Emergency Medicine Residency, Boonshoft School of Medicine, Wright State University, Fairborn, Ohio.
Emergency Medicine Residency, Boonshoft School of Medicine, Wright State University, Fairborn, Ohio.
J Emerg Med. 2024 Oct;67(4):e375-e378. doi: 10.1016/j.jemermed.2024.05.006. Epub 2024 May 25.
Testicular ischemia requires timely diagnosis and definitive management to avoid serious consequences such as orchiectomy. It is almost always caused by testicular torsion; however, there are other causes to be aware of.
A 32-year-old man developed testicular ischemia following a laparoscopic robotic-assisted inguinal hernia repair with preperitoneal mesh. The ischemia progressed to a fully infarcted testicle with no evidence of torsion on subsequent surgical exploration. He ultimately did require an orchiectomy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: While extremely rare, testicular ischemia or infarct must be considered in patients presenting with testicular pain shortly after inguinal hernia repair. Emergent surgical evaluation and loosening of the hernia mesh may be required to salvage the testicle.
睾丸缺血需要及时诊断和明确处理，以避免睾丸切除术等严重后果。睾丸缺血几乎总是由睾丸扭转引起的，但也有其他需要注意的原因。
一名 32 岁男性在腹腔镜机器人辅助腹股沟疝修补术和腹膜前网片修补术后出现睾丸缺血。随后的手术探查显示，睾丸缺血进展为完全梗死，无扭转证据。最终他确实需要进行睾丸切除术。
为什么急诊医生应该注意这一点？：虽然极其罕见，但在腹股沟疝修补术后不久出现睾丸疼痛的患者中，必须考虑睾丸缺血或梗死。可能需要紧急手术评估和疝网片松解来挽救睾丸。
