급성 음낭통을 주소로 내원한 고환수염전 환자에 대한 치험
The Clinical Experience of Torsion of Testicular Appendix with Acute Scrotal Pain
홍석원, 최홍용,
소속 상세정보
홍석원 ( )
서울적십자병원 비뇨기과
최홍용 ( )
서울적십자병원 비뇨기과
KMID : 0358319990400070901
Abstract
서론
남성에서 급성 음낭통이나 부종의 원인으로는 특발성 음낭부종, 급성 음낭수종 외상성의
고환파열이나 혈종, 고환종양의 출혈 등이 있으며, 이중에서 고환수염전은 가장 흔한 응급
질환의 하나로서, 청소년기 이전의 환자에서 흔히 발생한다. 그러나. 고환염전과 증상 및 이
학적 소견으로 감별이 어려우며 동위원소 고환주사, 초음파, 색도플러초음파 등 진단방법의
발달에도 불구하고 여전히 확진의 어려움이 있다. 또한, 고환수염전의 치료에 있어서 조기
절개술과 보존적 치료 중에 무엇이 좋은가에 대해서도 논란이 있다. 이에 저자들은 최근 8
년 동안 고환수염전으로 진단되었던 17명의 환자들을 비교 분석하여 앞으로의 치료에 도움
을 얻고자 하였다.
Purpose: Acute scrotal pain is one of the most alarming urologic symptoms,
concealing testicular inflammation, testicular torsion, torsion of testicular appendix and a
variety of miscellaneous diseases. Even with careful physical examination with recently
developed diagnostic equipments, a reliable diagnosis may not be achieved in a
significant number of patients. In these cases an operation is necessary for exclusion of
testicular torsion.
Materials and Methods: Between 1991 and 1998, we reviewed 17 patients diagnosed as
having torsion of testicular appenix, whose ages varied from 3 years to 15 years during
recent 8 years.
Results: 16 cases out of seventeen patients(94%) were younger 12 years and prevalent
age was 11 years(6/17). The average interval that elapsed from onset of symptoms until
the patient was seen for the first time on the hospital was 64 hours, with a range
varying from three hours to seven days. The most frequently observed symptoms and
signs were diffuse scrotal pain, swelling and erythema of the affected scrotum. The
explorative scrototomy were performed in 16 cases out of 17 patients who had appendix
testis torsion, and the 1 case had conservative treatment after getting confirmative
diagnosis by ultrasonography. The scrotal pall disappeared mostly within 1 day after
operation, and the complications didn't happen.
Conclusions: There is controversy as whether the majority of children with torsion of
the testicular appendix develop sufficiently grave symptoms to justify the surgical
exploration. For this reason, once a diagnosis of torsion of the spermatic cord is ruled
out, some investigators prefer conservative treatment. However, differential diagnosis
with torsion of the spermatic cord is difficult and acute scrotal pain disappear within 24
hours after excision of the twisted appendix. Therefore, we are in favor of surgical
treatment.
키워드
Torsion of testicular appendix; Acute scrotal pain;
원문 및 링크아웃 정보
등재저널 정보