Beliaev Andrei M, Mundy Ian
Department of General Surgery, Auckland City Hospital, Auckland, New Zealand.
BMJ Case Rep. 2013 May 22;2013:bcr2013010137. doi: 10.1136/bcr-2013-010137.
Bilateral simultaneous testicular torsion is a rare condition and can be misdiagnosed. The 16-year-old patient presented with a 3 h history of left hemi-scrotal pain, nausea and vomiting. His comorbidities included DiGeorge syndrome (22q11 deletion syndrome). Patient's scrotal examination was misleading because both testes were retracted. His cremasteric reflex was negative bilaterally. Scrotal ultrasound findings were consistent with the diagnosis of the left testicular torsion. An examination under anaesthesia revealed high riding and oblique position of the left testicle, but the position of the right testicle was unremarkable. The patient underwent an emergency left hemiscrotal exploration and untwisting of the left testicle. The right hemi-scrotal exploration revealed a 540° clock-wise right testicular torsion. The case demonstrates the importance of bilateral hemi-scrotal exploration in a patient presenting with acute testicular pain due to a testicular torsion. Bilateral scrotal exploration is mandatory not only for diagnostic but also for treatment purposes.
双侧同时发生睾丸扭转是一种罕见病症，可能会被误诊。该16岁患者出现左侧阴囊疼痛、恶心和呕吐3小时的症状。他的合并症包括DiGeorge综合征（22q11缺失综合征）。患者的阴囊检查具有误导性，因为双侧睾丸均回缩。双侧提睾反射均为阴性。阴囊超声检查结果与左侧睾丸扭转的诊断相符。麻醉下检查发现左侧睾丸位置上移且呈斜位，但右侧睾丸位置无异常。患者接受了急诊左侧阴囊探查及左侧睾丸扭转复位术。右侧阴囊探查发现右侧睾丸顺时针扭转540°。该病例表明，对于因睾丸扭转而出现急性睾丸疼痛的患者，双侧阴囊探查至关重要。双侧阴囊探查不仅出于诊断目的，也是治疗所需。
