Ahmadinejad Mojtaba, Mammohammadi Alireza, Hajialigol Amirhossein, Tajik Armin, Maleki Hadi, Pak Haleh, Zebarjadi Bagherpour Javad
Department of General Surgery, Faculty of Medicine Alborz University of Medical Sciences Karaj Iran.
Department of General Surgery, Faculty of Medicine Hamedan University of Medical Sciences Hamedan Iran.
Clin Case Rep. 2023 Sep 27;11(10):e8000. doi: 10.1002/ccr3.8000. eCollection 2023 Oct.
Sigmoid volvulus accounts for 20%-50% of colonic obstructions in Eastern countries. This occurs mostly in patients with a lack of mobility and a history of chronic constipation. There are some very known complications of a undescended intra-abdominal testicle such as cancer, ischemia, and infertility; But the rotation of the colon around the spermatic cord of one UDT is a very rare phenomenon that there is no similar report. A 67-year-old man came to the emergency department with a complaint of abdominal pain and obstipation. On examination, patient was febrile (: 38.5) and had mild general tenderness. According to the appearance of coffee beans in the X-ray, the diagnosis of sigmoid volvulus was made. In the requested tests, leukocytosis was observed. Rectosigmoidoscopy was unsuccessful. The patient underwent laparotomy. After manual untwisting, a tubular structure at the base of the meso-sigmoid was noticed. With further exploration, the testis was observed intra-abdominally. Orchidectomy and sigmoidectomy were performed by Hartmann's method. Sigmoid volvulus is one of the common cases that surgeons frequently encounter. The case scenarios are often the same, and from experience, most cases result from a long meso and an elongated sigmoid secondary to prolonged constipation. Therefore, it is clear that a scrotal examination would not be part of the routine examination of a patient with sigmoid volvulus. In this article, by reporting a very rare etiology for a very common pathology, we tried to point out the importance of head-to-toe examination in all patients.
在东方国家，乙状结肠扭转占结肠梗阻的20%-50%。这种情况大多发生在行动不便且有慢性便秘病史的患者中。腹腔内睾丸未降存在一些众所周知的并发症，如癌症、缺血和不育；但结肠围绕单侧未降睾丸精索旋转是一种非常罕见的现象，尚无类似报道。一名67岁男性因腹痛和便秘前来急诊科就诊。检查时，患者发热（体温38.5），有轻度全腹压痛。根据X线检查中咖啡豆样表现，诊断为乙状结肠扭转。在进行的检查中，发现白细胞增多。直肠乙状结肠镜检查未成功。患者接受了剖腹手术。手动扭转复位后，在乙状结肠系膜根部发现一个管状结构。进一步探查后，在腹腔内观察到睾丸。采用哈特曼法进行了睾丸切除术和乙状结肠切除术。乙状结肠扭转是外科医生经常遇到的常见病例之一。病例情况通常相同，根据经验，大多数病例是由于长期便秘导致乙状结肠系膜长和乙状结肠冗长所致。因此，显然阴囊检查不会成为乙状结肠扭转患者常规检查的一部分。在本文中，通过报告一种非常常见病理的极为罕见病因，我们试图指出对所有患者进行从头到脚检查的重要性。
