¶·È‰È·ÙÚÈ΋ BOƒEIOÀ ∂§§A¢√™, 17: 344 - 347, 2005

™˘ÛÙÚÔÊ‹ ˘‰·Ù›‰·˜ ·ÛÙ˘ ÙÔ˘ fiÚ¯È (Morgagni)∂Á¯ÂÈÚËÙÈ΋ ‹ Û˘ÓÙËÚËÙÈ΋ ıÂڷ›·;

Ã. ∫·ÛÂÏ¿˜, °. °ÚËÁÔÚÈ¿‰Ë˜, °. ΔÛÈÎfiÔ˘ÏÔ˜, ª. ª·ÓÙÔ˘Ú¿ÎË1, μ. ∫·ÛÂÏ¿˜

¶·È‰Ô¯ÂÈÚÔ˘ÚÁÈ΋ ∫ÏÈÓÈ΋, °.¡. “πÔÎÚ¿ÙÂÈÔ” £ÂÛÛ·ÏÔӛ΢1¶·È‰Ô·ÎÙÈÓÔÏÔÁÈÎfi ∂ÚÁ·ÛÙ‹ÚÈÔ °.¡. “πÔÎÚ¿ÙÂÈÔ” £ÂÛÛ·ÏÔӛ΢

¶ÂÚ›ÏË„Ë. ∏ ·ÛÙË ÙÔ˘ fiگˆ˜ ÁÓˆÛÙ‹ Î·È ˆ˜ ˘‰·Ù›‰· ·ÛÙË ÂÚÈÁÚ¿ÊËΠ·fi ÙÔÓ Morgagni ÙÔ 1761.

À¿Ú¯ÂÈ ÛÙÔ 92% ÙˆÓ ·ÚÚ¤ÓˆÓ Î·È ·ÔÙÂÏ› ˘fiÏÂÈÌÌ· ÙÔ˘ fiÚÔ˘ ÙÔ˘ Muller. ∏ Û˘ÛÙÚÔÊ‹ Ù˘ ˘‰·Ù›‰·˜ ·-

ÛÙ˘ ÙÔ˘ fiگˆ˜ Â›Ó·È Ë ÈÔ Û˘¯Ó‹ ·ÈÙ›· ÔͤԘ ËÌÈfiÛ¯ÂÔ˘ ÛÙËÓ ·È‰È΋ ËÏÈΛ·. ªÂ ÙËÓ ·ÚÔ‡Û· ÂÚÁ·Û›· ‰ÈÂ-

ÚÂ˘Ó‹Û·ÌÂ Â¿Ó Ë ÂÁ¯ÂÈÚËÙÈ΋ ıÂڷ›·, ˘ÂÚÙÂÚ› Ù˘ Û˘ÓÙËÚËÙÈ΋˜ Û ÂÚÈÙÒÛÂȘ Û˘ÛÙÚÔÊ‹˜ Ù˘ ·ÛÙˆ˜

Morgagni. ÀÏÈÎfi-ª¤ıÔ‰Ô˜: ∞Ó·ÛÎÔ‹Û·Ì fiÏÔ˘˜ ÙÔ˘˜ ʷΤÏÔ˘˜ ÙˆÓ ·È‰ÈÒÓ Ì Ô͇ ËÌÈfiÛ¯ÂÔ ( ÂÎÙfi˜ ÙˆÓ ÓÂÔ-

ÁÓÒÓ) Ô˘ ÓÔÛËχÙËÎ·Ó ÛÙËÓ ÎÏÈÓÈ΋ Ì·˜ ηٿ ÙÔ ¯ÚÔÓÈÎfi ‰È¿ÛÙËÌ· 2001-2002. μÚ¤ıËΠfiÙÈ ÓÔÛËχÙËηÓ

97 ·È‰È¿ Ì Ô͇ ËÌÈfiÛ¯ÂÔ. ∂Í ·˘ÙÒÓ Ù· 69 ‡ÛÙÂÚ· ·fi ÎÏÈÓÈÎfi Î·È ÂÚÁ·ÛÙËÚÈ·Îfi ¤ÏÂÁ¯Ô ‰È·ÈÛÙÒıËΠfiÙÈ

¤·Û¯·Ó ·fi Û˘ÛÙÚÔÊ‹ ·ÛÙ˘ ÙÔ˘ Morgagni. ∞fi Ù· ˘fiÏÔÈ· 28, Ù· 18 ›¯·Ó Û˘ÛÙÚÔÊ‹ fiگˆ˜, Ù· 6 ÔÚ¯ÂÔ-

Âȉȉ˘Ì›Ùȉ· Î·È Ù· 4 ȉÈÔ·ı¤˜ Ô›‰ËÌ· ÙÔ˘ ÔÛ¯¤Ô˘, Ù· ÔÔ›· Î·È ¯ÂÈÚÔ˘ÚÁ‹ıËηÓ. ∞ÔÙÂϤÛÌ·Ù·: ∞fi Ù· 69

·È‰È¿ Ì ‰È¿ÁÓˆÛË Û˘ÛÙÚÔÊ‹ ·ÛÙ˘ Morgagni, Ù· 22 ¯ÂÈÚÔ˘ÚÁ‹ıËÎ·Ó Î·È ·Ê·ÈÚ¤ıËÎÂ Ë Î‡ÛÙË (∞ √Ì¿‰·)

