was performed due to hemorrhagic ovary and huge cystic mass causing ischemic OT.

DISCUSSION

OT is often diagnosed based on the clinical presentation, including severe, sharp, sudden onset of unilateral lower abdominal pain and tenderness with a palpable laterouterine pelvic mass and nausea/vomiting. Emergency surgical intervention should be performed if OT is suspected to confirm the diagnosis and uncoil the twist to prevent ovarian damage.

CONCLUSION

In conclusion, emergency physicians should be aware of the possibility of OT in postpartum women. Therefore, early and timely surgical intervention should be undertaken.     

精索扭转14例临床分析

目的：总结我院对精索扭转的诊疗经验。方法：报告14例精索扭转病例的临床诊疗情况。结果：6例扭转时间短或是不完全扭转者得以保留睾丸，8例睾丸坏死予以手术切除。结论：手术探查是确诊精索扭转的方法；睾丸组织的血液供应是预测其生存能力的一项重要指标；本病病理诊断的价值有待进一步探讨。     

睾丸扭转(8例)的诊断和治疗

目的：报道睾丸扭转 ８ 例,结合文献讨论睾丸扭转的病因、临床表现、诊断和治疗。　方法：为增强对此病的认识,采用彩色多普勒超声（ Ｃ Ｄ）和放射性核素显像（ Ｒ Ｉ Ｓ）检查,并分析其诊断价值。　结论：应尽早手术探查和治疗。     

Ovarian torsion associated with appendicitis in a 5-year-old girl: a case report and review of the literature

Acute ovarian torsion is an uncommon cause of abdominal pain in female children and is often difficult to differentiate from other conditions causing lower abdominal pain. Acute adnexal pathology associated with appendicitis is very rare, with only a handful of reports available in the literature. Reported is a case of ovarian torsion associated with appendicitis in a 5-year-old girl along with a comprehensive literature review.     

睾丸混合性非精原细胞性生殖细胞癌1例并文献复习

目的:睾丸混合性非精原细胞性生殖细胞癌的文献报道极少,本文旨在探讨睾丸混合性非精原细胞性生殖细胞癌的临床症状、病理特点及诊疗方法。方法:分析1例睾丸混合性非精原细胞性生殖细胞癌的临床资料,并运用组织学、细胞化学和免疫组化技术对该例睾丸混合性非精原细胞性生殖细胞癌进行光镜观察和免疫标记并结合文献就该类肿瘤的临床特征进行探讨。结果:患者以睾丸无痛性肿大3年就诊,病理组织学表现为肿瘤排列结构多样,有乳头状结构、裂隙或腺样结构,细胞大,呈多角形或柱状,核不规则呈泡状,一个或多个核仁,核膜清楚,胞质嗜碱或嗜酸,间质少量淋巴细胞浸润。免疫组化显示:白细胞分化抗原(CD117)(-)、细胞角蛋白(CK8-18)(++)、CD30(++)、CK(+++)、波形纤维蛋白(Vimentin)(-)、胎盘型碱性磷酸酶(PLAP)(±)、抑癌基因产物(P53)(+)、甲胎蛋白(AFP)(+)和上皮膜抗原(EMA)(++)。病理诊断为睾丸畸胎胚胎癌,行手术根治术,按混合性非精原细胞性生殖细胞癌行术后辅助化疗。随访时间l年,健康生存。结论:睾丸混合性非精原细胞性生殖细胞癌是一种罕见的恶性肿瘤,多数临床症状不明显。诊断主要依靠体格检查、B超、CT、血清肿瘤标记物测定等,确诊需要病理学检查,手术切除是其首选的治疗方法。