Cystic carbuncle is an acute purulent disease that occurs in the scrotum outside the testis. It is characterized by scrotum redness, swelling and pain, hot and cold, and then the skin is tight and bright, shaped like a scoop, painful. “Surgery Dacheng” says: “Patients with carbuncle in the husband, scrotum swelling and heat pain.” It is equivalent to scrotal abscess and scrotal cellulitis in Western medicine.
Cause and Pathogenesis
scrotal abscess cause:The carbuncle is usually caused by wearing sweaty clothes for a long time, or sitting and lying on the wet ground, feeling wet and poisonous, or being scratched by the cyst and poisoning due to trauma; or due to improper diet, over-eating the ointment, and spitting cold. The spleen loses vitality, damp-heat is endogenous, and damp-heat is placed on the collaterals of the liver and kidney.
diagnosis
At first, the scrotum appeared redness, swelling, burning, obvious tenderness, and swelling of the inguinal nucleus. The scrotum swelling progresses quickly, and even swelling like a scoop, falling painful. Patients with cellulitis of the scrotum have diffuse redness and swelling of the scrotum, marked by edema, not necessarily purulent. For those with scrotal abscess, the scrotal redness and swelling are more limited and uplifted, and may be accompanied by fever, chills or mild chills, dry mouth, cold drinking, red urine, dry stool and other systemic symptoms. After the treatment, the heat subsides and the pain stops, and the swelling subsides quickly; if the body heat does not go away and the swelling and pain does not decrease, it will become pus.
【Differential diagnosis】
One, carbuncle testis or epididymis are swollen and hard, painful, and early scrotal swelling is not obvious. When the lesion penetrates the testicular tunica albuginea, inflammation spreads to the scrotum. In the early stage of cystic carbuncle, scrotum swelling and burning appear, and inflammation generally does not spread to the testicles.
2. Exclusion usually has a history of skin trauma to the scrotum. The scrotum rapidly changes from redness and swelling to purple-black decay, and even the testicles are exposed. The course of the disease progresses quickly, and it is prone to invagination. The condition is critical. It is an idiopathic gangrenous disease that occurs in the scrotum and is rare in clinical practice.
3. Water hernia scrotal enlargement, but the complexion is not red, the skin is not hot, soft, cystic and sexy, and the light transmission test is positive. When the water hernia is large, there is a feeling of falling and bulging, but the pain is not obvious, and there is no syndrome of fever and cold all over the body.
【Differentiation and Treatment】
One, internal governance hot and humid betting scrotum redness and heat, falling swelling pain, refusal to press, swelling and pain of groin heat nucleus, local swelling pain and throbbing pain during pus filling, scrotum swelling, acupressure fluctuations; may be accompanied by fever, dry mouth Like cold drinks, red hot urine; red tongue, yellow greasy or dry fur, pulse string or tight pulse.
Syndrome analysis:
The scrotum is injected into the damp and heat of the liver meridian, which blocks the meridian, and the blood is not smooth, so the scrotum is red and swollen, swelling and painful, refusal to press; the liver meridian follows the femoral yin, so the groin nucleus is swollen and painful; Therefore, localized pus, and the scrotum focal bulge, the finger pressure fluctuates; the heat is Yang evil, easy to damage the body fluid, so the whole body is fever, the mouth is dry and cold drinks; the damp heat disturbs the bladder, the gasification is abnormal, so the urine is hot ; Red tongue, yellow greasy coating or yellow dry, pulse string or tight number are signs of damp and hot betting.
Therapeutic method: clearing away heat and removing dampness, detoxification and
swelling:
scrotal abscess swelling: Recipe: Longdan Xiegan Decoction or Xiere Decoction. For those who have become pus, add trichosanthes, saponins, and pangolin toxin to drain pus.
External treatment method
For those who have not become pus, use Yulu San, Jinhuang San or Shuangbai San cold water to apply cold compress. If the area of redness and swelling is large, use Sanhuang Decoction (rhubarb, yellow cypress, scutellaria) decoction as a cold wet compress, frequently changing the dressing to keep cold and wet, which will help reduce inflammation, reduce swelling and relieve pain. For those who have become pus, promptly incise and drain the pus, and choose the incision that is closest to the abscess and is conducive to drainage. It is advisable to make a straight cut with a horizontal knife, and pay attention to avoid damaging the sheath and testis. Generally, latex film or half-sided rubber tube is used for drainage.
【Prevention of Photo Shooting】
1. Correctly handle the trauma of the scrotum in time and pay attention to keeping the scrotum clean and dry.
2. Hold up the scrotum with a scrotum belt, raise it appropriately, and relieve pain. For those who have been incised and drained, pay attention to smooth drainage.
3. Don’t eat fishy, spicy broiled food and other foods.
[Conclusion]
cyst carbuncle is equivalent to scrotal abscess and scrotal cellulitis in western medicine. The main features are: the scrotum is red, swollen, hot and painful, and the skin is tight and bright, like a scoop. The main pathogenesis is exogenous damp toxin, damp and hot betting. It should be distinguished from carbuncle, exunus, and water hernia. For damp-heat betting syndrome, the treatment should be used to clear away heat and remove dampness, detoxify and reduce swelling, and use Longdan Xiegan Decoction or Xiere Decoction as a prescription; local treatment should be performed according to acute infection.