ÂÓÒ ÛÙ· ˘fiÏÔÈ· 47 ÂÊ·ÚÌfiÛÙËÎÂ Û˘ÓÙËÚËÙÈ΋ ıÂڷ›· (μ √Ì¿‰·). √ ¯ÚfiÓÔ˜ ·Ú·ÌÔÓ‹˜ ÛÙÔ ÓÔÛÔÎÔÌ›Ô

‹Ù·Ó ÁÈ· ÙËÓ ∞ √Ì¿‰· 1-3 Ë̤Ú˜ Î·È ÁÈ· ÙËÓ μ √Ì¿‰· 0-2 Ë̤Ú˜. ™˘Ì¤Ú·ÛÌ·: ∞fi Ù· ·ÔÙÂϤÛÌ·Ù· Ù˘

ÌÂϤÙ˘ Ì·˜ ÚÔ·ÙÂÈ fiÙÈ ˘fi ÔÚÈṲ̂Ó˜ ÚÔ¸Ôı¤ÛÂȘ ÌÔÚԇ̠ӷ ·ÎÔÏÔ˘ı‹ÛÔ˘Ì ÙËÓ Û˘ÓÙËÚËÙÈ΋ ·Áˆ-

Á‹ ÛÙË ıÂڷ›· Ù˘ Û˘ÛÙÚ·Ê›۷˜ ·ÛÙ˘ Morgagni, Ú·ÎÙÈ΋ Ô˘ ÂÊ·ÚÌfi˙Ô˘Ì ÛÙËÓ ÎÏÈÓÈ΋ Ì·˜.

§¤ÍÂȘ-ÎÏÂȉȿ: afiÊ˘ÛË fiگˆ˜, Û˘ÛÙÚÔÊ‹.

Kasselas Ch, Grigoriadis G, Tsikopoulos G, Batouraki M, Kasselas B. Testicular appendixtorsion: Surgical or conservative treatment. Dept of Pediatric Surgery, ‘Hippokratio’ Gen. Hospital,Thessaloniki, Greece. Dept of Pediatric Radiology, ‘Hippokratio’ Gen. Hospital, Thessaloniki, Greece. Pae-

diatr N Gr 2005, 17: 344 - 347.

Aim: The appendix testis, otherwise known as hydatid of Morgagni, was first described by Morgagni in 1761.

It is found in 92% of male and is considered to be a remnant of the Mullerian duct. The torsion of the appendix

testis is the most common cause of acute scrotal pain in childhood. The purpose of our study was to investigate

whether the surgical treatment is a more reasonable choice than symptomatic therapy in cases of torsion of

appendix testis. Material-Method: We reviewed all the medical files of children (excluding the neonates) with the

diagnosis of acute scrotal pain that were treated in our clinic in period from 2001-2002. We found that we

treated 97 children with acute scrotal pain. After clinical evaluation and laboratory examinations, we diagnosed

that 69 of them suffered from torsion of appendix testis. From the remaining 28 children, 18 suffered from torsion

of the testis, 6 from acute epididymo-orchitis and 4 from idiopathic scrotal edema, and were all operated.

Results: From the 69 children with torsion of the appendix testis, 22 were operated and the hydatid of Morgagni

was removed (Group A) while the rest 47 children were treated with conservative therapy (Group B). Group A

children were discharged from the hospital 1-3 days while Group B children after 0-2 days respectively.

Conclusions: The results of our study lead us to conclude that under certain circumstances, symptomatic

therapy is a reasonable alternative for the treatment of torsion of appendix testis, and is followed in our clinic.

Key words: appendix testis, torsion.

