以腹痛为首发症状的围青春期男性睾丸扭转

Testicular Torsion with First Presentation of Abdominal Pain in Peri-adolescent Male Patients

目的：提高对以腹痛为首发症状的睾丸扭转的诊治水平。方法：回顾分析26例围青春期男性睾丸扭转病例,按首发症状分为腹痛（A组）和阴囊痛（B组）两组,比较其诊治特点。结果：A组7例（27%）,平均年龄18（12-25）岁,其中5例（72%）因缺血坏死行睾丸切除术,1例（14%）睾丸萎缩,1例（14%）局部睾丸坏死;B组19例（73%）,平均年龄17（13-22）岁,其中9例（47%）因缺血坏死行睾丸切除术、1例（5%）睾丸萎缩。结论：以腹痛为首发症状的睾丸扭转更容易延误诊治而导致睾丸切除。对腹痛的围青春期男性,应将睾丸扭转列为鉴别诊断疾病之一,并常规检查阴囊。

Objective：To investigate the diagnosis and treatment of testicular torsion with first presentation of abdominal pain.Methods：Medical records of 26 peri-adolescent male patients with the final diagnosis of testicular torsion were retrospectively analyzed.The patients were divided by first presentation into Group A（abdominal pain）and Group B（scrotum pain）.The characteristis of diagnosis and treatment were compared between the two groups.Results：Among the seven（27%）patients in Group A with mean age of 18（12~25）years,there were 5 cases（72%）of orchiectomy for testis loss,1 cases（14%）of atrophy,1 cases（14%）of focal infarction.Among the 19 patients（73%）in Group B with mean age of 17（13~22）years,there were 9 cases（47%）of orchiectomy for testis loss and 1 case（5%）of atrophy.Conclusions：The cases of testicular torsion with first presentation of abdominal pain are more likely to be misdiagnosed and underwent orchiectomy.Differential diagnosis of testicular torsion should be made and scrotum should be examined routinely when a peri-adolescent male complains of abdominal pain.