Al-Salem A H
Division of Paediatric Surgery, Department of Surgery, Qatif Central Hospital, Qatif, Saudi Arabia.
BJU Int. 1999 Jun;83(9):1023-5. doi: 10.1046/j.1464-410x.1999.00099.x.
To review the incidence and treatment of intra-uterine torsion of the testis which although rare is being recognized with increasing frequency.
From 1988 to 1997, five newborns (mean birth weight 3.62 kg, range 3.15-4.12) with unilateral torsion of the testis were treated; all underwent emergency exploration. The right testis was affected in three and the left in two boys.
In all except one child, the affected testis was enlarged, firm to hard, tender, the overlying skin dark red and the affected testis higher than the contralateral testis. In one child the right testis was enlarged and higher, but soft to firm, and the overlying skin was oedematous and red. The exploration revealed extravaginal torsion of the testis which was gangrenous in four; in one after detorsion there was haemorrhage and haematoma of the cord and the tunica, and the testis was slightly congested but not gangrenous. This testis was preserved and bilateral orchidopexies performed; at 18 months both testes are palpable and of normal size. In the remaining four children the testes were frankly necrotic; they underwent orchidectomy and contralateral orchidopexy. Histology in all four revealed a totally infarcted testis with extensive haemorrhage and vascular congestion.
The early diagnosis and treatment of intra-uterine torsion of the testis is essential.
回顾睾丸宫内扭转的发病率及治疗情况，该病虽罕见，但目前其诊断率日益提高。
1988年至1997年间，对5例单侧睾丸扭转的新生儿（平均出生体重3.62kg，范围3.15 - 4.12kg）进行了治疗；所有患儿均接受了急诊探查。3例右侧睾丸受累，2例左侧睾丸受累。
除1例患儿外，其余患儿患侧睾丸均肿大，质地硬，有压痛，表面皮肤暗红色，患侧睾丸位置高于对侧。1例患儿右侧睾丸肿大且位置较高，但质地软至硬，表面皮肤水肿、发红。探查发现睾丸鞘膜外扭转，4例睾丸已坏疽；1例扭转复位后精索及白膜有出血和血肿，睾丸轻度充血但未坏疽。该睾丸得以保留并进行了双侧睾丸固定术；18个月时双侧睾丸均可触及且大小正常。其余4例患儿睾丸明显坏死；他们接受了睾丸切除术及对侧睾丸固定术。所有4例的组织学检查均显示睾丸完全梗死，伴有广泛出血和血管充血。
睾丸宫内扭转的早期诊断和治疗至关重要。
