As soon as the ultrasound probe was put on, it was found that there was a very large testicle in the right scrotum, which was twice as big as the left testicle! There is a large amount of fluid surrounding the swollen testicles.
Color Doppler showed that there was no blood flow signal in the right swollen testicle, and the baby did not cry during the examination. It seemed that had no pain, , which is not good! Ultrasound doctors at Hunan Wangwang Hospital considered that the baby had symptoms of "acute testicular torsion and necrosis", and immediately notified the obstetrician, and a battle to defend the "egg" began!
was diagnosed with torsion of the baby's right testicle, and emergency surgery was performed to remove the right side and save the left side!
After the obstetrician communicated the condition with the family and obtained the consent of the family, he immediately transferred the baby to the Department of Urology for emergency surgery: During the operation, he saw that the right spermatic cord was torsion 40 degrees. The torsion was reset, and the testicular tunica cavity was opened and black blood was seen. The fluid flowed out, revealing that the testicle was swollen and turned black and purple. After it was determined that the right testicle was necrotic, the family was notified, and after obtaining consent, the right orchiectomy and left orchiopexy were performed. Although the family members regretted that one testicle was removed, they were also thankful that the other testicle was saved.
What is testicular torsion?
Testicular torsion, also known as spermatic cord torsion, is a torsion caused by anatomical abnormalities or increased mobility of the testis and spermatic cord itself, causing obstruction of blood circulation in the spermatic cord and causing testicular ischemia and necrosis. , is one of the common causes of scrotal emergencies.
Testicular torsion is divided into intrathecal type and extrathecal type . The intrathecal type is more common and most commonly occurs in young adults aged 12 to 18 years old. It often occurs during sleep, when just waking up, or after strenuous exercise. The extrathecal type is rare and mostly occurs in newborns or infants under 1 year old.
The typical clinical manifestation of testicular torsion is sudden and persistent testicular pain that can radiate to the groin and lower abdomen, accompanied by nausea and vomiting, and redness, swelling, and tenderness in the scrotum.
The sonographer at Hunan Wangwang Hospital specially reminds : When the testicles have become necrotic, the pain will reduce or disappear, and the scrotum will gradually turn blue-purple. The above-mentioned baby's right scrotum was swollen when he was born, and touching the scrotum did not cause the baby to cry or become upset. This shows that the baby's testicles had torsion while he was in the mother's belly. This is a very rare situation.
In the late pregnancy, due to the large size of the fetus and obstruction of the limbs, ultrasound examination cannot effectively detect fetal testicular torsion. There are no reports of prenatal diagnosis of "fetal testicular torsion" at home and abroad, so pregnant mothers should pay special attention to the baby when delivery is approaching. If you find abnormal fetal movement, especially if the fetus suddenly moves very frequently, you must go to the hospital in time for fetal heart rate monitoring and other related examinations.
In addition, boys who experience severe lower body pain or injury should be more vigilant and go to the hospital as quickly as possible. Do not think that "redness, swelling, pain, heat, and dysfunction" are just inflammation. Testicular torsion should be ruled out first.
Because the treatment of testicular torsion requires a race against time Once confirmed or highly suspected, exploratory surgery should be carried out quickly and decisively. The "Guidelines for the Diagnosis and Treatment of Urological Diseases" propose: 6 hours, 7-12 hours and 13-18 hours after torsion. The testicular survival rates were 97.2%, 79.3% and 61.3% respectively, and the testicles were basically necrotic after 24 hours. golden six hours! Time is closely related to the success rate of testicular rescue!
(Editor ZS. Picture source network, infringement and deletion)
Hunan Medical Chat special author: Hunan Wangwang Hospital Ultrasound Department 3/Chen Shaofeng Secretary Office/Wang Rui
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