Munter D W, Faleski E J
Department of Emergency Medicine, Darnall Army Community Hospital, Fort Hood, TX.
Am J Emerg Med. 1989 Mar;7(2):227-34. doi: 10.1016/0735-6757(89)90143-5.
Blunt scrotal trauma may result in a variety of injuries, including testicular rupture, torsion, dislocation, hematoma, or contusion, as well as epididymal, scrotal, and urethral injuries. Testicular rupture occurs in 50% of patients with traumatic hematocele, and is probably frequently misdiagnosed. If not aggressively diagnosed and surgically repaired, testicular rupture may lead to testicular atrophy and loss. Traumatic testicular torsion must also be diagnosed early to preclude testicular loss. Testicular scan, when rapidly available, is indicated in any case of suspected traumatic torsion. If testicular scanning is unavailable or equivocal, surgical exploration is indicated. Once torsion is ruled out, ultrasound is a useful diagnostic technique in acute scrotal trauma to differentiate those scrotal and testicular injuries requiring surgical intervention.
钝性阴囊创伤可能导致多种损伤，包括睾丸破裂、扭转、脱位、血肿或挫伤，以及附睾、阴囊和尿道损伤。外伤性血囊肿患者中有50%发生睾丸破裂，且可能经常被误诊。如果不积极诊断并进行手术修复，睾丸破裂可能导致睾丸萎缩和丧失。外伤性睾丸扭转也必须早期诊断以避免睾丸丧失。在任何疑似外伤性扭转的病例中，若能快速进行睾丸扫描则应进行此项检查。如果无法进行睾丸扫描或结果不明确，则应进行手术探查。一旦排除扭转，超声是急性阴囊创伤中一种有用的诊断技术，可用于鉴别那些需要手术干预的阴囊和睾丸损伤。
