Ta Anthony, D'Arcy Frank T, Hoag Nathan, D'Arcy John P, Lawrentschuk Nathan
aUrology Unit, Department of Surgery, University of Melbourne, Austin Health bOlivia Newton-John Cancer Research Institute cPeter MacCallum Cancer Centre, Melbourne dEmergency Department, Austin Health, Heidelberg, Victoria, Australia.
Eur J Emerg Med. 2016 Jun;23(3):160-5. doi: 10.1097/MEJ.0000000000000303.
The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective. It outlines the types and mechanisms of testicular torsion, and examines the current and possible future roles of labwork and radiological imaging in diagnosis. Emergency departments should be wary of younger males presenting with the acute scrotum.
对于急诊医生来说,急性阴囊是一种具有挑战性的病症,需要考虑包括睾丸扭转在内的多种可能诊断。迅速识别扭转并排除其他病因可能会使器官得以挽救,避免睾丸丧失带来的严重功能和心理问题,并尽量减少不必要的探查手术。本综述旨在使读者熟悉急性阴囊的最新管理策略,讨论诊断和管理的关键点,并从急诊角度评估病史和临床检查的优缺点。它概述了睾丸扭转的类型和机制,并探讨了实验室检查和放射影像学在诊断中的当前及未来可能的作用。急诊科应对出现急性阴囊症状的年轻男性保持警惕。