344

K§π¡π∫∏ ª∂§∂Δ∏

¶·È‰È·ÙÚÈ΋ B√ƒ∂I√À ∂§§∞¢√™, 17, 4 345

∂∂ÈÈÛÛ··ÁÁˆ̂ÁÁ‹‹

∏ ˘‰·Ù›‰· ·ÛÙË ÙÔ˘ fiگˆ˜ ÂÚÈÁÚ¿ÊËÎÂ

ÁÈ· ÚÒÙË ÊÔÚ¿ ÙÔ 1761 ·fi ÙÔÓ Morgagni, ÁÈ’ ·˘-

Ùfi Î·È Â›Ó·È Â˘Ú¤ˆ˜ ÁÓˆÛÙ‹ ˆ˜ ˘‰·Ù›‰· ·ÛÙË ÙÔ˘

Morgagni. O Ombredanne ÂÚȤÁÚ·„ ÙÔ 1913 ÌÈ·

·fiÊ˘ÛË ÙÔ˘ fiÚ¯È Ô˘ ‰ÂÓ ·Ó·ÁÓÒÚÈÛ ÙËÓ ÚÔ¤-

Ï¢ÛË Ù˘ Î·È Ô Colt to 1922 ÂÚȤÁÚ·„ ÁÈ· ÚÒ-

ÙË ÊÔÚ¿ Û˘ÛÙÚÔÊ‹ ·fiÊ˘Û˘ ÙÔ˘ fiگˆ˜1-4. ¶È-

ÛÙ‡ÂÙ·È fiÙÈ ·ÔÙÂÏ› ÂÌ‚Ú˘ÈÎfi ˘fiÏÂÈÌÌ· ÙÔ˘ fi-

ÚÔ˘ ÙÔ˘ Müller1. ∂ÎÙfi˜ ·fi ÙËÓ Î‡ÛÙË Morgagni,

ÛÙÔÓ fiÚ¯È ¤¯Ô˘Ó ÂÚÈÁÚ·Ê› ¿ÏϘ ÙÚÂȘ ·ÛÙÂȘ

Ô˘ Â›Ó·È Ù˘ Âȉȉ˘Ì›‰·˜, Ù˘ ·ÚÂȉȉ˘Ì›‰·˜ ‹

fiÚÁ·ÓÔ ÙÔ˘ Giraldes Î·È ÙÔ˘ ÛÂÚÌ·ÙÈÎÔ‡ fiÚÔ˘1,2

(∂ÈÎ. 1). ∏ ·ÛÙË Morgagni Â›Ó·È ·˘Ù‹ Ô˘ ·Ó¢ڛ-

ÛÎÂÙ·È ÈÔ Û˘¯Ó¿ ·fi fiϘ ÙȘ ·ÛÙÂȘ ÛÙÔ˘˜ ¿ÚÚÂ-

Ó˜ (92%), ÙÔ Ì¤ÁÂıfi˜ Ù˘ ÔÈΛÏÂÈ Î·È ÂÌÊ·Ó›˙ÂÈ

‰È¿ÌÂÙÚÔ ·fi 1-10 mm1,2. Ÿˆ˜ Î·È ÔÈ ˘fiÏÔȘ

·ÛÙÂȘ ÙÔ˘ fiگˆ˜ Â›Ó·È ¤ÌÌÈÛ¯Ë, ÂÚȤ¯ÂÈ ˙ÂÏ·ÙÈ-

Ó҉˜ ÂÚȯfiÌÂÓÔ, ·Ï›ÊÂÙ·È ·fi ˙ÂÏ·ÙÈÓ҉˜

ÂÈı‹ÏÈÔ Î·È Â›Ó·È Ë ÈÔ Û˘¯Ó¿ Û˘ÛÙÚÂÊfiÌÂÓË Î‡-

ÛÙË ÙÔ˘ fiÚ¯È (90%)1. ∏ ˘„ËÏfiÙÂÚË Û˘¯ÓfiÙËÙ· Û˘-

ÛÙÚÔÊ‹˜ Ù˘ ·ÛÙˆ˜ Morgagni ηٷÁÚ¿ÊÂÙ·È

ÛÙËÓ ÚÔÂÊË‚È΋ ËÏÈΛ· ÌÂٷ͇ 10-13 ÂÙÒÓ, ÁÂÁÔ-

Ófi˜ Ô˘ ÂÚÌËÓ‡ÂÙ·È ·fi ÙËÓ Â›‰Ú·ÛË Ô˘ ·-

ÛÎÔ‡Ó Ù· ÔÈÛÙÚÔÁfiÓ· Ô˘ ÂÎÎÚ›ÓÔÓÙ·È ÛÙËÓ ËÏÈΛ·

·˘Ù‹2,3. ΔÔ Ì¤ÁÂıfi˜ Ù˘ ÛÂ Û˘Ó¿ÚÙËÛË Ì ÙÔÓ ÏÂÙfi

Ì›Û¯Ô Ù˘ ·ÔÙÂÏÔ‡Ó ÚԉȷıÂÛÈÎfi ·Ú¿ÁÔÓÙ·.

™˘Ó‹ıˆ˜ ÂÌÊ·Ó›˙ÂÙ·È Î·Ù¿ ÙËÓ ‰È¿ÚÎÂÈ· ¤ÓÙÔÓ˘

ۈ̷ÙÈ΋˜ ‰Ú·ÛÙËÚÈfiÙËÙ·˜ ·ÏÏ¿ ÌÔÚ› Ó· ÂΉË-

ψı› Î·È Î·Ù¿ ÙËÓ Î·Ù¿ÎÏÈÛË. ™ÎÔfi˜ Ù˘ ·ÚÔ‡-

Û˘ ÌÂϤÙ˘ Â›Ó·È Ó· ‰ÈÂÚ¢ӋÛÔ˘ÌÂ Â¿Ó Ë Û˘ÓÙË-

ÚËÙÈ΋ ıÂڷ›· Ù˘ Û˘ÛÙÚ·Ê›۷˜ ·ÛÙ˘ Mor-

gagni Â›Ó·È ·ÛÊ·Ï‹˜ Î·È ·ÍÈfiÈÛÙË, ÒÛÙ ӷ ÂÈϤ-

ÁÂÙ·È ÁÈ· ÙËÓ ıÂڷ›· ÙˆÓ ÌÈÎÚÒÓ ·ÛıÂÓÒÓ.

