Campobasso P, Donadio P, Spata E, Salano F, Belloli G
Divisione di Chirurgia Pediatrica, Ospedale Regionale di Vicenza, Italia.
Pediatr Med Chir. 1994 Nov-Dec;16(6):521-6.
"Acute scrotum" in infants and children is generally due to testicular torsion, torsion of the appendix of testis or acute orchi-epididymitis. However they are other less frequent causes of "acute scrotum". The differential diagnosis is often very difficult. 265 consecutive cases of acute scrotum are reviewed. 47% of the all patients presented torsion of the appendix of testis, 26% torsion of testis and 26% acute orchi-epididymitis. The torsion of testis was most frequent in children under 1 year (67%), in the older patients the torsion of appendix of testis was most frequent (46% in patients 1-6 years old, 57% in patients over 6 years). The value and limit of ultrasound, scrotal scintigraphy and doppler ultrasound are discussed and an algorithm for the diagnosis of causes of acute scrotum is presented. In equivocal cases, early surgical exploration may be necessary to exsclude torsion of testis and to prevent testicular loss.
婴幼儿及儿童的“急性阴囊”通常由睾丸扭转、睾丸附件扭转或急性睾丸附睾炎引起。然而，还有其他一些不太常见的“急性阴囊”病因。鉴别诊断往往非常困难。本文回顾了连续265例急性阴囊病例。所有患者中，47%表现为睾丸附件扭转，26%为睾丸扭转，26%为急性睾丸附睾炎。睾丸扭转在1岁以下儿童中最为常见（67%），在年龄较大的患者中，睾丸附件扭转最为常见（1 - 6岁患者中占46%，6岁以上患者中占57%）。讨论了超声、阴囊闪烁显像和多普勒超声的价值及局限性，并提出了急性阴囊病因的诊断算法。在不明确的病例中，可能需要早期手术探查以排除睾丸扭转并防止睾丸丧失。
