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RESULTS AND BENEFITS OF ULTRASOUND EXAMINATION IN
ACUTE SCROTAL SYNDROME
Mirzakarimov B.KH.
Karimov D.K.
Yulchiyev K.S.
Andijan State Medical Institute, Andijan city
https://doi.org/10.5281/zenodo.12547266
Relevance of the problem:
Since the 90s of the last century, almost all pediatric
surgeons have switched to active surgical tactics for acute testicular diseases in
children, the use of ultrasound and Doppler ultrasound both during the acute disease
and in the chronic stage, which has led to more accurate diagnosis and successful
treatment of the results. [3, 5, 7, 10]. However, in the local literature, issues of
hormonal and spermatogenic function in adult men who have suffered acute testicular
disease (ATD) in early childhood have been practically not studied. Of particular
importance are the optimization of surgical treatment and therapeutic and diagnostic
measures in the acute period of the disease, as well as the development of
pathogenetic approaches to the postoperative treatment of patients in this contingent
[1, 2, 4, 6, 8, 9].
Purpose of the study.
Optimization of non-invasive diagnostic methods for
acute inflammation of the scrotum in children.
Methods and materials of study:
Based on a retrospective analysis, the
results of treatment of 202 patients who were treated with a diagnosis of acute
testicular disease (ATD) in the emergency surgery and urology departments of
the Andijan Regional Children's Multidisciplinary Medical Center for 2015-2022
were studied. The clinical material of the study consisted of children aged from 3
months to 18 years. Patients were divided into 3 groups using modern clinical
and statistical classification (ICD-10). According to this data, 124 (61.4%) had
torsion of the hydatid (epididydymis), 57 (28.2%) testicular torsion,
epididymitis, orchiepididymitis, orchitis 21 (10.0%)
The results of ultrasound and Doppler examination of patients were
retrospectively studied. The results of ultrasound examination of 32 scrotums
performed for diagnostic purposes in case of ATD are summarized. The
echographic picture of acute testicular diseases was characterized by a number
of signs and was divided into 2 main groups: specific signs and nonspecific or
secondary echosymptoms characteristic of each disease.
The nonspecific echographic criteria for acute testicular disease included
the following extratesticular changes: 1. Thickening and layering of the
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testicular mucosa on the affected side compared to the contralateral side; 2.
Increased blood flow in the testicular mucosa; 3. Accumulation of free fluid in
the vaginal cavity.
Nonspecific ultrasound signs were secondary inflammatory changes against
the background of scrotal edema-hyperemia syndrome.
In this study, nonspecific ultrasound symptoms were identified in the
obvious clinical picture of the disease: complication of hydatid torsion, testicular
torsion, epididymitis and epididymorchitis.
In uncomplicated hydatid torsion and subclinical orchitis, no secondary
inflammatory changes were detected. Nonspecific echosymptoms in traumatic
injuries were found only in the case of hematoma of the testicular mucosa and
testicular rupture.
Results of the study.
Ultrasound diagnostic criteria for testicular torsion
during ultrasound are: a sharp decrease in blood flow in the internal organs (up
to its disappearance) or its increase by 2-4 times along with an increase in the
size and composition of the testicle, ultrasound diagnostic criteria for hydatid
torsion in ultrasound: significant (>20%) enlargement or enlargement of the
epididymis with an increase in blood flow up to 10% of normal and
heterogeneity of composition are ultrasound diagnostic criteria for acute
epididymitis with Doppler ultrasound: moderate enlargement or homogeneity
of the epididymis. with a moderate increase in blood flow (up to 10%), an
increase in blood flow up to 10% of normal in combination with an increase in
the size of the testicle and the heterogeneity of its composition are ultrasound
diagnostic criteria for acute orchitis in ultrasound diagnostics. The sensitivity
and specificity of ultrasound symptoms in acute testicular diseases in young
children do not depend on the stage of the disease, and the sensitivity and
specificity of clinical signs increase significantly with late presentation to the
hospital.
Conclusion. In patients with testicular torsion, the echographic picture is
characterized by clear changes. The pathognomonic echographic sign of
testicular torsion is a slowdown or loss of blood flow in its parenchyma with
increased blood flow in the testicular membrane.
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CURRENT APPROACHES AND NEW RESEARCH IN
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