Lyronis Ioannis D, Ploumis Nikoloas, Vlahakis Ioannis, Charissis Giorgos
Kasteli Health Centre, Crete, Greece.
Indian J Pediatr. 2009 Apr;76(4):407-10. doi: 10.1007/s12098-009-0008-2. Epub 2009 Feb 10.
The aim of the present study was to evaluate the etiology, history, physical examination findings, and seasonal variation of acute scrotal problems in children.
A retrospective review of all boys, presenting with acute scrotum to the Pediatric Surgery Clinic of the University Hospital Heraklion between January 1989 and December 2006 was performed.
A total of 140 boys presented with scrotal pain were included. Overall the commonest cause of acute scrotum was epididymo-orchitis (35%, 95%CI: 27%-43%), followed by torsion of appendages. In contrast the most common cause in boys of preschool age was spermatic cord torsion (P<0.020). All cases of spermatic cord torsion were characterized by severe testicular pain and an absent cremasteric reflex. The interval between pain initiation and presentation to our clinic was 11.4 hours (SD:3.07) when the testis was salvaged by detorsion, and 19.0 hours (SD:6.32) when the testis was removed. The difference between means was statistical significant (p<0.001). The incidence of torsion of appendages (p<0.036) and/or spermatic cord (p<0.047) was increased in winter.
The absence of cremasteric reflex in association with testicular tenderness strongly suggests testicular torsion. The low temperatures during winter may account for the increased incidence of the torsion of both the spermatic cord torsion and the appendages.
本研究旨在评估儿童急性阴囊问题的病因、病史、体格检查结果及季节变化。
对1989年1月至2006年12月期间在伊拉克利翁大学医院儿科外科门诊就诊的所有急性阴囊患儿进行回顾性研究。
共纳入140例阴囊疼痛患儿。总体而言，急性阴囊最常见的病因是附睾炎（35%，95%可信区间：27%-43%），其次是附件扭转。相比之下，学龄前男孩最常见的病因是精索扭转（P<0.020）。所有精索扭转病例均表现为严重的睾丸疼痛和提睾反射消失。睾丸通过扭转复位得以挽救时，从疼痛开始到就诊于我们诊所的间隔时间为11.4小时（标准差：3.07），而睾丸被切除时为19.0小时（标准差：6.32）。均值差异具有统计学意义（p<0.001）。附件扭转（p<0.036）和/或精索扭转（p<0.047）的发生率在冬季增加。
提睾反射消失伴睾丸压痛强烈提示睾丸扭转。冬季低温可能是精索扭转和附件扭转发生率增加的原因。
