Mariz José, Martinez Joaquin, Arroja Sheila, Blaivas Michael
Emergency Department of ULS Braga, Braga, Portugal.
Medical School of University of Minho, Braga, Portugal.
Intern Emerg Med. 2025 Jun;20(4):1153-1163. doi: 10.1007/s11739-025-03864-z. Epub 2025 Mar 18.
Ultrasound of the scrotum plays a crucial role in assessing acute scrotal conditions in the Emergency Department. Although the Emergency Physician and Intensivist have shared responsibility for the care of the critically ill patient, the Emergency Physician typically uses Point-of-care Ultrasound in a broader range of applications than the intensivist to include advanced abdominal, obstetric, testicular, musculoskeletal, and ocular ultrasonography. Acute scrotum refers to the sudden onset of scrotal erythema, swelling, or pain, and it is not a rare condition in the Emergency Department. Prompt intervention is required in cases of testicular torsion or rupture, and ultrasound of the scrotum has high utility for emergency physicians seeing acute scrotal complaints with any frequency. However, the incidence of acute scrotum incidence is low compared to other disease states requiring ultrasound diagnosis. This presents a problem when considering ultrasound training of Emergency Physicians for ultrasound of the scrotum in a Point-of-care perspective. With this narrative review, we will attempt to raise the awareness of emergency medicine doctors to the importance of ultrasound of the scrotum in the Emergency Department. We will also discuss educational aspects in testicular ultrasound and the use of contrast-enhanced ultrasound. Finally, we propose an algorithm for action.
阴囊超声在急诊科评估急性阴囊疾病中起着关键作用。虽然急诊医生和重症监护医生共同负责危重病患者的护理,但急诊医生通常比重症监护医生在更广泛的应用中使用床旁超声,包括高级腹部、产科、睾丸、肌肉骨骼和眼部超声检查。急性阴囊是指阴囊突然出现红斑、肿胀或疼痛,在急诊科并非罕见病症。对于睾丸扭转或破裂病例需要及时干预,阴囊超声对于经常诊治急性阴囊主诉的急诊医生具有很高的实用价值。然而,与其他需要超声诊断的疾病状态相比,急性阴囊的发病率较低。从床旁超声的角度考虑急诊医生进行阴囊超声检查的培训时,这就出现了一个问题。通过这篇叙述性综述,我们将试图提高急诊医学医生对阴囊超声在急诊科重要性的认识。我们还将讨论睾丸超声的教育方面以及对比增强超声的使用。最后,我们提出一个行动算法。