Van Glabeke E, Philippe-Chomette P, Gall O, Oro H, Larroquet M, Audry G
Service de chirurgie viscérale infantile et néonatale, hôpital d'enfants Armand-Trousseau, Paris, France.
Arch Pediatr. 2000 Oct;7(10):1072-6. doi: 10.1016/s0929-693x(00)00315-8.
Torsion of the spermatic cord is frequent in neonates suffering from acute scrotal distress. A retrospective study was carried out to determine the viability and the outcome of testis treated by surgical exploration.
Surgical exploration of 30 neonates presenting acute scrotal distress found: 18 torsions of the spermatic cord, six intrascrotal bleedings or hematoma due to delivery trauma, five tunica vaginalis inflammations and one ischemia without torsion. The torsion occurred in utero in 16 cases and after birth in two cases. The contralateral uninvolved testis was fixed to the scrotum in all cases. The torsion was extravaginal in 17 cases and intravaginal in one case. In all cases of prenatal torsion, there was total necrosis of the testis. One case of postnatal torsion operated on four hours after the beginning of the torsion was saved.
Although the viability of the torsioned testis is compromised in cases of prenatal torsion, surgical exploration is necessary to confirm diagnosis and to avoid any contralateral torsion because bilateral torsion exists. Only emergency surgical exploration can save a testis that has undergone post-natal torsion as reported in others series.
精索扭转在患有急性阴囊疼痛的新生儿中很常见。进行了一项回顾性研究以确定经手术探查治疗的睾丸的存活情况和结果。
对30例出现急性阴囊疼痛的新生儿进行手术探查发现：18例精索扭转，6例因分娩创伤导致的阴囊内出血或血肿，5例鞘膜炎症，1例无扭转的缺血。扭转发生在子宫内16例，出生后2例。所有病例中对侧未受累的睾丸均固定于阴囊。扭转17例为鞘膜外，1例为鞘膜内。在所有产前扭转病例中，睾丸均完全坏死。1例产后扭转在扭转开始后4小时进行手术得以挽救。
尽管产前扭转病例中扭转睾丸的存活能力受到损害，但手术探查对于确诊以及避免因存在双侧扭转而导致的对侧扭转是必要的。如其他系列报道的那样，只有急诊手术探查才能挽救发生产后扭转的睾丸。
