Christenberry D P, Powell R W
Division of Pediatric Surgery, University of South Alabama Medical Center, Mobile 36617.
Am J Surg. 1987 Dec;154(6):628-30. doi: 10.1016/0002-9610(87)90230-3.
Over a 3 year period, 191 infants and children underwent operative repair of inguinal or communicating hydroceles or both. Of these patients, 131 underwent the Goldstein test to determine the presence or absence of a contralateral hernia sac. The Goldstein test was performed by introducing a soft rubber catheter through the hernia sac into the abdominal cavity and distending the peritoneal cavity with air. The contralateral groin and, in males, the scrotum were then palpated for crepitance. The presence of crepitance constituted a positive test result. Of the 131 tests performed, the results were positive in 38 (29 percent) and negative in 93 (71 percent). There was one false-positive test result (2 percent) and no false-negative results. The test was not performed in 60 patients because of technical problems in passing the catheter (22 percent), presence of a ventriculoperitoneal shunt (2 percent), previous contralateral herniorrhaphy (1.6 percent), presentation with bilateral hernias (26 percent), and patient age of 12 years (1 percent). Continued differences in approaches to the management of pediatric patients who present with unilateral groin hernias prompted this study. We believe that the Goldstein test represents a safe, economical, rapid, accurate, and humane approach to this common problem.
在3年期间，191名婴幼儿接受了腹股沟或交通性鞘膜积液或两者的手术修复。在这些患者中，131名接受了戈尔茨坦试验以确定对侧疝囊是否存在。戈尔茨坦试验的操作方法是将一根软橡胶导管经疝囊插入腹腔，然后用空气扩张腹膜腔。接着触诊对侧腹股沟，男性还需触诊阴囊，以检查有无捻发音。出现捻发音即为试验阳性结果。在进行的131次试验中，结果阳性的有38例（29%），阴性的有93例（71%）。有1例假阳性试验结果（2%），无假阴性结果。60例患者未进行该试验，原因包括导管插入技术问题（22%）、存在脑室腹腔分流术（2%）、既往对侧疝修补术（1.6%）、双侧疝表现（26%）以及患者年龄12岁（1%）。对于单侧腹股沟疝患儿的治疗方法持续存在差异，促使我们开展了这项研究。我们认为戈尔茨坦试验是解决这一常见问题的一种安全、经济、快速、准确且人道的方法。
