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在急诊科使用床旁超声(POCUS)进行快速睾丸挽救。

Rapid testicular salvage in the emergency department using point of care ultrasound [POCUS].

作者信息

Taha Khaled, Bonachera Adrian, Hegarty Nicholas, Tivnan Edel, Umana Etimbuk, Smith Diakidis Dimitris, Mustafa Jawad, Breslin Tomás, Alhadi Bassem, Devlin Erin

机构信息

Emergency Department, Mater Misericordiae University Hospital, Dublin, Ireland.

Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland.

出版信息

Int J Emerg Med. 2025 Apr 17;18(1):80. doi: 10.1186/s12245-025-00844-0.

DOI:10.1186/s12245-025-00844-0
PMID:40247183
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12004850/
Abstract

BACKGROUND

Testicular torsion is a time-sensitive urological emergency characterized by twisting of the spermatic cord, leading to ischaemia and, if untreated, necrosis. Young males under 25 are at the highest risk due to congenital defects like the Bell Clapper deformity. Prompt diagnosis and management are crucial.

CASE PRESENTATION

A 30-year-old male presented with severe right testicular pain, and point-of-care ultrasound (POCUS) in the Emergency Department confirmed torsion within a few minutes upon arrival to Emergency Department. Manual detorsion restored blood flow, confirmed by bedside Doppler imaging using POCUS within 15 min of arrival. The patient underwent successful bilateral orchidopexy.

CONCLUSION

This case emphasizes the importance of early targeted emergency POCUS in recognizing and managing testicular torsion, ensuring optimal outcomes.

摘要

背景

睾丸扭转是一种对时间敏感的泌尿外科急症,其特征是精索扭转,导致缺血,若不治疗则会发生坏死。25岁以下的年轻男性由于存在如钟摆畸形等先天性缺陷,风险最高。及时诊断和处理至关重要。

病例介绍

一名30岁男性因右侧睾丸剧痛就诊,急诊科的床旁超声检查(POCUS)在其抵达急诊科几分钟内就确诊了扭转。手法复位恢复了血流,在抵达后15分钟内通过床旁POCUS使用多普勒成像得到证实。该患者接受了成功的双侧睾丸固定术。

结论

本病例强调了早期针对性急诊POCUS在识别和处理睾丸扭转方面的重要性,以确保获得最佳结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/32ced7033572/12245_2025_844_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/f2b25d8984c8/12245_2025_844_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/b3c38bd200d6/12245_2025_844_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/aa316afa1049/12245_2025_844_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/32ced7033572/12245_2025_844_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/f2b25d8984c8/12245_2025_844_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/b3c38bd200d6/12245_2025_844_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/aa316afa1049/12245_2025_844_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/12004850/32ced7033572/12245_2025_844_Fig4_HTML.jpg

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本文引用的文献

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Manual detorsion under sedation and POCUS.在镇静和床旁超声引导下进行手法复位。
J Paediatr Child Health. 2025 Feb;61(2):281-283. doi: 10.1111/jpc.16742. Epub 2024 Dec 12.
2
Manual detorsion in pediatric testicular torsion: A narrative review of the literature.小儿睾丸扭转手法复位:文献综述
Urologia. 2024 Aug;91(3):628-631. doi: 10.1177/03915603241229800. Epub 2024 May 9.
3
Real-time Point-of-care Ultrasound for the Diagnosis and Treatment of Testicular Torsion.用于睾丸扭转诊断和治疗的即时现场实时超声检查
POCUS J. 2021 Nov 23;6(2):70-72. doi: 10.24908/pocus.v6i2.15186. eCollection 2021.
4
Reducing COVID-19 Health Inequities by Identifying Social Needs and Clinical Deterioration of Discharged Emergency Department Patients.通过识别急诊科出院患者的社会需求和临床恶化情况来减少 COVID-19 健康不平等。
West J Emerg Med. 2022 Oct 18;23(6):794-801. doi: 10.5811/westjem.2022.8.55253.
5
Real-time Ultrasound-Guided Manual Testicular Detorsion: A Case Report.实时超声引导下手法复位睾丸扭转:一例报告
Clin Pract Cases Emerg Med. 2022 Aug;6(3):248-251. doi: 10.5811/cpcem2022.6.57256.
6
Ultrasound-Guided Manual Testicular Detorsion in the Emergency Department.急诊科超声引导下手法复位睾丸扭转
J Emerg Med. 2020 Jan;58(1):85-92. doi: 10.1016/j.jemermed.2019.09.020. Epub 2019 Oct 22.
7
Door To Detorsion Time Determines Testicular Survival.精索复位时间决定睾丸存活。
Urology. 2019 Nov;133:211-215. doi: 10.1016/j.urology.2019.08.003. Epub 2019 Aug 10.
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Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis.睾丸扭转伴血流保留:关键超声特征及诊断的增值方法
Pediatr Radiol. 2018 May;48(5):735-744. doi: 10.1007/s00247-018-4093-0. Epub 2018 Feb 21.
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Urol Nurs. 2017 Mar-Apr;37(2):61-71, 93.
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