Gordon L M, Stein S M, Ralls P W
Department of Radiology, LAC + USC Medical Center 90033, USA.
AJR Am J Roentgenol. 1996 Jun;166(6):1323-5. doi: 10.2214/ajr.166.6.8633441.
We performed this study to determine whether scrotal trauma can cause hyperemia of the epididymis. This diagnosis is helpful because traumatic epididymitis can be treated conservatively.
We retrospectively reviewed color Doppler and gray-scale sonograms of five patients who had suffered trauma to the scrotum that resulted in epididymal hyperemia, which we called traumatic epididymitis. We also reviewed the presentation and management of each patient.
Color Doppler sonography revealed focal (one patient) and diffuse (four patients) hyperemia. Gray-scale images revealed epididymal enlargement in all patients. These findings were indistinguishable from those of infectious epididymitis by sonography. One patient also had hyperemia of the testis. Four of the five patients were managed conservatively; the other underwent surgical exploration for a coexisting testicular rupture.
Careful evaluation of the epididymis with both gray-scale and color Doppler sonography should be part of every sonographic survey of the scrotum for blunt trauma. Traumatic epididymitis, which may be noted on color Doppler images, should not be confused with infectious epididymitis. Surgery is not necessary unless another injury requires it.
我们开展本研究以确定阴囊创伤是否会导致附睾充血。这一诊断很有帮助，因为创伤性附睾炎可采用保守治疗。
我们回顾性分析了5例阴囊创伤导致附睾充血（我们称之为创伤性附睾炎）患者的彩色多普勒和灰阶超声图像。我们还回顾了每位患者的临床表现及治疗情况。
彩色多普勒超声显示局灶性充血（1例患者）和弥漫性充血（4例患者）。灰阶图像显示所有患者的附睾均肿大。这些表现通过超声检查与感染性附睾炎无法区分。1例患者还伴有睾丸充血。5例患者中有4例接受了保守治疗；另1例因同时存在睾丸破裂而接受了手术探查。
对于阴囊钝性创伤的每次超声检查，都应包括用灰阶和彩色多普勒超声对附睾进行仔细评估。彩色多普勒图像上可能出现的创伤性附睾炎不应与感染性附睾炎相混淆。除非有其他损伤需要，否则无需进行手术。
