MRI診断が有用であった外傷性精巣破裂の1例

Abstract

17歳男.左陰嚢を強打し, その後有痛性の腫脹を認めた為近医を受診し, 超音波検査で左精巣破裂が疑われ, 精査加療目的で入院となった.入院時, 左陰嚢部は約2倍に腫脹し, 軽度発赤を認めた.画像所見より, 外傷性の左精巣破裂と診断し, 精巣白膜修復術を施行した.術後経過は良好で, 術後8日目に退院した.術後1ヵ月現在, 陰嚢の腫脹, 萎縮等は認めず, 抗精子抗体は陰性であった

Traumatic rupture of the testis is rare because of the protection afforded by surrounding structures. Moreover, it is difficult to accurately diagnose preoperatively. A 17-year-old man was referred to our department with the complaint of painful swelling of the left testis after being hit by a basketball. Although ultrasonography and computed tomography did not reveal the rupture of the tunica albuginea, we preoperatively diagnosed the rupture of the left testis by magnetic resonance imaging (MRI). We repaired the tunica albuginea and preserved the left testis. In this report, the advantages of MRI for preoperative diagnosis of traumatic rupture of the testis are discussed. In addition, previous cases with traumatic rupture of the testis in the Japanese literature are also reviewed.