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睾丸横位异位罕见病例——病例报告及文献综述

Rare case of transverse testicular ectopia - Case report and review of literature.

作者信息

Raj Vinod, Redkar Rajeev, Krishna Swathi, Tewari Shruti

机构信息

Lilavati Hospital & Research Centre, India.

出版信息

Int J Surg Case Rep. 2017 Nov 7;41:407-410. doi: 10.1016/j.ijscr.2017.09.032. eCollection 2017.

DOI:10.1016/j.ijscr.2017.09.032
PMID:29546003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5723351/
Abstract

UNLABELLED

This case report has been reported in line with the SCARE criteria; Consensus-based surgical case report guidelines of International Journal of Surgery 2016.

INTRODUCTION

Transverse Testicular Ectopia (TTE) is a rare condition which manifests with unilateral undescended testis and contralateral hernia. Till now around 100 cases have been described in the literature. The management depends on the anatomy of the vas, vessels and testis found on surgical exploration. An algorithm exists for its management and we propose a modified algorithm for management of TTE.

CASE PRESENTATION

Five year male presented with complaints of unilateral undescended testis on the right and hernia on the left. Clinically the right testis was impalpable and left testis palpable in the left hemiscrotum and fluid hernia on the same side.

DISCUSSION

Transverse testicular ectopia is a rare condition presenting with UDT and contralateral inguinal hernia. Although more than 100 cases have been described in the literature so far, those managed with a transeptal contralateral orchidopexy are two cases to the best of our knowledge. TTE was first described by Von Lenhossek in 1886. The mean age of presentation is around 4 years and most of the cases are diagnosed on surgical exploration. The management of TTE remains controversial even though an algorithm has been described for its management due to its varied presenting scenarios.

CONCLUSION

TTE is a rare condition which requires high index of suspicion for diagnosis preoperatively. Whenever suspected we recommend an USG and/or MRI prior to diagnostic laparoscopy and proceed with orchidopexy. Diagnostic laparoscopy is both helpful in diagnosis and management. Transeptal contralateral orchidopexy gives good tension free fixation of testes in the scrotum.

摘要

未标注

本病例报告已按照SCARE标准进行报告;这是《国际外科学杂志》2016年基于共识的外科病例报告指南。

引言

睾丸横过异位(TTE)是一种罕见疾病,表现为单侧隐睾和对侧疝。迄今为止,文献中已描述了约100例病例。治疗取决于手术探查中发现的输精管、血管和睾丸的解剖结构。存在一种针对其治疗的算法,我们提出了一种改良的TTE治疗算法。

病例介绍

一名5岁男性,主诉右侧单侧隐睾和左侧疝。临床检查发现右侧睾丸无法触及,左侧睾丸可在左侧阴囊内触及,且同侧有交通性疝。

讨论

睾丸横过异位是一种罕见疾病,表现为隐睾和对侧腹股沟疝。尽管迄今为止文献中已描述了100多例病例,但据我们所知,采用经中隔对侧睾丸固定术治疗的仅有两例。TTE最早由冯·伦霍塞克于1886年描述。平均发病年龄约为4岁,大多数病例通过手术探查确诊。尽管已经描述了一种针对TTE治疗的算法,但由于其表现形式多样,TTE的治疗仍存在争议。

结论

TTE是一种罕见疾病,术前诊断需要高度怀疑。一旦怀疑,我们建议在诊断性腹腔镜检查前进行超声检查和/或磁共振成像,然后进行睾丸固定术。诊断性腹腔镜检查对诊断和治疗都有帮助。经中隔对侧睾丸固定术能使睾丸在阴囊内实现良好的无张力固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/8d9d96586fb6/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/cf351193b005/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/5bccc5f393c3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/56429941e5d8/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/936e3b3ffd85/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/cd6e600fb80e/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/8d9d96586fb6/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/cf351193b005/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/5bccc5f393c3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/56429941e5d8/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/936e3b3ffd85/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/cd6e600fb80e/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ee1/5723351/8d9d96586fb6/gr6.jpg

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