By Michel Bléry; Marie-France Bellin
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Additional info for Echographie en urgence pour le radiologue
Example text
3 Complications infectieuses. a. Inflammation du cordon : cordon augmenté de volume hyperéchogène. 3 Suite. b. Pyocèle avec un épanchement multicloisonné. c. Abcès épididymaire : collection hypoéchogène à contenu épais avasculaire. d. Nécrose testiculaire : testicule droit hypoéchogène avasculaire en Doppler couleur.
Obstacle uréthral : cancer de prostate. ■ Obstacle unilatéral sur rein unique fonctionnel : endoluminal (calcul, caillot), pariétal (tumeur urothéliale), compression extrinsèque (tumeur, adénopathie, collection, vaisseaux, endométriose…). ■ IRA organique (Na urinaire/K urinaire > 1) Néphropathie tubulaire aiguë : – nécrose tubulaire aiguë : état de choc, hémolyse aiguë intravasculaire, myoglobinurie (rhabdomyolyse), CIVD, néphrotoxiques (médicamenteux, industriels), pancréatite aiguë hémorragique ; – obstruction tubulaire aiguë (précipitat intratubulaire) : syndrome de lyse tumorale (acide urique), myélome (protéinurie de Bence-Jones), médicaments, hypercalcémie sévère.
Tous droits réservés 56 Échographie en urgence pour le radiologue La bourse douloureuse aiguë est définie comme la survenue d'une douleur scrotale brutale avec ou sans augmentation de volume. La mise en jeu du pronostic testiculaire impose une démarche diagnostique cohérente et rapide. Si l'échoDoppler ne doit jamais retarder un geste chirurgical dans une torsion évidente, la non-réalisation de l'examen dans une bourse aiguë étiquetée « probable orchiépididymite » a conduit à la perte définitive du testicule pour un nombre non négligeable de patients (torsion méconnue, nécrose sur sepsis).