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科恩综合征患者的睾丸扭转

Testicular torsion in a patient with Cohen syndrome.

作者信息

Yılmaz Ömer, Yeşildal Cumhur, Malkoç Ercan, Soydan Hasan

机构信息

Department of Urology, Gülhane Military Medical Academy Haydarpaşa Training Hospital, İstanbul, Turkey.

出版信息

Turk J Urol. 2015 Mar;41(1):51-2. doi: 10.5152/tud.2015.27136.

Abstract

Cohen syndrome is an extremely rare autosomal recessive disorder. A 12-year-old boy with Cohen syndrome applied to a primary health care center because of severe pain in the left groin and was diagnosed with epididymo-orchitis. Despite the administered the antibiotic treatment, pain increased. Therefore, the family brought the patient to the emergency department 16 h after the first diagnosis. The patient had mild mental retardation, myopia, and craniofacial dysmorphism, which are components of Cohen syndrome. There was no blood flow on the left testicle at color Doppler ultrasonography. Further, scrotal exploration was performed because of a high risk of torsion. The left testicle was torsioned, and the color was dark blue. Revascularization could not be achieved by detorsion; left orchiectomy and right testicular fixation were then conducted. In conclusion, to the best of our knowledge, this is the first reported case of testicular torsion in Cohen syndrome. If a patient with this syndrome has acute groin pain, testicular torsion should be immediately ruled out with Doppler ultrasonography. These patients may not clearly and correctly express themselves because of mild mental retardation. Moreover, detailed genitourinary, particularly testicular examination may clarify the omitted pathologies and make them well known in future in this syndrome.

摘要

科恩综合征是一种极其罕见的常染色体隐性疾病。一名患有科恩综合征的12岁男孩因左腹股沟剧痛前往初级卫生保健中心就诊,被诊断为附睾炎。尽管进行了抗生素治疗,但疼痛仍加剧。因此,家属在首次诊断16小时后将患者送至急诊科。该患者有轻度智力障碍、近视和颅面畸形,这些都是科恩综合征的组成部分。彩色多普勒超声检查显示左侧睾丸无血流信号。此外,由于扭转风险高,进行了阴囊探查。左侧睾丸扭转,颜色呈深蓝色。扭转复位未能实现血管再通;随后进行了左侧睾丸切除术和右侧睾丸固定术。总之,据我们所知,这是首例报道的科恩综合征合并睾丸扭转病例。如果该综合征患者出现急性腹股沟疼痛,应立即用多普勒超声排除睾丸扭转。由于轻度智力障碍,这些患者可能无法清晰、正确地表达自己。此外,详细的泌尿生殖系统检查,尤其是睾丸检查,可能会明确遗漏的病变,并使它们在该综合征中为未来所熟知。

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