儿童和青少年的急性阴囊
The acute scrotum in childhood and adolescence.
机构信息
Sektion Kinderchirurgie, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
出版信息
Dtsch Arztebl Int. 2012 Jun;109(25):449-57; quiz 458. doi: 10.3238/arztebl.2012.0449. Epub 2012 Jun 22.
BACKGROUND
The acute scrotum in childhood or adolescence is a medical emergency. Inadequate evaluation and delays in diagnosis and treatment can result in irreversible harm, up to and including loss of a testis. Various diseases can produce this clinical picture. The testis is ischemic in only about 20% of cases.
METHODS
This review is based on a selective literature search, the existing clinical guideline, and the authors' experience.
RESULTS
The clinical approach to the acute scrotum must begin with a standardized, rapidly performed diagnostic evaluation. Dopper ultrasonography currently plays a central role. Its main use is to demonstrate the central arterial blood supply and venous drainage of the testis. The resistance index of the testicular vessels should also be determined.
CONCLUSION
Physical examination and properly performed Doppler ultrasonography enable adequate evaluation of the acute scrotum in childhood and adolescence. In the rare cases of diagnostic uncertainty, immediate surgical exposure of the testis remains the treatment of choice.
背景
儿童或青少年的急性阴囊急症是一种医疗急症。评估不足以及诊断和治疗的延迟可能导致不可逆转的伤害，甚至包括睾丸丧失。各种疾病都可能产生这种临床表现。只有约 20%的病例中睾丸会发生缺血。
方法
本综述基于选择性文献检索、现有的临床指南和作者的经验。
结果
急性阴囊的临床处理必须从标准化、快速进行的诊断评估开始。Doppler 超声目前发挥着核心作用。其主要用途是显示睾丸的中央动脉血液供应和静脉引流。还应确定睾丸血管的阻力指数。
结论
体格检查和适当进行的 Doppler 超声检查能够充分评估儿童和青少年的急性阴囊。在诊断不确定的极少数情况下，立即手术暴露睾丸仍然是首选的治疗方法。
Zotero 插件