睾丸扭转诊治的探讨及误诊分析

目的探讨睾丸扭转的诊治经验及误诊原因,提高诊治水平。方法对23例睾丸扭转患者的临床资料进行分析总结。结果左侧睾丸扭转14例,右侧9例,发病至就诊时间3 h至10 d。其中22例接受手术,1例手法复位,18例切除睾丸,4例行睾丸复位固定。22例手术均未行健侧固定亦未再出现睾丸扭转。结论睾丸扭转的早期诊断,尽早手术探查是避免睾丸坏死的关键。     

Prenatally diagnosed testicular torsion.

A case is reported of absent testis in a boy of 7 months who was noted to have a cystic intra-abdominal mass at 18-19-week prenatal ultrasound scan. This is the second report of prenatally detected testicular torsion, the previous case being noted much later in pregnancy. On both occasions, the diagnosis was only established after birth.     

Intrauterine/newborn testicular torsion

Although spermatic cord torsion in the neonate is uncommon, early recognition with prompt surgical exploration and detorsion of the cord can result in preservation of some testicular tissue. Palpation of the infantile testes can be difficult, and distinguishing testicular from extratesticular abnormalities may not be possible. High-resolution real-time ultrasonography is an effective, noninvasive method of differentiating between the two. If sonography demonstrates and abnormal testicle, prompt surgical exploration is indicated.     

睾丸扭转患者的护理

睾丸扭转又称精索扭转,在临床上不常见.它是由于睾丸和精索本身的解剖异常或活动度加大而引起的.扭转后使精索内的血液循环障碍,引起睾丸组织缺血坏死,常常需要急诊处理.     

Scrotal scintigraphy in testicular torsion.

Testicular torsion is a surgical emergency that requires prompt diagnosis and treatment to maximize testicular survival. When the clinical diagnosis is uncertain, testicular scintigraphy can be performed to evaluate testicular perfusion. This noninvasive imaging study is widely validated and highly accurate in predicting nontorsion, which excludes the need for exploration.     

Acute pancreatitis masquerading as testicular torsion

A 40-year-old man presented with fat necrosis of scrotum as the complication of acute pancreatitis. Excessive fluid accumulation in the pancreas and the extrapancreatic spaces, including around the spermatic cord, was seen on computed tomography. Surgical specimen showed typical fat necrosis of tunica vaginalis and the spermatic cord. After the surgery, pain of the testicle subsided completely, without recurrence. From the clinical presentation alone, it had been difficult to differentiate this patient's condition from torsion of the spermatic cord.     

Methamphetamine use can mimic testicular torsion

We report the case of a patient presenting with the classic clinical appearance of testicular torsion. Ultrasound showed testicular ischemia supporting the clinical diagnosis, but the lack of visualization of spermatic cord torsion was of concern. An attempt of clinical detorsion was considered unsuccessful and the patient was explored. No torsion was found. On postoperative review of the patient's medical history, we found methamphetamine use, with a positive urine test at the time of his emergent consultation for the scrotal pain episode. The use of amphetamines has been previously reported as the cause of ischemia of multiple organs, but we could not find previous reports of involvement of the testis mimicking torsion. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound 41 :461–463, 2013     

睾丸扭转的诊治及误诊分析

目的提高睾丸扭转的诊断和治疗水平。方法对12例睾丸扭转的临床资料进行总结,平均年龄13．5岁,〈20岁占83．3％,左侧占75％。结果6例患者经B超及CDFI确诊为睾丸扭转,6例误诊。8例患侧睾丸切除。结论早期诊断,及时治疗是提高疗效的关键。CDFI应作为诊断该疾病的首选检查方法。及时手术探查是提高睾丸成活率的关键。     

彩色多普勒超声对睾丸扭转后存活力的预测价值

目的 探讨彩色多普勒超声(CDU)预测睾丸存活力的临床价值.方法 比较42例睾丸扭转患者的临床表现、术中所见及手术前后阴囊CDU表现,将术中睾丸活力分为A～D级,保留A～C级活力睾丸,切除D级活力睾丸.将CDU随访的术后睾丸存活力分为Ⅰ～Ⅲ级,Ⅰ～Ⅱ级睾丸存活,III级睾丸萎缩.结果 42例中睾丸复位17例,切除25例.复位组睾丸存活7例,术中睾丸活力分别为A级2例,B级3例,C级2例,术前CDU主要表现为:睾丸实质回声均匀,血供减少或消失;睾丸局部片状或放射状低回声,大部分实质尚存血供.萎缩10例,术中睾丸活力分别为C级8例,D级2例,术前CDU(包括切除组25例)主要表现为睾丸大片放射状低同声或弥漫性明显回声不均匀,无或仅睾丸边缘少量血供.复位组与切除组的健侧睾丸CDU随访无明显异常发现.结论 阴囊CDU检查能够预测复位后睾丸的存活力,CDU评价后及时手术是提高扭转睾丸存活力的关键.     

Doppler ultrasound diagnosis of testicular cord torsion

The author confirmed clinical diagnosis of torsion of the testis with Doppler ultrasound flowmeters in 12 of 15 patients. Doppler examination in addition to clinical examination was more accurate than clinical examination alone. Problems were encountered when examining newborns, but progress in probe technology may yield better results in this area. The Doppler technique is a useful adjunct in the management of torsion of the testis.     

Antenatal sonographic diagnosis of testicular torsion.

Antenatal testicular torsion is a well-established condition diagnosed and treated after birth. This report describes the antenatal diagnosis of testicular torsion with surgical and pathological confirmation. Antenatal and postnatal sonographic findings included enlarged testis and epipdidymis surrounded by hemorrhagic fluid organized in two concentric compartments ('double ring hemorrhage' image). A contralateral hydrocele with bulging of the scrotal septum towards the unaffected side were also present. Pathological examination demonstrated a recent extravaginal torsion, which is the predominant mechanism for testicular torsion in the fetus and neonate. Recognition of this phenomenon and the ultrasonographic images associated with it may enable the diagnosis of antenatal testicular torsion to be made on prenatal sonography of the fetus.     

睾丸扭转的MSCT、MRI征象分析（附4例报道）

目的 分析睾丸扭转的 MSCT 和 MRI 表现,探讨 MSCT 或 MRI 诊断睾丸扭转的临床价值.方法 收集 4 例经手术、病理证实的睾丸扭转的影像学资料,MSCT 及 MRI 平扫各 1 例,MSCT 及 MRI 平扫＋增强检查各1例.分析其临床及影像学表现,复习睾丸扭转的 CT 和 MRI 表现的相关文献.结果 3 例睾丸肿大,1例睾九萎缩.4 例睾丸边界均较清楚.CT平扫睾丸密度不均匀增高,1 例增强扫描为环形强化;MRI T1WI序列睾丸内见片状T1WI高信号,T2WI低信号区,精索信号不均,1例增强扫描未见明显强化.结论 睾丸扭转在 MSCT 或 MRI 上有一定特征性,结合临床表现及超声多普勒,能够提高术前诊断率.     

急性睾丸扭转的诊断与处理探讨

急性睾丸扭转是青少年常见的阴囊急诊,需要及时处理,否则会产生严重后果[1]。本院自2001年1月到2004年12月共接诊睾丸扭转患者35例,现报告如下。1资料与方法1.1临床资料本组急性睾丸扭转病人共35例,年龄6~35岁,平均16.7岁。其中左侧34,右侧1例。就诊时距发病时间6h到20d,平均40