鼠蹊部外傷致精索橫斷之手術案例報告

陳生文、張彰琦、陳修聖

台北市立聯合醫院忠孝院區外科部泌尿科

Experience of surgical management of groin shear force injury: A case report

Sheng-Wen Chen, Chang-Chi Chang, Shiou-Sheng Chen

Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao branch

Introduction:

    Inguinal shear force injury is an uncommon cause of acute scrotum. It presents with an surgical management scenario that a 38 year old men who suffered from traffic accident and progressive left scrotal swelling and bruise was noted. We present the surgical management of transversely cut off spermatic cord during motorcycle accident in our hospital.

Case presentation: 

This 38 year old men is a Uber-eat delivery man. He suffered from motor vehicle accident and had left groin lesion collision to smartphone rack fixed on motorcycle. He came to our ER for help due to progressive left scrotal swelling and bruise was noted. Scrotum ultrasound showed left scrotal hematoma, suspect testicular rupture. Surgical management of scrotal exploration was further scheduled. Intact testis and enlarged epididymis was found. Tunica vaginalis was then resected along spermatic cord and massive hematoma with active bleeding was noted after tunica vaginalis opened. A transverse cut off spermatic cord was impressed. Thus, carefully hemostasis with left orchiectomy was performed after informed to his family.

Conclusion:

   Scrotal traumas are rare. Most are blunt traumas caused by a direct blow on the scrotum which might cause testicular rupture. Without immediate repairment, autoimmune antibody against sperm generated after testicular rupture. However, injury mechanism was important when approaching the case of acute scrotum. We present a case of acute scrotum after motorcycle accident. Intact testis was noted during operation and transverse cut off spermatic cord was impressed.