睾丸扭转反复误诊致坏死1例并文献复习  

Testis Necrosis Following Repeated Misdiagnosis of Testicular Torsion:A Case Report and Literature Review

作　　者：张际青[1] 胡小鹏[1] 孔秀珍[2] 黄明亮[3] 苟举民[3] 刘家辉[3] 张小东[1] 

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020 [2]解放军第404医院病理科,山东威海264200 [3]解放军第404医院泌尿外科,山东威海264200

出　　处：《中华男科学杂志》2009年第5期445-448,共4页National Journal of Andrology

摘　　要：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。Objective： To improve clinicians＇ability of diagnosing testicular torsion. Methods： We reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiaguosis and relevant literature. Results ： The patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for nonviability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis. Conclusion： Timely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.

关 键 词：睾丸扭转 精索扭转 彩色多普勒超声 提睾反射 误诊 

分 类 号：R697.22[医药卫生—泌尿科学]