Các trường hợp khẩn cấp ở bìu

Pediatric Radiology - Tập 39 - Trang 516-521 - 2009
Matteo Baldisserotto1
1Radiology Department, Hospital Sao Lucas da Pontificia, Universidade Católica do Rio Grando do Sul, Porto Alegre, Brazil

Tóm tắt

Bài đánh giá này mô tả các kết quả lâm sàng, siêu âm thang xám và siêu âm Doppler màu của các tình trạng khác nhau có thể là nguyên nhân gây ra tình trạng bìu cấp tính. Hình ảnh siêu âm của xoắn tinh hoàn, xoắn phụ tinh hoàn, viêm mào tinh hoàn - tinh hoàn, thoát vị bị kẹt và phù bìu vô căn được mô tả. Một số nghiên cứu chính liên quan đến độ nhạy và độ đặc hiệu của siêu âm trong chẩn đoán các bệnh này cũng được xem xét. Siêu âm thang xám và siêu âm Doppler màu cho thấy độ chính xác cao trong chẩn đoán nguyên nhân của tình trạng bìu cấp tính và có thể phân biệt giữa các bệnh cần can thiệp phẫu thuật ngay lập tức và những bệnh có thể điều trị bảo tồn.

Từ khóa

#siêu âm #bìu cấp tính #xoắn tinh hoàn #viêm mào tinh hoàn #thoát vị bị kẹt

Tài liệu tham khảo

Atkinson GO Jr, Patrick LE, Ball TI Jr et al (1992) The normal and abnormal scrotum in children: evaluation with color Doppler sonography. AJR 158:613–617 Abbate B, Danti DA, Niccoli F (1993) Acute scrotum in childhood: considerations on 457 cases. Pediatr Med Chir 15:75–77 Van Glabeke E, Khairouni A, Larroquet M et al (1999) Acute scrotal pain in children: results of 543 surgical explorations. Pediatr Surg Int 15:353–357 McAndrew HF, Pemberton R, Kikiros CS et al (2002) The incidence and investigation of acute scrotal problems in children. Pediatr Surg Int 8:435–437 Cuckow PM, Frank JD (2000) Torsion of the testis. BJU Int 86:349–353 Caesar R, Kaplan G (1994) Incidence of the bell clapper deformity in an autopsy series. Urology 44:114–116 Barada JH, Weingarten JL, Cromie WJ (1989) Testicular salvage and age-related delay in the presentation of testicular torsion. J Urol 142:746–748 Tryfonas G, Violaki A, Tsikopoulos G et al (1994) Late postoperative results in males treated for testicular torsion during childhood. J Pediatr Surg 29:553–556 Maroto A, Serres X, Torrent N et al (1992) Sonographic appearance of torsion knot in spermatic cord torsion. AJR 159:1029–1030 Kalfa N, Veyrac C, Baud C et al (2004) Ultrasonography of the spermatic cord in children with testicular torsion: impact on the surgical strategy. J Urol 172:1692–1695 Vijayaraghavan SB (2006) Sonographic differential diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion. J Ultrasound Med 25:563–574 Wilbert DM, Schaerfe CW, Stern WD et al (1993) Evaluation of the acute scrotum by color-coded Doppler ultrasonography. J Urol 149:1475–1477 Baker LA, Sigman D, Mathews RI et al (2000) An analysis of clinical outcomes using color doppler testicular ultrasound for testicular torsion. Pediatrics 105:604–607 Burks DD, Markey BJ, Burkhard TK et al (1990) Suspect testicular torsion and ischemia: evaluation with color Doppler sonography. Radiology 175:815–821 Garel L, Dubois J, Azzie G et al (2000) Preoperative manual detorsion of the spermatic cord with Doppler ultrasound monitoring in patients with intravaginal acute testicular torsion. Pediatr Radiol 30:41–44 Kaye JD, Levitt SB, Friedman SC et al (2008) Neonatal torsion: a 14-year experience and proposed algorithm for management. J Urol 179:2377–2383 van der Sluijs JW, den Hollander JC, Lequin MH et al (2004) Prenatal testicular torsion: diagnosis and natural course. An ultrasonographic study. Eur Radiol 14:250–255 LaQuaglia M, Bauer S, Eraklis A et al (1987) Bilateral neonatal torsion. J Urol 138:1051–1054 Groisman GM, Nassrallah M, Bar-Maor JA (1996) Bilateral intra-uterine testicular torsion in a newborn. Br J Urol 78:800–801 Brown SM, Casillas VJ, Montalvo BM (1990) Intrauterine spermatic cord torsion in the newborn: sonographic and pathologic correlation. Radiology 177:755–757 Traubici