Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
J Ultrasound Med. 2023 Dec;42(12):2757-2764. doi: 10.1002/jum.16312. Epub 2023 Aug 9.
Testicular torsion (TT) is a pediatric surgical emergency that requires prompt treatment. This study investigated the feasibility of point-of-care ultrasound (POCUS) for diagnosing TT in the pediatric emergency department (ED).
We retrospectively reviewed the medical records of patients, aged 18 years or younger, who visited a university-affiliated hospital pediatric ED with acute scrotal pain without trauma history and underwent diagnostic ultrasounds between January 2010 and October 2022.
This study included 731 patients (median age: 9 years), Of these, 315 (43%) were in the POCUS-performed group: 188 in the POCUS-only group, and 127 in the POCUS-and-RADUS group. The other 416 patients (56.9%) were in the RADUS-only group. In total, 45 patients (6.2%) were diagnosed with TT (19 in the POCUS-performed group and 26 in the RADUS-only group). The sensitivity, specificity, and positive and negative predictive values of POCUS for diagnosing TT were 94.7%, 92.9%, 46.2%, and 99.6%, respectively. The median time to perform POCUS was shorter than RADUS (23 versus 61 minutes, P < .001). The POCUS-performed group had a shorter ED length of stay than the RADUS-only group (93 versus 170 minutes, P < .001). Among the patients diagnosed with TT, performing POCUS first did not significantly delay the ED process, including time to operation (250 versus 205 minutes, P = .142).
For patients with acute scrotal pain, evaluation performed by pediatric emergency physicians using POCUS performs well in screening TT, and can decrease length of stay in the ED.
睾丸扭转（TT）是一种儿科急症，需要及时治疗。本研究探讨了即时超声（POCUS）在儿科急诊（ED）中诊断 TT 的可行性。
我们回顾性分析了 2010 年 1 月至 2022 年 10 月期间，在一所大学附属医院儿科 ED 就诊的 18 岁以下因急性阴囊疼痛且无外伤史而接受诊断性超声检查的患者的病历。
本研究共纳入 731 例患者（中位年龄：9 岁），其中 315 例（43%）进行了 POCUS 检查：188 例仅行 POCUS，127 例行 POCUS 和 RADUS 检查。其余 416 例（56.9%）仅行 RADUS 检查。共有 45 例（6.2%）患者诊断为 TT（POCUS 检查组 19 例，RADUS 检查组 26 例）。POCUS 诊断 TT 的敏感性、特异性、阳性预测值和阴性预测值分别为 94.7%、92.9%、46.2%和 99.6%。POCUS 检查时间中位数短于 RADUS（23 分钟比 61 分钟，P<0.001）。POCUS 检查组 ED 停留时间短于 RADUS 检查组（93 分钟比 170 分钟，P<0.001）。在诊断为 TT 的患者中，先进行 POCUS 检查并未显著延迟 ED 进程，包括手术时间（250 分钟比 205 分钟，P=0.142）。
对于急性阴囊疼痛的患者，儿科急诊医生使用 POCUS 进行评估在筛查 TT 方面表现良好，并可缩短 ED 停留时间。
