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伴有腹股沟疝的睾丸横位异位:一例罕见病例报告。

Transverse testicular ectopia with an inguinal hernia: A rare case report.

作者信息

Sattout Hanin, Jabra Maya, Malahefji Hiba, Morjan Mohamad

机构信息

Department of Endocrinology, Faculty of Medicine, University of Aleppo, Aleppo, Syria.

Faculty of Medicine, University of Aleppo, Aleppo, Syria.

出版信息

Int J Surg Case Rep. 2024 Aug;121:109949. doi: 10.1016/j.ijscr.2024.109949. Epub 2024 Jun 27.

Abstract

INTRODUCTION

Transverse testicular ectopia (TTE) is a rare congenital condition characterized by migration of both testes through the same inguinal canal and often presents with an inguinal hernia. TTE is associated with various genitourinary anomalies.

CASE PRESENTATION

A three-year-old boy presented with a non-palpable right testis and a palpable undescended left testis in the left inguinal area. Ultrasound (US) indicated the presence of both testes in the left inguinal canal. In surgery, the two testes were found with separated cord and one hernia sac which was dissected and ligated thus the two cords freed. Next, subdartos pouches were created on both scrotum sides, so that testes placed into the left side first, and then a window created in the scrotal septum which allowed the right testis to be translocated and secured in the right subdartos pouch without tension.

DISCUSSION

TTE is a rare condition and the etiology is not definitively known. TTE usually presents with an inguinal hernia and contralateral cryptorchidism. The diagnosis is made during surgery, but some radiological methods can help in diagnosis. Management is usually surgical and involves interventions such as hernia repair, reduction of the testis and orchiopexy. Continuous monitoring is essential for ensuring postoperative testes health and evaluating the risk of malignancy.

CONCLUSION

TTE should be suspected in cases with unilateral empty scrotum and family history of genital disorders. US is critical for accurately localizing the testes, along with surgical exploration, to proceed with the appropriate surgical intervention.

摘要

引言

睾丸横过异位(TTE)是一种罕见的先天性疾病,其特征是双侧睾丸通过同一腹股沟管下降,常伴有腹股沟疝。TTE与各种泌尿生殖系统异常相关。

病例报告

一名三岁男孩就诊,右侧睾丸无法触及,左侧腹股沟区可触及左侧隐睾。超声(US)显示双侧睾丸位于左侧腹股沟管内。手术中发现双侧睾丸精索分离,有一个疝囊,予以分离并结扎,从而使两条精索松解。接下来,在阴囊两侧创建肉膜囊,先将睾丸放入左侧,然后在阴囊隔上开一个窗口,使右侧睾丸能够移位并固定在右侧肉膜囊内且无张力。

讨论

TTE是一种罕见疾病,病因尚不明确。TTE通常表现为腹股沟疝和对侧隐睾。诊断在手术中做出,但一些影像学方法有助于诊断。治疗通常采用手术,包括疝修补、睾丸复位和睾丸固定等干预措施。持续监测对于确保术后睾丸健康和评估恶性肿瘤风险至关重要。

结论

对于单侧阴囊空虚且有生殖器疾病家族史的病例,应怀疑TTE。超声对于准确确定睾丸位置至关重要,同时结合手术探查,以便进行适当的手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba7f/11261408/2e424300f813/gr1.jpg

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