PDF(Pubmed)
Abstract：
Testicular trauma can be classified aetiologically as blunt or penetrative. Bicycles and motorbikes are considered high risk for road traffic accidents accounting for 9-17% % of all blunt trauma. We present a case of assessment and management of isolated blunt testicular trauma in a tertiary care hospital. A 36-year-old gentleman presented to the accident and emergency department with testicular pain after a road traffic accident while riding a motorcycle. On arrival, he was fully conscious and denied any other injuries. On examination, he had bruising and gross swelling of the right hemiscrotum. Ultrasound of the scrotum revealed testicular rupture and emergency exploration was undertaken which confirmed the diagnosis. Testis was non-salvageable therefore orchidectomy was done. The patient had unremarkable post-operative recovery. A majority of testicular ruptures are secondary to blunt trauma mainly caused by sport-related injuries and road traffic accidents. Ultrasonography remains a non-invasive modality to investigate testicular injuries with a sensitivity of 100%. When not available in an emergency setting, scrotal exploration should be undertaken for both diagnostic and therapeutic purposes. Surgical repair done within 72 hours yields a 90% salvage rate after which the salvage rate is reduced significantly. Tumor markers should be checked in patients managed conservatively. Early assessment and diagnosis are crucial in the management of acute testicular rupture. Early intervention can salvage injured testes and an orchidectomy can be avoided.
摘要：
睾丸创伤在病因上可分为钝性或穿透性。自行车和摩托车被认为是道路交通事故的高风险，占所有钝性创伤的9-17％。我们介绍了三级医院中孤立的钝性睾丸创伤的评估和管理案例。一名36岁的绅士在骑摩托车时发生道路交通事故后，因睾丸疼痛出现在事故和急诊科。抵达后,他完全清醒，否认有其他伤害。在检查中，他的右半球有瘀伤和严重肿胀。阴囊超声检查显示睾丸破裂，并进行了紧急探查，证实了诊断。睾丸不可挽救，因此进行了睾丸切除术。患者术后恢复不明显。大多数睾丸破裂是继发于钝性创伤，主要由运动相关伤害和道路交通事故引起。超声检查仍然是一种非侵入性的方式来调查睾丸损伤，灵敏度为100％。当在紧急设置中不可用时，阴囊探查应同时进行诊断和治疗.在72小时内完成的手术修复可产生90％的抢救率，此后抢救率显着降低。肿瘤标志物应在保守治疗的患者中进行检查。早期评估和诊断对于急性睾丸破裂的治疗至关重要。早期干预可以挽救受损的睾丸，并且可以避免睾丸切除术。
