Department of Radiology and Biomedical Imaging, University of California San Francisco and Zuckerberg San Francisco General Hospital, 1001 Potrero Ave. Building 5, 1X57, San Francisco, CA, 94110, USA.
Emerg Radiol. 2021 Feb;28(1):31-36. doi: 10.1007/s10140-020-01814-0. Epub 2020 Jun 27.
To evaluate the prevalence of epididymal injuries with scrotal trauma, review imaging appearance, clinical management, and outcomes.
In this retrospective study, the radiology report database was queried for scrotal ultrasounds containing keywords pertaining to trauma, from 1998 to 2019. Exams with no clinically documented trauma, exams with trauma > 1 year ago, and duplicate exams were excluded. Chart review was conducted for age, trauma mechanism, time interval between trauma and ultrasound, signs of infection, and clinical management. Reports were reviewed to record the presence of scrotal injury, traumatic epididymitis, or epididymal hematoma. Cases with epididymal injury underwent image review. Descriptive statistics, Fisher's exact test, and Mann-Whitney's U test were performed to evaluate for associations between clinical parameters and epididymal injury.
Initial search yielded 385 exams. A total of 103 exams met inclusion criteria. Trauma mechanisms included straddle injury (35%), blunt scrotal trauma by ball or other object (29%), assault (28%), penetrating injury (4%), and fall (3%). Sixty-eight patients (66%) had scrotal injury on imaging. Twenty-six (25%) had epididymal injury. Thirteen were isolated to the epididymis, and 13 had associated testicular or extra-testicular findings. There were 12 cases of traumatic epididymitis and 14 epididymal hematomas. All epididymal injuries were managed non-operatively. A total of 7 were prescribed antibiotics, including 1 subject who otherwise had no evidence of infection.
Epididymal injury is encountered in 25% of scrotal ultrasounds for trauma evaluation. Traumatic epididymitis can be seen in 12%. It is important for radiologists to recognize this entity, as it can be mistaken for infection.
评估阴囊创伤伴附睾损伤的发生率，回顾影像学表现、临床处理和结局。
本回顾性研究通过检索 1998 年至 2019 年包含与创伤相关关键词的阴囊超声的放射学报告数据库，排除无临床记录的创伤、创伤时间超过 1 年的检查以及重复的检查。对年龄、创伤机制、创伤与超声检查之间的时间间隔、感染迹象和临床处理进行图表审查。对报告进行了回顾，以记录是否存在阴囊损伤、创伤性附睾炎或附睾血肿。对有附睾损伤的病例进行图像回顾。采用描述性统计、Fisher 确切检验和 Mann-Whitney U 检验，评估临床参数与附睾损伤之间的关系。
最初的搜索结果为 385 次检查。共有 103 次检查符合纳入标准。创伤机制包括骑跨伤（35%）、球类或其他物体所致钝性阴囊创伤（29%）、殴打（28%）、穿透伤（4%）和坠落伤（3%）。68 例患者（66%）在影像学上有阴囊损伤。26 例（25%）有附睾损伤。13 例仅累及附睾，13 例有睾丸或睾丸外异常发现。有 12 例创伤性附睾炎和 14 例附睾血肿。所有附睾损伤均非手术治疗。共 7 例患者使用了抗生素，包括 1 例无感染证据的患者。
在阴囊创伤评估的超声检查中，25%可发现附睾损伤。12%可出现创伤性附睾炎。放射科医生识别该疾病非常重要，因为它可能被误诊为感染。
