Orozco-Sánchez J, Sámano-Martinez A, Neri-Vela R
Servicio de Cirugía Pediátrica y Cirgíaa Plástica, Hospital Juárez de México, D.F.
Bol Med Hosp Infant Mex. 1993 Aug;50(8):590-5.
Three cases of extravaginal torsion of the spermatic cord with infarct of the testicle in the newborn are presented. All three cases had acute fetal distress. They had in common being the products of multiparous women, born in a distocic fashion with a prolonged labor without prenatal control. One of the had a shoulder impaction with required forceps use. Two of them were delivered on vaginal way and the other one by cesarean section. In all three cases, torsion was present at birth. Diagnosis was made between third and fifth day of life; the clinical findings were: enlargement of the right scrotal bag, purple discoloration of the skin, a painless hard mass that did not permit the passage of light (transillumination) and the absence of cremasteric reflex. A right resolution ultrasound was useful in determining the inflammatory tumoral mass. A right orchidectomy and pexy of the contralateral testicle were done in the three cases with nonabsorbable sutures and no testicular implants. The following diagnoses should be discarded prior to a definitive diagnosis: scrotal edemas, hydrohematocele, strangled inguinal hernia with infarct and testicular neoplasia.
本文报告了3例新生儿精索鞘膜外扭转并睾丸梗死的病例。所有3例均有急性胎儿窘迫。他们的共同特点是多产妇的产物,分娩方式异常,产程延长且未进行产前检查。其中1例有肩部嵌顿,需使用产钳助产。2例经阴道分娩,另1例剖宫产。所有3例在出生时即存在扭转。诊断在出生后第3至5天作出;临床表现为:右侧阴囊增大,皮肤呈紫色,有一个无痛性硬块,不透光(透光试验阴性)且提睾反射消失。右侧超声检查有助于确定炎性肿瘤性肿块。3例均行右侧睾丸切除术及对侧睾丸固定术,使用不可吸收缝线,未植入睾丸假体。在明确诊断之前,应排除以下诊断:阴囊水肿、血囊肿、绞窄性腹股沟疝伴梗死及睾丸肿瘤。