makes the diagnosis of testicular torsion more likely. Relief of pain with elevation of the affected testicle. (Prehn's sign–positive for epididymitis).關閉廣告醫學筆記匯集整理EDNotes跳到主文個人醫學筆記匯集整理(密碼:1205)IG:急診室醫學筆記ed_notes_部落格全站分類：收藏嗜好相簿部落格留言名片Jul27Mon202023:24Testiculartorsion睪丸扭轉Excellentsalvageratesareexpectedwith<6hoursofsymptoms,butsalvagedeclinesrapidlythereafter. 常見15- 25 y/o Suddenonset,crampingpain,testisaxis改變(Transverselying)NegativePrehn'ssign(No liftingsign) : 睪丸上提無法緩解疼痛 可和 Epididymo-orchitis做D/D: Prehn'ssign+ (上提睪丸會緩解疼痛) Thepresenceofvomitingmakesthediagnosisoftesticulartorsionmorelikely. Reliefofpainwithelevationoftheaffectedtesticle(Prehn'ssign–positiveforepididymitis)doesnotreliablydistinguishtorsionfromepididymitis.       Themostsensitivefindinginexcludingtesticulartorsionistheunilateralpresenceofthecremastericreflex,butthesensitivityrangesfrom73%to96%.Theabsenceofanipsilateralcremastericreflexisanonspecificfindingandmaybeassociatedwithscrotalinflammationfromanycause             Testicularappendages  Appendixtestis,appendixepididymis,paradidymis (organ of Giraldes), and vas aberrans Prepubertalboys(9-11y/o)classically lack the systemic symptoms ofnauseaandvomitingPainlocalizedtotheupperpoleofthetestisorepididymisAbluespotmaybeobservedthroughthescrotalskin—thebluedot sign IfthediagnosiscanbeensuredandnormalintratesticularbloodflowtotheinvolvedtestisconfirmedbycolorDopplerUS,surgicalexplorationisnotnecessary.Torsionofanappendageisusuallyself-limitingandbestmanagedwithanalgesics,bedrest,supportiveunderwear,andreassurance,withtheexpectedsymptomresolutionwithin3to5days.     Theinitialattemptshouldincludeoneandone-halfrotations(540degrees). Anyreliefofpainisapositiveendpoint,andthesuccessofthemaneuvercanbeassessedwithDopplerUS,worseningofthepatient'spainsuggeststhatdetorsionshouldthenbedoneintheoppositedirection(onethirdofcases) 文章標籤急診醫學全站熱搜創作者介紹deanguy1205醫學筆記匯集整理EDNotesdeanguy1205發表在痞客邦留言(0)人氣()E-mail轉寄全站分類：醫療保健個人分類：泌尿此分類上一篇：Acuteurineretention(AUR)此分類下一篇：Testic