ÀÀÏÏÈÈÎÎfifi –– ªª¤¤ııÔÔ‰‰ÔÔ˜̃

∞Ó·ÛÎÔ‹Û·Ì ÙÔ˘˜ ʷΤÏÔ˘˜ ÙˆÓ ·È‰ÈÒÓ

Ô˘ ÓÔÛËχÙËÎ·Ó ÛÙËÓ ÎÏÈÓÈ΋ Ì·˜ ηٿ ÙÔ ¯ÚÔ-

ÓÈÎfi ‰È¿ÛÙËÌ· 2001-2002 Ì ‰È¿ÁÓˆÛË «Ô͇ ËÌÈfi-

Û¯ÂÔ». ∞fi ÙËÓ ÌÂϤÙË ·ÔÎÏ›ÛÙËÎ·Ó Ù· ÓÂÔÁÓ¿

·ÊÔ‡ ÛÙËÓ Î·ÙËÁÔÚ›· ·˘ÙÒÓ ÙˆÓ ·ÛıÂÓÒÓ Ë ¤Íˆ-

ÂÏ˘ÙÚÔÂȉÈ΋ Û˘ÛÙÚÔÊ‹ ÙÔ˘ fiگˆ˜ ·ÔÙÂÏ› ÙËÓ

Û˘ÓÙÚÈÙÈ΋ ÏÂÈÔ„ËÊ›· Ù˘ ·ÈÙ›·˜ ÙÔ˘ ÔͤԘ ËÌÈfi-

Û¯ÂÔ˘. ∂›Û˘ ›¯·Ì ÂÈÎÔÈÓˆÓ›· Ì ÙÔ˘˜ ÁÔÓ›˜

ÙˆÓ ·È‰ÈÒÓ Â›Ù ÙËÏÂʈÓÈο ›Ù Ì ÂÈÛÙÔÏ‹, ÌÂ

ÛÎÔfi Ó· ηٷÁÚ¿„Ô˘Ì ÙËÓ ÔÚ›· ÙˆÓ ·ÛıÂÓÒÓ

Î·È ÙÔÓ ‚·ıÌfi ÈηÓÔÔ›ËÛ‹˜ ÙÔ˘˜ ·fi ÙËÓ ÓÔÛË-

Ï›· Î·È ıÂڷ›· ÙˆÓ ·È‰ÈÒÓ ÙÔ˘˜.

∞∞ÔÔÙÙÂÂÏϤ¤ÛÛÌÌ··ÙÙ··

ªÂ ‰È¿ÁÓˆÛË Ô͇ ËÌÈfiÛ¯ÂÔ ÓÔÛËχÙËÎ·Ó 97

·È‰È¿ Ì ̤ÛÔ fiÚÔ ËÏÈΛ·˜ Ù· 10,5 ¤ÙË ¯ˆÚ›˜ ÂÔ-

¯È·Î‹ ‰È·ÊÔÚ¿. ™˘ÛÙÚÔÊ‹ ·ÛÙ˘ Morgagni ‡ÛÙÂ-

Ú· ·fi ÎÏÈÓÈÎfi ·ÏÏ¿ Î·È ÂÚÁ·ÛÙËÚÈ·Îfi ¤ÏÂÁ¯Ô

(Echo, Color Doppler), ‚Ú¤ıËΠfiÙÈ Â›¯·Ó 69 ·È-

‰È¿. ∞˘Ù¿ Ù· ·È‰È¿ ·ÔÙ¤ÏÂÛ·Ó ÙÔ ˘ÏÈÎfi Ù˘ ÌÂ-

ϤÙ˘ Ì·˜. Δ· ˘fiÏÔÈ· 28 ·È‰È¿, ·ÊÔ‡ ·ÔÎÏ›-

ÛÙËΠÂÍ’ ·Ú¯‹˜ ·fi ÙoÓ ÎÏÈÓÈÎfi Î·È ÂÚÁ·ÛÙËÚÈ·Îfi

¤ÏÂÁ¯Ô Ë Û˘ÛÙÚÔÊ‹ ·ÛÙ˘ Morgagni, ¯ÂÈÚÔ˘ÚÁ‹-

ıËÎ·Ó Î·È ‚Ú¤ıËΠfiÙÈ 18 ·fi ·˘Ù¿ ¤·Û¯·Ó ·fi

Û˘ÛÙÚÔÊ‹ fiÚ¯ÂÔ˜, 6 ·fi ÔÚ¯ÂÔÂȉȉ˘Ì›Ùȉ· Î·È 4

·fi ȉÈÔ·ı¤˜ Ô›‰ËÌ· ÔÛ¯¤Ô˘. Δ· 69 ·È‰È¿ ÌÂ Û˘-

ÛÙÚÔÊ‹ ·ÛÙ˘ Morgagni ¯ˆÚ›ÛÙËÎ·Ó Û 2 ÔÌ¿‰Â˜.

