Schwarz R J, Blair G K
Department of Surgery, British Columbia Children's Hospital, Vancouver.
Can J Surg. 1995 Aug;38(4):374-6.
Penetrating injury to the scrotum is uncommon. Usually not serious in itself it may be associated with other more serious conditions. A 15-year-old boy was involved in a tobogganing accident, and a shard of wood penetrated the left scrotum, the anterior abdominal wall and the rectus sheath one-third of the way from umbilicus to xiphisternum. There was also a liver laceration. Removal of the piece of wood and closure of the wounds with drainage resulted in successful recovery. A 45-year-old man, sustained a penetrating straddle-type injury from a broom handle. The handle penetrated Dartos fascia but there was no testicular injury. It also perforated the rectus sheath 6 cm inferior to the costal margin, and both anterior and posterior gastric walls. The tract of the handle extended along the base of the transverse mesocolon and posterior to the pancreas. The perforations were debrided and repaired. The patient received a 5-day course of broad-spectrum antibiotics and recovered fully. As a result of their experience with these two patients the authors recommend that when there is penetration of Dartos fascia, the testicle and cord should be inspected, lavage and débridement should be carried out, and any foreign bodies should be removed and the injuries repaired. Antibiotics should be given perioperatively. In all cases the entire tract should be explored to its terminus to search for other injuries. Even upper abdominal injuries can occur with penetrating scrotal injuries.
阴囊穿透伤并不常见。其本身通常并不严重，但可能与其他更严重的情况相关。一名15岁男孩遭遇了一起雪橇事故，一块木片穿透了左阴囊、前腹壁以及从脐部到剑突的三分之一处的腹直肌鞘。同时还存在肝脏裂伤。取出木片并进行伤口缝合引流后，患者成功康复。一名45岁男性遭受了扫帚柄造成的穿透性骑跨伤。扫帚柄穿透了肉膜，但未造成睾丸损伤。它还在肋缘下方6厘米处穿透了腹直肌鞘以及胃的前壁和后壁。扫帚柄的通道沿着横结肠系膜根部延伸并位于胰腺后方。对穿孔进行了清创和修复。患者接受了为期5天的广谱抗生素治疗并完全康复。基于对这两名患者的治疗经验，作者建议当肉膜被穿透时，应检查睾丸和精索，进行冲洗和清创，取出任何异物并修复损伤。应在围手术期给予抗生素。在所有病例中，应探查整个通道直至其末端以寻找其他损伤。即使是穿透性阴囊损伤也可能导致上腹部损伤。
