Kattan S
Department of Surgery King Khalid University Hospital, Riyadh, Saudi Arabia.
Scand J Urol Nephrol. 1994 Sep;28(3):277-9.
A five year retrospective review of 15 cases of spermatic cord torsion in male patients 18-years or older was performed. Eighty percent of patients were correctly diagnosed at time of initial presentation while 20% of patients were misdiagnosed as epididymitis. Fifty three percent of cases has history of similar previous attacks. The average delay prior to presentation was 7 hours. Absence of fever was the rule occurring in all patients. Leucocytosis and significant pyuria were commonly encountered occurring in 33% and 27% of patients respectively. Our orchidectomy rate was 20%. Our data suggest that while, in adult patients presenting with scrotal pain, the absence of pyuria make the diagnosis of epididymitis unlikely as a cause of the condition, the presence of significant pyuria even if associated with leucocytosis does not exclude spermatic cord torsion and further studies with Doppler examination and Radionuclide Scans are necessary to establish the diagnosis.
对18岁及以上男性患者的15例精索扭转病例进行了为期五年的回顾性研究。80%的患者在初次就诊时被正确诊断，而20%的患者被误诊为附睾炎。53%的病例有类似既往发作史。就诊前的平均延迟时间为7小时。所有患者均无发热。白细胞增多和明显脓尿分别常见于33%和27%的患者中。我们的睾丸切除术率为20%。我们的数据表明，在出现阴囊疼痛的成年患者中，无脓尿时附睾炎作为病因的诊断可能性不大，即使伴有白细胞增多，明显脓尿的存在也不能排除精索扭转，需要通过多普勒检查和放射性核素扫描进行进一步研究以明确诊断。
