Aubert J, Couret H, Eyraud J
J Urol Nephrol (Paris). 1978 Oct-Nov;84(10-11):733-40.
The authors report 3 cases of torsion of the spermatic pedicle in the newborn and give us a very complete review of the literature. The term torsion of the testicle should be replaced by torsion of the "spermatic pedicle", the exact level of the torsion being different in the adolescent from the newborn. In the adolescent, it is the horizontal position of the testicle with lengthening of the intravaginal portion of the pedicle or yet the existence of a true membrane between the epididymis and the testicle which favors intravaginal torsion. This anatomical predisposition was bilateral nine times out of ten. In the newborn, it is the testicle and the tunica vaginalis not yet fixed which, as on a pivot, turn with the cord which lies above the tunica vaginalis. The unevenness of the cremasteric fibers and the (Terme non familier) in the helicoid spermatic veins can facilitate the torsion. Bilateral torsion is even possible in the newborn. The clinical features of torsion in the newborn is non-tenderness when the scrotum is swollen, ecchymotic or nontransilluminating. The only logical approach is emergency surgical exploration. Unfortunately, the already irreversible ischemic necrosis (illégible) a castration. The possibility of bilatertion of the opposite testicle. The nontenderness of the lesion explains the frequent error in diagnosis and a certain number of cases of testicular atrophy in adults from birth.
作者报告了3例新生儿精索蒂扭转病例，并对相关文献进行了非常全面的综述。“睾丸扭转”一词应被“精索蒂扭转”所取代，青少年与新生儿精索扭转的确切部位不同。在青少年中，睾丸的水平位置、精索鞘膜内部分的延长，或者附睾与睾丸之间存在真正的膜，这些因素有利于鞘膜内扭转。这种解剖学上的易患因素十有八九是双侧的。在新生儿中，睾丸和尚未固定的鞘膜如同围绕一个支点，与位于鞘膜上方的精索一起扭转。提睾肌纤维的不均衡以及螺旋状精索静脉中的（术语不常见）可促使扭转发生。双侧扭转在新生儿中甚至也是可能的。新生儿扭转的临床特征是阴囊肿胀时无压痛、有瘀斑或不透光。唯一合理的方法是紧急手术探查。不幸的是，已经发生的不可逆缺血性坏死（字迹不清）导致了睾丸切除。对侧睾丸双侧扭转的可能性。病变无压痛解释了诊断中频繁出现的错误以及一些成年人自出生起就出现睾丸萎缩的病例。