J, Daneman A, Navarro O et al (2003) Testicular torsion in neonates and infants: sonographic features in 30 patients. AJR 180:1143–1145 Sidler D, Brown RA, Millar AJ et al (1997) A 25-year review of the acute scrotum in children. S Afr Med J 87:1696–1698 Mushtaq I, Fung M, Glasson MJ (2003) Retrospective review of paediatric patients with acute scrotum. Aust N Z J Surg 73:55–58 Murphy FL, Fletcher L, Pease P (2006) Early scrotal exploration in all cases is the investigation and intervention of choice in the acute paediatric scrotum. Pediatr Surg Int 22:413–416 McCombe AW, Scobie WG (1988) Torsion of scrotal contents in children. Br J Urol 61:148–150 Hesser U, Rosenborg M, Gierup J et al (1993) Gray-scale sonography in torsion of the testicular appendages. Pediatr Radiol 23:529–532 Baldisserotto M, de Souza JC, Pertence AP et al (2005) Color Doppler sonography of normal and torsed testicular appendages in children. AJR 184:1287–1292 Campobasso P, Donadio P, Spata E et al (1994) Acute scrotum in children: analysis of 265 consecutive cases. Pediatr Med Chir 16:521–526 Tank ES (1980) Testicular torsion. In: Holder TM, Ashcraft FW (eds) Pediatric surgery. WB Saunders, Philadelphia, pp 824–825 Chiang MC, Chen HW, Fu RH et al (2007) Clinical features of testicular torsion and epididymo-orchitis in infants younger than 3 months. J Pediatr Surg 42:1574–1577 Siegel A, Snyder H, Duckett JW (1987) Epididymitis in infants and boys: underlying urogenital anomalies and efficacy of imaging modalities. J Urol 138:1100–1103 Oğuzkurt P, Tanyel FC, Büyükpamukçu N (1998) Acute scrotum due to edidymo-orchitis associated with vasal anomalies in children with anorectal malformations. J Pediatr Surg 33:1834–1836 Kriss VM, Miller SD, McRoberts WJ (1995) Ectopia of the vas deferens. Pediatr Radiol 25:381–382 Banever GT, Moriarty KP (2005) Posterior urethral valves in a newborn with imperforate anus: clinical presentation and management. J Pediatr Surg 40:1332–1334 Ardill RH, Manivel JC, Beier-Hanratty S et al (1990) Epididymitis associated with müllerian duct cyst and calculus: sonographic diagnosis. AJR 155:91–92 Ku JH, Jung TY, Lee JK et al (2006) Influence of bladder management on epididymo-orchitis in patients with spinal cord injury: clean intermittent catheterization is a risk factor for epididymo-orchitis. Spinal Cord 44:165–169 Patriquin HB, Yazbeck S, Trinh B et al (1993) Testicular torsion in infants and children: diagnosis with Doppler sonography. Radiology 188:781–785 Najmaldin A, Burge DM (1987) Acute idiopathic scrotal oedema: incidence, manifestations and aetiology. Br J Surg 74:634–635 Klin B, Lotan G, Efrati Y et al (2002) Acute idiopathic scrotal edema in children – revisited. J Pediatr Surg 37:1200–1202 Grainger AJ, Hide IG, Elliott ST (1998) The ultrasound appearances of scrotal oedema. Eur J Ultrasound 8:33–37 Anderson KA, McAninch JW, Jeffrey RB et al (1983) Ultrasonography for the diagnosis and staging of blunt scrotal trauma. J Urol 130:933–935 Jeffrey RB, Laing FC, Hricak H et al (1983) Sonography of testicular trauma. AJR 141:993–995 Deurdulian C, Mittelstaedt CA, Chong WK et al (2007) US of acute scrotal trauma: optimal technique, imaging findings, and management. Radiographics 27:357–369 Chandra RV, Dowling RJ, Ulubasoglu M et al (2007) Rational approach to diagnosis and management of blunt scrotal trauma. Urology 70:230–234 Guichard G, El Ammari J, Del Coro C et al (2008) Accuracy of ultrasonography in diagnosis of testicular rupture after blunt scrotal trauma. Urology 71:52–56 Schaffer RM (1985) Ultrasonography of scrotal trauma. Urol Radiol 7:245–249 Mass RL, Hatch EI (1991) Inguinal hernia repair in early infancy. Am J Surg 161:596–599 Ogata M, Imai S, Hosotani R et al (1994) Abdominal ultrasonography for the diagnosis of strangulation in small bowel obstruction. Br J Surg 81:421–424