Stone K T, Kass E J, Cacciarelli A A, Gibson D P
Department of Urology, William Beaumont Hospital, Royal Oak, Michigan.
J Urol. 1995 Mar;153(3 Pt 1):782-4.
Currently, management of the newborn with suspected antenatal torsion is somewhat controversial. Many surgeons recommend early surgical exploration within the first few days of life, primarily to avoid errors in diagnosis. However, since the surgical and general anesthetic risks at this age are increased, it might be preferable to defer an operation until risks to the patient are minimized. The optimal solution to this dilemma would be the ability to diagnose torsion and exclude other conditions noninvasively. We present a series of 12 patients 1 to 14 days old who presented with a scrotal mass secondary to suspected antenatal testis torsion. Color Doppler ultrasound in each case demonstrated abnormal testicular blood flow and architecture consistent with testis torsion. Eventual exploration of all 12 patients confirmed prenatal torsion. We conclude that scrotal ultrasound with color Doppler enhancement can accurately identify neonates with antenatal testis torsion and exclude other scrotal pathological conditions. If elected, surgery for torsion can then be deferred until the risks of anesthesia and surgery are improved.
目前，对于疑似产前睾丸扭转的新生儿的处理存在一定争议。许多外科医生建议在出生后的头几天内尽早进行手术探查，主要是为了避免诊断错误。然而，由于这个年龄段的手术和全身麻醉风险增加，推迟手术直到患者风险降至最低可能更为可取。解决这一困境的最佳办法是能够无创地诊断扭转并排除其他疾病。我们报告了一系列12例年龄在1至14天的患者，他们因疑似产前睾丸扭转而出现阴囊肿块。每例患者的彩色多普勒超声均显示睾丸血流和结构异常，符合睾丸扭转表现。对所有12例患者最终进行的探查均证实为产前扭转。我们得出结论，彩色多普勒增强阴囊超声能够准确识别产前睾丸扭转的新生儿，并排除其他阴囊病理状况。如果选择手术，那么可以推迟睾丸扭转手术，直到麻醉和手术风险降低。