Δ· 22 ·È‰È¿ Ô˘ ·ÔÙ¤ÏÂÛ·Ó ÙËÓ OÌ¿‰· ∞ ·ÓÙÈ-

ÌÂÙˆ›ÛÙËÎ·Ó ¯ÂÈÚÔ˘ÚÁÈο Î·È ·Ê·ÈÚ¤ıËÎÂ Ë Î‡-

ÛÙË, ÂÓÒ Ù· ˘fiÏÔÈ· 47 ·È‰È¿ ·ÔÙ¤ÏÂÛ·Ó ÙËÓ

OÌ¿‰· μ Î·È ÂÊ·ÚÌfiÛÙËÎÂ Û˘ÓÙËÚËÙÈ΋ ıÂڷ›·

Ì ·ÓÙÈÊÏÂÁÌÔÓÒ‰Ë ·Ó·ÏÁËÙÈο Î·È ·ÓÙÈ‚ÈÔÙÈο

Ê¿Ú̷η. ¢ÂÓ ‰È·ÈÛÙÒıËΠÛÙ·ÙÈÛÙÈο ÛËÌ·ÓÙÈ΋

‰È·ÊÔÚ¿ ÌÂٷ͇ ÙˆÓ 2 ÔÌ¿‰ˆÓ fiÛÔÓ ·ÊÔÚ¿ ÙÔÓ

¯ÚfiÓÔ ÓÔÛËÏ›·˜ ÛÙÔ ÓÔÛÔÎÔÌ›Ô, Ô˘ ‹Ù·Ó ηٿ

̤ÛÔ fiÚÔ 2 Ë̤Ú˜. OÈ ·ÛıÂÓ›˜ Ù˘ OÌ¿‰·˜ ∞ ÓÔ-

ÛËχÙËÎ·Ó ·fi 1-3 Ë̤Ú˜ ÂÓÒ ·˘ÙÔ› Ù˘ OÌ¿‰·˜

μ ·fi 0-2 Ë̤Ú˜. O ¯ÚfiÓÔ˜ ·Ô¯‹˜ ·fi ÙÔ Û¯ÔÏ›Ô

‹Ù·Ó 3 Ë̤Ú˜, ÂÓÒ Ô ¯ÚfiÓÔ˜ ·Ô¯‹˜ ·fi ÙÔ Ì¿ıËÌ·

Ù˘ Á˘ÌÓ·ÛÙÈ΋˜ ‹Ù·Ó 7 Ë̤Ú˜ Î·È ÁÈ· ÙȘ 2 ÔÌ¿‰Â˜.

∂ÈÎ. 1. OÈ Î‡ÛÙÂȘ ÙÔ˘ fiگˆ˜: a) ÛÂÚÌ·ÙÈÎÔ‡ fiÚÔ˘ b)

Âȉȉ˘Ì›‰·˜ c) ·ÚÂȉȉ˘Ì›‰·˜ Ë ÔÚÁ¿ÓÔ˘ ÙÔ˘ Giraldes

d) Morgagni.

∏ ÂÈÎÔÈÓˆÓ›· Ì ÙÔ˘˜ ÁÔÓ›˜ ‹Ù·Ó ÂÊÈÎÙ‹ Ì 55

·fi ·˘ÙÔ‡˜ ÂÎ ÙˆÓ ÔÔ›ˆÓ ÔÈ 12 ‹Ù·Ó ÁÔÓ›˜ ·È-

‰ÈÒÓ Ù˘ OÌ¿‰·˜ ∞ Î·È ÔÈ ˘fiÏÔÈÔÈ 43 ÁÔÓ›˜ ·È-

‰ÈÒÓ Ù˘ OÌ¿‰·˜ μ. ¢È·ÈÛÙÒÛ·Ì fiÙÈ ÔÈ ÁÔÓ›˜

ÙˆÓ ·È‰ÈÒÓ Ô˘ ·ÓÙÈÌÂÙˆ›ÛÙËÎ·Ó Û˘ÓÙËÚËÙÈο

‹Ù·Ó Û·ÊÒ˜ ÈÔ ÈηÓÔÔÈË̤ÓÔÈ, ÛÙËÚÈ˙fiÌÂÓÔÈ Î˘-

Ú›ˆ˜ ÛÙÔ ÁÂÁÔÓfi˜ Ù˘ ıÂڷ›·˜ ÙˆÓ ·È‰ÈÒÓ ÙÔ˘˜

Ì ·ÔÊ˘Á‹ ÙÔ˘ ¯ÂÈÚÔ˘ÚÁ›Ԣ, ·ÊÔ‡ ˘¿Ú¯ÂÈ ÌÂ-

Á¿ÏË ÚÔηٿÏË„Ë Î·È ÊÔ‚›· ·ÎfiÌË Î·È ÁÈ· ·Ï¤˜

Î·È ÌÈÎÚ¤˜ ¯ÂÈÚÔ˘ÚÁÈΤ˜ ÂÂÌ‚¿ÛÂȘ.

