外傷性睾丸脱出症の1例

Abstract

A case report of a traumatic dislocation of the testis is described. The patient was a 19-year-old man whose perineum received a high speed impact against the smooth wedge shape of the gasoline tank in a motor cycle accident. Immediate surgical replacement of the testis was successfully performed. Right testis was found between the Scarpa's fascia and the aponeurosis of external oblique in the superficial inguinal pouch. The testis was rotated through 180 degrees in its horizontal axis, such that the inferior pole was lying superiorly. Tunica vaginalis was ruptured, but testis had a normal appearance. Spermatic cord also showed normal appearance. Including our case, 50 cases (55 testes) of this entity have been reported in Japan. According to the classification of Alyea, 4 testes (7.3%) were in the pubic, 1 (1.8%) in the penile, 0 in the crural, 24 (43.6%) in the inguinal, 1 (1.8%) in the perineal, 4 (7.3%) in the inguinal canal, 4 (7.3%) in the abdomen, and 0 in the femoral canal. Seventeen (30.9%) testes had compound dislocation. Recent reports reveal an increased number of motor cycle accidents, and age distribution has its peak incidence at the ages of 20-29 (34%).