Çocuklarda Testis Torsiyonu: 10 Yıllık Retrospektif Bir Çalışma

Abstract

Amaç: Bu çalışmanın amacı çocuk yaş grubunda testis torsiyonlu hastaların klinik, radyolojik ve patolojik özelliklerini, hastaların hastaneye başvuru zamanına göre müdahale yöntemlerini ve testis kurtarma oranlarını belirlemektir.

Gereç ve Yöntemler: Bu retrospektif çalışma Ocak 2011-Haziran 2021 yılları arasında karın ağrısı veya skrotal ağrı ile çocuk cerrahisi kliniğine başvuran ve değerlendirme sonrası testis torsiyonu tanısı alan 0-18 yaş arası hastaları kapsamaktadır. Hastaların yaşı, hastaneye başvuru şikayeti, semptomların süresi, hastaneye başvurduğu ay, etkilenen testisin lateralizasyonu, preoperatif tanı çalışmaları, yapılan müdahalenin tipi (orşiektomi/detorsiyon) ve postoperatif tanı belirlendi. Patoloji birimine inceleme için gönderilen materyallere ait Hematoksilen-Eozin boyalı arşiv preparatları iki patolog tarafından yeniden gözden geçirildi.

Bulgular: Bu 10 yıllık dönemde 0-18 yaş arası 28 hasta testis torsiyonu nedeni ile hastanemize başvurmuştu. Hastaların hepsinde (%100) skrotal ağrı ve hassasiyet mevcuttu. Hastaların 4 tanesi (%14.3) yenidoğandı ve 21 hasta (%75) 12-18 yaşları arasındaydı. Orşiektomi materyallerinin incelenmesinde makroskopik olarak testis parankimi seçilemiyordu ve materyaller hemorajikti. Mikroskopik incelemede hemorajik enfarktüs saptandı.

Sonuç: Akut skrotum çocukluk çağında sık görülen cerrahi acillerdir. Akut skrotuma neden olabilecek çok sayıda antite mevcuttur; ayrıcı tanının doğru ve zamanında yapılması hastayı gereksiz cerrahiden kurtaracak ve testis kaybını önleyecektir.

Keywords

• akut skrotum
• çocuk
• testis torsiyonu

Testicular Torsion in Children: A 10-Year Retrospective Study

Abstract

Objective: The purpose of the present study is to determine the clinical, radiological and pathological characteristics of testicular torsion patients, the intervention techniques applied according to time to hospital admission of the patient and testis-saving rates in the childhood age group.

Material and Methods: This retrospective study included the patients aged between 0-18 years who applied to pediatric surgery clinic due to the complaint of abdominal pain or scrotal pain between January 2011 to January 2021 and were diagnosed with testicular torsion after evaluation. The patient age, hospital admission complaint, duration of the symptoms, month of hospital admission, lateralization of the affected testicle, preoperative diagnostic studies, type of the implemented intervention (orchiectomy/detorsion) and postoperative diagnosis were determined. Hematoxylin-Eosin-stained archive slides of the materials sent to pathology department for examination were reviewed by two pathologists.

Results: In this period of 10 years; 28 patients aged between 0-18 years admitted to our hospital because of testicular torsion. Scrotal pain and tenderness were present in all the patients (100%). Of the patients; 4 (14.3%) were neonatal and 21 (75%) were between the ages 12-18 years. Testicular parenchyma could not be macroscopically selected in the examination of orchiectomy materials and the materials were hemorrhagic. Hemorrhagic infarction was detected by microscopic examination.

Conclusion: Acute scrotum is a frequently seen surgical emergency in the childhood period. There are many entities that may cause acute scrotum; performing differential diagnosis accurately and timely can protect the patient from unnecessary surgery and testicular loss.

Keywords

• acute scrotum
• child
• testicular torsion

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