™™˘̆˙̇‹‹ÙÙËËÛÛËË

∏ Û˘ÛÙÚÔÊ‹ Ù˘ ˘‰·Ù›‰·˜ ·ÛÙ˘ Morgagni

·ÔÙÂÏ› ÙËÓ ÈÔ Û˘¯Ó‹ ·ÈÙ›· ÔͤԘ ËÌÈfiÛ¯ÂÔ˘

ÛÙËÓ ·È‰È΋ ËÏÈΛ·1-3,5,6. ÕÏÏ· ·›ÙÈ· Â›Ó·È Ë Û˘-

ÛÙÚÔÊ‹ ÙÔ˘ fiگˆ˜, Ë ÔÍ›· ÔÚ¯ÂÔÂȉȉ˘Ì›Ùȉ·, Ë

˘‰ÚÔ΋ÏË Î·È ÙÔ È‰ÈÔ·ı¤˜ Ô›‰ËÌ· ÙÔ˘ ÔÛ¯¤Ô˘. ∏

‰È·ÊÔÚÈ΋ ‰È¿ÁÓˆÛË Â›Ó·È Û˘Ó‹ıˆ˜ ‡ÎÔÏË Î·È Á›-

ÓÂÙ·È Î˘Ú›ˆ˜ Ì ÎÏÈÓÈÎfi ·ÏÏ¿ Î·È Î·Ù¿ ÂÚÈÙÒ-

ÛÂȘ ÌÂ Û˘ÌÏËڈ̷ÙÈÎfi ÂÚÁ·ÛÙËÚÈ·Îfi ¤ÏÂÁ¯Ô

(Echo, Color Doppler, C-T) Ô˘ ¤¯ÂÈ ÌÂÁ¿ÏË ‰È·-

ÁÓˆÛÙÈ΋ ·ÎÚ›‚ÂÈ· Î·È ÌÔÚ› Ó· Ì·˜ ‰ÒÛÂÈ ÏË-

ÚÔÊÔڛ˜ ÁÈ· ÙËÓ ·ÁÁ›ˆÛË, ÙËÓ ˘Ê‹ Î·È ÙÔ Ì¤ÁÂ-

ıÔ˜ Ù˘ ‚Ï¿‚˘7 (∂ÈÎ. 2,3). ∏ ÎÏÈÓÈ΋ ‰È¿ÁÓˆÛË ÛÂ

fiϘ Ù˘ ÂÚÈÙÒÛÂȘ Ù˘ ÌÂϤÙ˘ Ì·˜ Û˘ÌʈÓÔ‡-

Û·Ó Ì ·˘Ù‹ ÙÔ˘ ˘ÂÚ˯ÔÁÚ·Ê‹Ì·ÙÔ˜. ŒÓÙÔÓË Â˘-

·ÈÛıËÛ›· ηٿ ÙËÓ „ËÏ¿ÊËÛË ÂÓfi˜ ÌÔÚÊÒÌ·ÙÔ˜

¯ÚÒÌ·ÙÔ˜ ΢·ÓfiÌ·˘ÚÔ˘ (Blue dot) Î·È ÌÂÁ¤ıÔ˘˜

ÌÈ˙ÂÏÈÔ‡, Ô˘ ÂÓÙÔ›˙ÂÙ·È ÛÙÔÓ ¿Óˆ fiÏÔ ÂÓfi˜

ηٿ Ù· ¿ÏÏ· Ê˘ÛÈÔÏÔÁÈÎÔ‡ fiگˆ˜, ÌÔÚ› Ó· ı¤-

ÛÂÈ Ì ·ÛÊ¿ÏÂÈ· ÙËÓ ÎÏÈÓÈ΋ ‰È¿ÁÓˆÛË. ∏ ËÏÈΛ·

ÛÙËÓ ÔÔ›· ·ÚÔ˘ÛÈ¿˙ÂÙ·È Ë ˘„ËÏfiÙÂÚË Û˘¯ÓfiÙËÙ·

Û˘ÛÙÚÔÊ‹˜ ·ÛÙ˘ Morgagni, Â›Ó·È Ë ÚÔÂÊË‚È΋

ÌÂٷ͇ 10-13 ÂÙÒÓ5. ™ÙËÓ ËÏÈΛ· ·˘Ù‹ Ë ÛˆÌ·ÙÈ΋

‰Ú·ÛÙËÚÈfiÙËÙ· Â›Ó·È ÂÓÙÔÓfiÙÂÚË, Ë ¤ÎÎÚÈÛË ÔÈ-

ÛÙÚÔÁfiÓˆÓ ·˘Í¿ÓÂÈ Î·ıÒ˜ Î·È ÙÔ Ì¤ÁÂıÔ˜ Ù˘ ·-

ÛÙ˘ Î·È Ù· ·ÓˆÙ¤Úˆ ÙËÓ Î·ıÈÛÙÔ‡Ó ÈÔ ÂÈÚÚ‹

ÛÂ Û˘ÛÙÚÔÊ‹1. ™ÙËÓ ‰È΋ Ì·˜ ÛÂÈÚ¿, Ô Ì¤ÛÔ˜ fiÚÔ˜

ËÏÈΛ·˜ ‹Ù·Ó Ù· 10,5 ¤ÙË, ÁÂÁÔÓfi˜ Ô˘ Û˘ÌʈÓ›

Î·È Ì ÙËÓ ‰ÈÂıÓ‹ ‚È‚ÏÈÔÁÚ·Ê›·5,6,8. ∏ ȉȷ›ÙÂÚË

¢·ÈÛıËÛ›· ÙˆÓ ÁÔÓ¤ˆÓ ·ÎfiÌË Î·È Û ‹È· Û˘-

Ìو̷ÙÔÏÔÁ›· Ù˘ ÂÚÈÔ¯‹˜ ÙˆÓ ÁÂÓÓËÙÈÎÒÓ ÔÚ-

Á¿ÓˆÓ, ‹Ù·Ó Ë ·ÈÙ›· ÚÔÛ¤Ï¢Û˘ ÙˆÓ ·È‰ÈÒÓ ÛÙ·

›ÁÔÓÙ· Â͈ÙÂÚÈο È·ÙÚ›· Ù˘ ÎÏÈÓÈ΋˜ (∂ÈÎ. 4).

ŸÙ·Ó Ë ‰È¿ÁÓˆÛË Ù˘ Û˘ÛÙÚ·Ê›۷˜ ·ÛÙ˘ Mor-

gagni ÙÂı› Ì ‚‚·ÈfiÙËÙ· ÌÔÚ› Ó· Á›ÓÂÈ ÂÈÏÔÁ‹

346 ¶·È‰È·ÙÚÈ΋ B√ƒ∂I√À ∂§§∞¢√™, 17, 4

∂ÈÎ. 2. ÀÂÚ˯ÔÁÚ¿ÊËÌ· Û˘ÛÙÚÔÊ‹˜ ·ÛÙˆ˜ ÙÔ˘ Mor-

gagni. ∂ÈÎ. 4. O͇ ËÌÈfiÛ¯ÂÔ.

