急性陰嚢症の臨床的検討

Abstract

1)1986年5月から1990年11月迄の急性陰嚢症39例の確定診断の内訳は急性精巣上体炎23例, 精索捻転13例, 精巣上体垂捻転2例, 精巣垂捻転1例であった。2)超音波検査で捻転部を描出できる場合は精索捻転と診断できる。精巣内部エコーの不均一は精巣壊死を示す。3)blue dot signが認められれば, 付属小体捻転と診断できる。4)Doppler血流計では必ずしも精索捻転の診断はできない。5)急性陰嚢症において, 精索捻転が完全に否定できないならば, 手術的に診断治療する必要がある

Acute scrotum is a clinical syndrome which includes various disorders. Differential diagnosis of these disorders is not always easy. We reviewed cases experienced in our hospital, focusing on diagnostic procedures. Final diagnosis in 39 cases were acute epididymitis in 23 cases, torsion of the testis in 13 cases, torsion of appendix epididymis in 2 cases and torsion of appendix testis in 1 case. It became clear ultrasonography was a useful diagnostic procedure; if the torsed portion is delineated, torsion of the testis can be diagnosed. Heterogenous echoes from the interior of the testis indicate the necrosis of the testis. Inspection was also useful; if the blue dot sign is detected, torsion of the appendix testis/epididymis is indicated. However, Doppler ultrasound did not always provide a correct diagnosis of torsion of the testis. If torsion of the spermatic cord cannot be completely ruled out, early surgical intervention and treatment are considered essential.