Jones Gareth Huw, Kirkman-Brown Jackson, Sharma Davendra Murray, Bowley Douglas
Department of Otolaryngology Head and Neck, Fairfield General Hospital, Bury, UK.
Centre for Human Reproductive Science (ChRS), Birmingham, UK.
BMJ Case Rep. 2015 Aug 28;2015:bcr2014207924. doi: 10.1136/bcr-2014-207924.
In association with lower extremity amputation, complex genitourinary injuries have emerged as a specific challenge in modern military trauma surgery. Testicular injury or loss has profound implications for the recovering serviceman, in terms of hormone production and future fertility. The initial focus of treatment for patients with traumatic testicular loss is haemostasis, resuscitation and management of concurrent life-threatening injuries. Multiple reoperations are commonly required to control infection in combat wounds; in a review of 300 major lower extremity amputations, 53% of limbs required revisional surgery, with infection the commonest indication. Atypical infections, such as invasive fungal organisms, can also complicate military wounding. We report the case of a severely wounded serviceman with complete traumatic andropause, whose symptomatic temperature swings were initially mistaken for signs of occult sepsis.
与下肢截肢相关的复杂泌尿生殖系统损伤已成为现代军事创伤外科中的一项特殊挑战。睾丸损伤或缺失对正在康复的军人在激素分泌和未来生育能力方面有着深远影响。创伤性睾丸缺失患者的初始治疗重点是止血、复苏以及对同时存在的危及生命的损伤进行处理。通常需要多次再次手术来控制战伤感染；在对300例主要下肢截肢病例的回顾中，53%的肢体需要进行翻修手术，其中感染是最常见的指征。非典型感染，如侵袭性真菌生物，也会使战伤情况复杂化。我们报告了一名严重受伤军人出现完全性创伤性更年期的病例，其有症状的体温波动最初被误诊为隐匿性脓毒症的迹象。
