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儿童睾丸扭转早期诊断错误导致的睾丸丧失

Testicular Loss in Children Due to Incorrect Early Diagnosis of Torsion.

作者信息

Kumar Vijay, Matai Pallavi, Prabhu Santosh Padubidri, Sundeep P T

机构信息

Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Clin Pediatr (Phila). 2020 May;59(4-5):436-438. doi: 10.1177/0009922820903037. Epub 2020 Feb 5.

Abstract

. Testicular torsion is a common surgical emergency in children that requires a high index of suspicion, early diagnosis, and exploration. Most children present early to their primary pediatricians or physicians. The aim of this retrospective study is to determine the surgical outcome of testicular torsion with early as well as delayed presentation or referral at our pediatric surgical unit. . Records of 50 patients who presented with testicular torsion at our pediatric surgical unit over the span of 10 years (2007-2017) were reviewed retrospectively. The duration and characteristics of symptoms, initial consultation with primary care health professional, time duration between the initial consultation and referral to a tertiary care center, clinical findings prior to surgery, and operative findings were noted. . Fifty patients were in the age group ranging from 38 days to 18 years. All the patients consulted the primary care health professionals within 3 to 6 hours after the onset of testicular pain. The patients presented to our hospital within the range of 3.5 hours to 10 days of onset of initial symptoms. Out of 50 patients who presented to our hospital with torsion testis, 45 (90%) patients underwent orchidectomy as the testicle was gangrenous and 5 patients underwent orchiopexy as the testicle was viable. . The risk of testicular loss is very high if there is delay in the initial diagnosis of testicular torsion. Greater effort in educating the primary health care professionals may reduce this delay. Primary objective of treating the acute scrotum should be prevention of testicular loss than treating symptoms.

摘要

睾丸扭转是儿童常见的外科急症,需要高度怀疑、早期诊断并进行探查。大多数儿童会早期就诊于他们的初级儿科医生或内科医生。本回顾性研究的目的是确定在我们儿科外科病房,睾丸扭转早期以及延迟就诊或转诊后的手术结果。回顾了我们儿科外科病房在10年(2007 - 2017年)期间收治的50例睾丸扭转患者的记录。记录了症状的持续时间和特征、与初级保健卫生专业人员的初次会诊、初次会诊与转诊至三级护理中心之间的时间、手术前的临床发现以及手术发现。50例患者年龄在38天至18岁之间。所有患者在睾丸疼痛发作后3至6小时内咨询了初级保健卫生专业人员。患者在初始症状发作后3.5小时至10天内就诊于我院。在我院就诊的50例睾丸扭转患者中,45例(90%)因睾丸坏疽接受了睾丸切除术,5例因睾丸存活接受了睾丸固定术。如果睾丸扭转的初始诊断延迟,睾丸丧失的风险非常高。加大对初级卫生保健专业人员的教育力度可能会减少这种延迟。治疗急性阴囊的主要目标应该是预防睾丸丧失而不是治疗症状。

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