يعتبر َلوِي الحبل المنوي من أهم الإسعافات الجراحية البولية يحدث في مرحلة اليفع من
العمر و يؤدي إلى اختناق التروية الدموية الخصوية، مما يؤدي إلى إقفارها و اضطراب
وظيفتها و ضمورها و حتى إلى موتها و ذلك إذا لم يتم التشخيص و التدبير في الزمن المناسب
و من هنا تأتي أهمية و خطورة الموضوع، و قد تمت دراسة 22 حالة لوِي حبل منوي في
مشفى الأسد الجامعي بجامعة تشرين و ذلك خلال فترة 3 سنوات و 3 شهور كان التشخيص
فيها مؤكدًا بالأعراض السريرية و الفحص السريري، حيث حدث ألم خصوي حاد و مفاجئ في
كل الحالات ( 100 %) مع تورم و كبر في حجم الخصية في ( 95 %) و انكماشها نحو الأعلى
و توضعها بشكل أفقي في كل الحالات أيضًا. ( 100 %) و أما البربخ فتوضع أماميًا في
(%100) من الحالات، و قد أُجرِي الإيكو دوبلر ملونًا و قبل العمل الجراحي في 20 حالة
(90.9%)، و تم الرد الجراحي مع تثبيت الخصية المقابلة في كل الحالات و لم يجر أي
استئصال خصوي.
و بالخلاصة فإنه يجب أن يشك بانفتال الخصية في كل حالات ألم الخصية الحاد و المفاجئ
عند اليفع، و يمكن الاستعانة بالفحوص المتممة التشخيصية كالدوبلر الملون و كالتفريسة
الومضانية و لكن بدون إضاعة الوقت، و بالطبع فإنه يجب متابعة الحالة مستقبلا.
Torsion of the spermatic cord (torsion of the testis) is an important surgical
urologic emergency most commonly seen in adolescent males. It causes
strangulation of the blood supply to the testis. Unless treatment is done in
accurate time testicular ischemia, functional disorders, atrophy even death
of the testis may occur. So it is an important and risky lesion necessitates
suitable management. 22 cases of testicular torsion were studied at
ALASSAD University Hospital (University of Tishreen ) during 3 years and
3 months .Diagnostic was confirmed by symptoms and clinical examination:
Acute and sudden testicular pain happened in all cases (100%), testicular
swelling was found in (95%), retracted testis with horizontal orientation in
(100%), anterior epididymal position in (100%). Colored Doppler
sonography was done in (90.9%). Surgical detorsion with contra- lateral
orchiopexy was achieved in all cases without orchiectomy.
In conclusion, testicular torsion is supposed to be suspected in all cases of
testicular, acute, sudden pain, in adolescent male and this can be verified by
complementary exameninatios as: color Doppler sonography and scintillation scan without washing time, and all cases should to be followed
up in the future.
References used
anderson PA, Giacomantonio JM: The acutely painful scrotum in children: Review of 113 consecutive cases. Can Med Assoc J 1985,132: 1153
Barada JH, Weingarten JL, Cromie WJ: Testicular salvage and agerelated delay in the presentation of testicular torsion, J Urol 1989.142:746
Bartsch.G., Frank, S., Marberger, H.,and Mikuz, G.:Testicular torsion:iate results with special regard to fertility and endocrine function. J.Urol., 124:375,1980
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