Recently, a 7-year-old boy came to Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) for 4 days because of scrotal swelling and pain. The family members of the children reported that they had been checked in many hospitals, and they were all diagnosed with epididymitis, and they had been treated with anti-inflammatory treatment. After color Doppler ultrasonography, the ultrasound radiologist found a round nodule of about 6x6mm in the upper pole of the testis, with clear borders, the internal echo was sieve-like, and no obvious blood flow signal was found in the testis. Ultrasound performance. After consultation, Wang Yuecheng, the director of the department, clearly pointed out that this is one of the emergencies of the urinary system in children: torsion of the appendix epididymis or appendix testis.
Wang Yuecheng introduced that testicular appendages are residual bodies during embryonic development. Clinically, testicular appendages and epididymal appendages are more common. Testicular appendages are attached to the upper pole of the testis, accounting for about 45%; epididymal appendages are attached to the epididymis. head, accounting for about 40%. In normal adults, the display rate of attachments is about 80%, and it is difficult for children to display them.
At present, it is believed that anatomical abnormality is the inherent condition of torsion of testicular appendages. Vigorous exercise or direct violence are external factors. Testicular torsion is more common in children and adolescents, can occur between 2-14 years old, and mainly occurs in children 6-14 years old. Rare in adults, the symptoms resemble testicular torsion but are usually milder than testicular torsion. Clinically, due to less understanding of acute testicular torsion, it is easy to be mistaken for acute testicular torsion or acute epididymitis, especially it is easy to be misdiagnosed as acute testicular torsion and lead to unnecessary surgery. Therefore, the correct diagnosis of the disease is very important for clinical treatment.
Acute testicular torsion is a common self-limiting disease in children and adolescents, and the treatment principles are mainly anti-inflammatory and analgesic, according to Zhang Jun, director of the Department of Urology. Surgery should be considered only for patients with obvious necrosis and ineffective symptomatic treatment. Color Doppler ultrasonography is helpful for early and accurate diagnosis of acute testicular torsion, and at the same time, it can be differentiated from acute testicular torsion and acute epididymitis, and unnecessary surgery can be avoided.
Xiaoxiang Morning News reporter Mei Mei correspondent Zhang Lu
News clues reveal channel: Download the “Morning Video” client from the app market and enter the topic “Morning Help”; or call Morning Video News Hotline 0731-85571188.