∂ÈÎ. 3. ∞ÍÔÓÈ΋ ΔÔÌÔÁÚ·Ê›· Û˘ÛÙÚÔÊ‹˜ ·ÛÙˆ˜ Morga-

gni.

¶·È‰È·ÙÚÈ΋ B√ƒ∂I√À ∂§§∞¢√™, 17, 4 347

·Ó¿ÌÂÛ· ÛÙËÓ ¯ÂÈÚÔ˘ÚÁÈ΋ ‹ Û˘ÓÙËÚËÙÈ΋ ·ÓÙÈÌÂ-

ÙÒÈÛË5,6,8,9. ∏ Û˘Ó‹ı˘ Ú·ÎÙÈ΋ Ï›Á· ¯ÚfiÓÈ· Óˆ-

Ú›ÙÂÚ· ‹Ù·Ó Ë ¯ÂÈÚÔ˘ÚÁÈ΋ ·Ê·›ÚÂÛË Ù˘ ·ÛÙ˘.

™‹ÌÂÚ· ¤Ó‰ÂÈÍË ¯ÂÈÚÔ˘ÚÁÈ΋˜ ÂÍ·›ÚÂÛ˘ Ù›ıÂÙ·È

fiÙ·Ó ˘¿Ú¯ÂÈ ‰È·ÁÓˆÛÙÈ΋ ·ÌÊÈ‚ÔÏ›· ÌÂٷ͇ ÙÔ˘

·È‰Ô¯ÂÈÚÔ˘ÚÁÔ‡ Î·È ÙÔ˘ ·ÎÙÈÓÔÏfiÁÔ˘, ÛÙ·‰È·Î‹

Âȉ›ӈÛË ¿ÛËÙ˘ ÊÏÂÁÌÔÓ‹˜ Î·È ·Ó¿Ù˘ÍË

·ÓÙȉڷÛÙÈ΋˜ ˘‰ÚÔ΋Ï˘. ΔÔ ÏÂÔÓ¤ÎÙËÌ· Ù˘

¯ÂÈÚÔ˘ÚÁÈ΋˜ ·ÓÙÈÌÂÙÒÈÛ˘ Â›Ó·È fiÙÈ ÂȂ‚·ÈÒ-

ÓÂÙ·È ·ıÔÏÔÁÔ·Ó·ÙÔÌÈο Ë ‰È¿ÁÓˆÛË6. ∏ Û˘ÓÙË-

ÚËÙÈ΋ ıÂڷ›· ÂÚÈÏ·Ì‚¿ÓÂÈ ÙËÓ ¯ÔÚ‹ÁËÛË ·ÓÙÈ-

ÊÏÂÁÌÔÓˆ‰ÒÓ ·Ó·ÏÁËÙÈÎÒÓ Î·È ·ÓÙÈ‚ÈÔÙÈÎÒÓ Ê·Ú-

̿ΈÓ. À¿Ú¯ÂÈ Î·È Û‹ÌÂÚ· ÂÓ‰ÔÈ·ÛÌfi˜ ·fi ·Ú-

ÎÂÙÔ‡˜ ·È‰Ô¯ÂÈÚÔ˘ÚÁÔ‡˜ Î·È ·È‰È¿ÙÚÔ˘˜ ÁÈ· ÙËÓ

ÂÈÏÔÁ‹ Ù˘, ‰ÈfiÙÈ ¤¯ÂÈ ÂÈÎÚ·Ù‹ÛÂÈ Ë ÂÓÙ‡ˆÛË fiÙÈ

··ÈÙÔ‡ÓÙ·È ·ÚÎÂÙ¤˜ Ë̤Ú˜ ıÂڷ›·˜, ηٿ ÙȘ

Ôԛ˜ Ô ·ÛıÂÓ‹˜ Ú¤ÂÈ Ó· ·Ú·Ì›ÓÂÈ ÎÏÈÓ‹Ú˘

̤¯ÚÈ ÙËÓ Ï‹ÚË ›·Û‹ ÙÔ˘ 2. ∞ÓÙ›ıÂÙ· ÛÙËÓ ‰È΋ Ì·˜

ÌÂϤÙË ‚Ú¤ıËΠfiÙÈ Ô Ì¤ÛÔ˜ ¯ÚfiÓÔ˜ ÓÔÛËÏ›·˜

‹Ù·Ó Ô ›‰ÈÔ˜ Î·È ÁÈ· ÙÔ˘˜ ·ÛıÂÓ›˜ Ô˘ ¯ÂÈÚÔ˘ÚÁ‹-

ıËÎ·Ó Î·È ÁÈ· ·˘ÙÔ‡˜ Ô˘ ·ÓÙÈÌÂÙˆ›ÛÙËÎ·Ó Û˘-

ÓÙËÚËÙÈο Î·È Ô ¯ÚfiÓÔ˜ ·Ô¯‹˜ ·fi ÙÔ Û¯ÔÏÂ›Ô Î·È

ÙËÓ Á˘ÌÓ·ÛÙÈ΋ ‹Ù·Ó ›‰ÈÔ˜ ÁÈ· fiÏÔ˘˜ ÙÔ˘˜ ·ÛıÂ-

Ó›˜. ŒÓ·˜ ÛËÌ·ÓÙÈÎfi˜ ·Ú¿ÁÔÓÙ·˜ Ô˘ Ï¿‚·ÌÂ

˘’ fi„ÈÓ Ì·˜ ‹Ù·Ó Ë ÌÂÁ¿ÏË ÈηÓÔÔ›ËÛË ÙˆÓ ÁÔ-

Ó¤ˆÓ ÙˆÓ ·È‰ÈÒÓ Ô˘ ‰ÂÓ ·ÓÙÈÌÂÙˆ›ÛÙËÎ·Ó ¯ÂÈ-

ÚÔ˘ÚÁÈο, ‰ÈfiÙÈ ˘¿Ú¯ÂÈ ÌÂÁ¿ÏË ÊÔ‚›· ·ÎfiÌË Î·È

ÁÈ· ÌÈÎÚ¤˜ Î·È ·Ï¤˜ ¯ÂÈÚÔ˘ÚÁÈΤ˜ ÂÂÌ‚¿ÛÂȘ, ÂÈ-

‰Èο fiÙ·Ó ÔÈ ·ÛıÂÓ›˜ Â›Ó·È ÌÈÎÚ‹˜ ËÏÈΛ·˜. ªÂ ÙËÓ

·ÚÔ‡Û· ÌÂϤÙË Ì·˜ ηٷϋͷÌ ÛÙÔ Û˘Ì¤Ú·-

ÛÌ· fiÙÈ Ë Û˘ÓÙËÚËÙÈ΋ ıÂڷ›· Ù˘ Û˘ÛÙÚ·Ê›۷˜

·ÛÙ˘ Morgagni Â›Ó·È ·ÍÈfiÈÛÙË Î·È ·ÛÊ·Ï‹˜,

‰ÂÓ ÛÙÂÚÂ›Ù·È ÙˆÓ ÛËÌ·ÓÙÈÎÒÓ ÏÂÔÓÂÎÙËÌ¿ÙˆÓ,

