Esposito Ciro, Escolino Maria, Savanelli Antonio, Alicchio Francesca, Roberti Agnese, Settimi Alessandro
Department of Pediatrics, Pediatric Surgery Unit, Federico II University of Naples, Italy.
Med Sci Law. 2013 Oct;53(4):247-8. doi: 10.1177/0025802413481013. Epub 2013 Aug 14.
A 2-year-old boy came to our attention for a left non-palpable testis (NPT). The parents asked us to perform a laparoscopy to pull down a left intrabdominal testis (IAT), identified ultrasonographically before surgery. The ultrasonography (US) performed in another institution showed a right intrascrotal testis of normal size and a left IAT of 0.85 × 0.78 mm(2) located near the internal inguinal ring. We performed a laparoscopy that showed a blind-ending vas deferens and blind-ending inner spermatic vessels as in case of vanishing testis and a large lymphnode located near the internal inguinal ring that was closed. Parents were disappointed after laparoscopic diagnosis because the US performed before surgery showed them an IAT; for this reason they undertook a legal challenge against the pediatrician and the radiologist who had given them false information. In conclusion, we believe that in cases of NPT, laparoscopy is the gold standard for diagnosis and US is unnecessary and misleading.
一名2岁男孩因左侧隐睾（NPT）引起我们的注意。家长要求我们进行腹腔镜检查以下拉左侧腹腔内睾丸（IAT），术前经超声检查确定其位置。在另一家机构进行的超声检查（US）显示右侧阴囊内睾丸大小正常，左侧IAT为0.85×0.78mm²，位于腹股沟内环附近。我们进行了腹腔镜检查，结果显示如睾丸消失病例一样，输精管呈盲端且精索内血管呈盲端，同时在腹股沟内环附近发现一个肿大的封闭淋巴结。腹腔镜诊断后家长感到失望，因为术前超声检查显示为IAT；因此，他们对向他们提供错误信息的儿科医生和放射科医生提起了法律诉讼。总之，我们认为在隐睾病例中，腹腔镜检查是诊断的金标准，超声检查不必要且具有误导性。
