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1、·445·中华男科学杂志NationalJournalofAndrologyZhonghuaNanKeXueZaZhiOriginalArticleNJA2009,15(5):445-448·论著·http://www.androl.cn3睾丸扭转反复误诊致坏死1例并文献复习1123331张际青,胡小鹏,孔秀珍,黄明亮,苟举民,刘家辉,张小东(1.首都医科大学附属北京朝阳医院泌尿外科,北京100020;解放军第404医院,2.病理科,3.泌尿外科,山东威海264200)摘要:目的:提高临床医生对睾丸扭转的诊断能力。方法:报道1
2、例睾丸扭转因延迟就诊和2次误诊致坏死。结合文献,对其解剖、临床表现、超声诊断及误诊原因进行复习与分析。结果:1例表现为下腹痛的睾丸扭转患者,2次分别被误诊为肠痉挛和输尿管结石。术中探查证实睾丸扭转,睾丸已经坏死并切除。术后病理证实为睾丸坏死并弥漫性出血。结论:发病后及时就诊、准确诊断和正确治疗是避免睾丸丢失的关键。彩色多普勒超声检查为明确本病的一种理想影像学检查方法,并对手术有指导作用。关键词:睾丸扭转;精索扭转;彩色多普勒超声;提睾反射;误诊中图分类号:R697.22文献标识码:A文章编号:100923591(2009)05
3、20445204TestisNecrosisFollowingRepeatedMisdiagnosisofTesticularTorsion:ACaseReportandLiteratureReview1123ZHANGJi2qing,HUXiao2peng,KONGXiu2zhen,HUANGMing2liang,331GOUJu2min,LIUJia2hui,ZHANGXiao2dong1.DepartmentofUrology,BeijingChaoyangHospitalAffiliatedtoCapitalMedic
4、alUniversity,Beijing100020,China;2.DepartmentofPathology,3.DepartmentofUrology,No.404HospitalofPLA,Weihai,Shandong264200,ChinaAbstract:Objective:Toimproveclinicians'abilityofdiagnosingtesticulartorsion.Methods:Wereviewedthedataofacaseoftesticulartorsionthatresultedi
5、nnecrosisbecauseofdelayedpresentationandrepeatedmisdiagnosis,andanalyzeditsanatomicfea2tures,clinicalmanifestations,ultrasoundresults,thecausesofmisdiagnosisandrelevantliterature.Results:Thepatientpresented5hoursaftertheonsetofsymptoms,complainingofsevereparoxysmalp
6、aininthelowerleftabdomen,accompaniedwithnauseaandvomiting,andwastwicemisdiagnosedashavingenterospasmorureteralcalculusattwodifferenthospitals.Fifteenhourslater,surgicalexplorationrevealedanabout9002degreetesticulartorsioninthespermaticcord,whichnecessitatedorchiecto
7、myfornonviabilityofthetestis.Postoperativepathologicalexaminationconfirmedtesticularnecrosisanddiffusedhemorrhageinthetestisandepididymis.Conclusion:Timelypresentation,correctdiagnosisandpropertreatmentarekeystosavingtheaffectedtestis.ColorDopplerultra2soundisanidea
8、loptionforthedefinitediagnosisofacutescrotaldiseases,anditoffersavaluableguidanceforrelatedsurgeryaswell.NatlJAndrol,2009,15(5):445-448Key