Ô˘ ıˆÚÂ›Ù·È fiÙÈ ¤¯ÂÈ Ë ¯ÂÈÚÔ˘ÚÁÈ΋ ·ÓÙÈÌÂÙÒÈ-

ÛË Î·È Â›Ó·È Û ÌÂÁ¿ÏÔ ‚·ıÌfi ÈÔ ÂÈı˘ÌËÙ‹ ·fi

ÙÔ˘˜ ÁÔÓ›˜. ∞˘ÙÔ› Â›Ó·È Î·È ÔÈ ÏfiÁÔÈ Ô˘ ÂÊ·ÚÌfi-

˙ÂÙ·È ÛÙËÓ ÎÏÈÓÈ΋ Ì·˜ ÙÂÏÂ˘Ù·›· ÁÈ· ÙËÓ ıÂڷ›·

ÙˆÓ ÌÈÎÚÒÓ ·ÛıÂÓÒÓ Ì·˜.

μμÈÈ‚‚ÏÏÈÈÔÔÁÁÚÚ··ÊÊ››··1. Hutson JM. Torsion of the testis. In: J.A. O’Neill, M.J.

Rowe, J.L. Grosfeld, E.W. Fonkalsrud, A.G. Coran,

Eds. Pediatric Surgery, 5th edition, Philadelphia:

Mosby, 1998: 1099-1100.

2. Skandalakis JE, et al. The male reproductive duct. In:

Skandalakis JE, Gray SW, Eds: Embryology for sur-

geons, 2nd Ed, Baltimore: Williams and Wilkins 1994:

605-608.

3. Ombredanne L. Torsions testiculaires chez les enfants.

Bull. Mém Soc Chir Paris 1913: 779-791.

4. Colt GH. Torsion of the hydatid of Morgagni. Br J Surg

1922: 464.

5. Schul MW, Keating MA. The acute pediatric scrotum. Jo-

urnal Emerg. Med 1993, 11: 565-567.

6. Kass EJ, Stone KT, Cacciareli AA, Mitchel B. Do all child-

ren with an acute scrotum require exploration? J Urol

1993, 150: 667-669.

7. Weber MD, Rosslein C. Color Doppler sonography in the

diagnosis of acute scrotum in boys. Eur J Pediatr Surg

2000; 10: 235-241.

8. Campobasso P, Donadio P, Spata E, Salano F, Belloli G.

Acute scrotum in pediatric age: analysis of 265 conse-

cutive cases. Pediatr. Med Chir 1996; 18: 15-20.

9. Monga M, Scarpero HM, Ortenberg J: Metachronous

bilateral torsion of the testicular appendixes. Int, J

Urol 1999, 6(11): 589-591.

∞ÏÏËÏÔÁÚ·Ê›·:Ã. ∫·ÛÂÏ¿˜

π. ¢Ú·ÁÔ‡ÌË 4 ∂, ¶·ÓfiÚ·Ì·

552 36 – £ÂÛÛ·ÏÔÓ›ÎË

Corresponding author:Ch. Kaselas

4E, I. Dragoumi Str – Panorama

552 36 – Thessaloniki,

Greece