垣内 雅隆¹, 丸上 永晃¹, 小田 侑希², 石田 憲太朗¹, 多田 明良¹, 松永 剛³, 丸上 亜希⁴, 田中 利洋¹, 平井 都始子⁴, 藤本 清秀²

Masataka KAKIUCHI¹, Nagaaki MARUGAMI¹, Yuuki ODA², Kentarou ISHIDA¹, Akira TADA¹, Takeshi MATSUNAGA³, Aki MARUGAMI⁴, Toshihiro TANAKA¹, Toshiko HIRAI⁴, Kiyohide FUJIMOTO²

¹奈良県立医科大学放射線・核医学科, ²奈良県立医科大学泌尿器科, ³奈良県立医科大学中央検査部, ⁴奈良県立医科大学総合画像診断センター

¹Department of Radiology and Nuclear Medicine, Nara Medical University, ²Department of Urology, Nara Medical University, ³Department of Central Clinical Laboratory, Nara Medical University, ⁴Department of General Diagnostic Imaging Center, Nara Medical University

キーワード : bell clapper deformity, intermittent testicular torsion, acute scrotum, ultrasonography

精巣捻転症は早急な診断と適切な治療が行われなければ，精巣機能の喪失につながる泌尿器緊急疾患である．間欠性精巣捻転症では，来院時に精索の捻転が解除されて症状が軽減しており，診断や今後の治療方針決定に難渋することが多い.今回，超音波で精巣の易回転性を評価し，間欠性精巣捻転症と診断しえた症例を経験したので，評価法を含めて報告する．症例は20代男性，5日前より間欠的な左側陰嚢痛を自覚しており，当院泌尿器科を受診した．超音波検査では，患側である左精巣には，反時計回りの180度の回転がプローブ走査で確認できた．検査中には疼痛の増強の訴えはなかった．

Testicular torsion is a urologic emergency in acute scrotum. Rapid diagnosis and subsequent therapy are required to salvage the testicle. It is often difficult to diagnose and cure intermittent testicular torsion, because the clinical and radiographic evaluations may be normal. In the present case, we evaluated the mobility of the testis and succeeded in diagnosing intermittent testicular torsion. A man in his 20s had a 5-day history of intermittent left scrotal pain. A 180-degree counterclockwise rotation of the affected left testis was detected by probe scanning. There were no complaints of increased scrotal pain during the examination.