The trauma testis is reversed into urology emergencies, manifested in scrotal pain after trauma, which is rare in clinic.Because there is a clear history of external injuries and varying degrees of scrotal swelling, and did not notice the existence of traumatic testicular to reversing during physical examination, it is often difficult to find the specific signs of testicular torsion: such as higher testicular positions, horizontal or slopes, prehn & prime; sSign positive and so on.If a conservative treatment is not done for further examination, testicular necrosis will be caused.Closed scrotum injury causes testes to swelling and painful tissue hematoma, hydrogen hemorrhage, and tissue edema. It is difficult to accurately evaluate testicular injuries during physical examination.
Radioxin 99MTC scrotal testicular scanning is considered a gold standard for diagnosis of testicular reversal.
The testes are manifested as a "cold nodule" that is not accumulated due to blood flow. Although radioactive nucleo scanning diagnosis of testicular reversal is high, most hospitals lack examination equipment.And emergency diagnosis.CDFI can not only show the morphological changes of the testicular, but also reflect the blood flow dynamics of the testicular. The diagnosis of testicular to reversing the sensitivity is as high as 82%-100%, the specificity is 100%, and the accuracy rate is 97%.Testicles blood flow irrigation information is the only basis for identifying testicular reversal and testicular injuries. The testicular blood supply of injuries is basically normal or mild, and the twisted testicular blood supply is significantly reduced or disappeared.CDFI non -invasive, simple and easy to do, is the first choice for diagnosis of testicular torsion. It should be used as a routine examination of closed scrotal damage.
Pay attention to the following points in actual work:
(1) Whether the blood flow is or not can be used as the only criterion for diagnosis of external injury testicles.Due to the injury scrotum and sheath hematoma compression of testicular, testicular hematoma and tissue edema, tough toughness and compliance of testicular white membranes, after injury, and vascular spasm and other factors, closed testicular injuries generally have a decrease in blood flow.Trauma can also cause enhancement of blood flow signals around the testicles in the scrotum and cover up the weakening or disappearance of the blood flow signal in the testicles.(2) It is necessary to adhere to the bilateral control, and compare the blood flow signal of the internal teste of the side with the hemorrhage signal signal of the healthy side testicles.(3) Pay attention to whether the changes in testicular morphology are consistent with the changes in blood flow.(4) Learn from the history of the medical in detail. Although the scrotum has a clear history of trauma, it should be paid to the consistency of clinical manifestations and violence and scrotal injuries.(5) Repeat examination to avoid misdiagnosis.(6) Suspected people should actively investigate.
The trauma testicular reversal is caused by trauma violence. Most of the testicles have no dissection variation. The number of torsional degree is unknown. Coupled with the blood stasis and bloating of scrotum after trauma, the technique is blind, it is difficult to succeed, and even aggravate twisting.
In terms of treatment: You should no longer try to reset, and you should immediately investigate, reset and fix it, and save the testicular vitality.
Whether the opposite testicles need to be explored according to the situation in the operation.Some scholars routinely explore the testicular testicular of the spontaneous testicular torsioners, and found that 20%have abnormalities [9]. Theoretically, preventive detection of inspection of the opposite testicular has some damage to testicles.Most of the traumatic testicular reversal does not have an anatomical mutation. We generally do not need to detect the opposite testicular detection. Unless there is an anatomical variation of the tirled testicles during the surgery, the opposite sperm is obviously long, and the testeas cannot be rescued.Explore the opposite testicles.
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