scholarly journals Torsion of undescended abdominal testicle in a 16-year-old and its management

2020 ◽  
Vol 13 (1) ◽  
pp. e232179
Author(s):  
Muhamamd Isfandyar Khan Malik ◽  
Joshua Abbas ◽  
Shariq Sabri ◽  
George Michael ◽  
Simon Ellenbogen
Keyword(s):  
Emergency Department ◽  
Testicular Torsion ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
External Genitalia ◽  
Malignant Potential ◽  
Testicular Pain ◽  
Left Testicle ◽  
Right Iliac Fossa Pain

A 16-year-old boy attended the Emergency Department with sudden severe right iliac fossa pain and associated vomiting. He denied any urinary symptoms, diarrhoea or testicular pain. On examination, he had a locally tender right iliac fossa with guarding. External genitalia and testicular examination revealed an absent right testicle, the left testicle was not tender. The patient was haemodynamically stable. A clinical diagnosis of acute appendicitis and possible testicular torsion was made and the patient sent for an urgent diagnostic laparoscopy. At laparoscopy, the patient was found to have a torted, non-viable right-sided testicle in the abdominal cavity. On discussion with urology, a decision was made to excise the torted testicle as it was atrophic and had significant malignant potential. The appendix was normal. The patient made an unremarkable recovery and was discharged.

scholarly journals Torsion Testicular Patient Characteristics

2021 ◽  
Vol 53 (2) ◽  
Author(s):  
Safendra Siregar ◽  
Devlin Alfiana ◽  
Jason Liarto ◽  
Zola Wijayanti
Keyword(s):  
Medical Records ◽  
Testicular Torsion ◽  
Patient Characteristics ◽  
Descriptive Study ◽  
Delayed Presentation ◽  
Testicular Pain ◽  
Left Testicle ◽  
Receive Treatment ◽  
The Right ◽  
To Receive

Testicular torsion is an emergency urological condition that is caused by the torsion of the spermatic cord structures, causing disruption of circulation of the affected testicle. This study aimed to describe the characteristics of patients with testicular torsion treated at Dr. Hasan Sadikin General Hospital Bandung from January 2016 to January 2020. This was a retrospective descriptive study on 34 medical records of patients diagnosed and treated for testicular torsion. Nine patients (29.4%) were <20 years old and 25 patients were >21 years old. The onset was mostly between 6 to 24 hours (38.2%), followed by between 2–7 days (23.5%), less than 6 hours (20.6%), between 1–2 weeks (8.8%), and between 2–4 weeks (8.8%). Left testicular torsion were more frequent than the right torsion (61.8% vs. 38.2%). The etiology of the torsion was mostly idiopathic with no identifiable precedent (88%). Orchidectomy was more frequently performed compared to orchiopexy (78.4% vs. 21.6%). All but one patient (97.1%) presented with testicular pain as the main symptom. Patients presented mostly with a high risk TWIST score (64.7%); however, more presented with low risk compared to the intermediate risk TWIST score (26.5% vs. 8.8%). Orchidectomy is the most frequently performed operation on pre-pubertal and adult patients, possibly due to relatively delayed presentation (>24 hours) to the hospital to receive treatment. Patients were mostly younger; predominantly with high TWIST score and affected left testicle.

scholarly journals Diagnostic laparoscopy in right iliac fossa pain

2018 ◽  
Vol 4 (4) ◽  
pp. 139-143
Author(s):  
Dr. Ravichandran K.S. ◽  
◽  
Dr. Sivachandran K. ◽  
Keyword(s):  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Right Iliac Fossa Pain

scholarly journals Case Report: Intussepting mucocele appendix

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1939
Author(s):  
Tom Crawley-Smith
Keyword(s):  
Case Report ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Operative Management ◽  
Right Hemicolectomy ◽  
Malignant Potential ◽  
Rare Presentation ◽  
Mucocele Of The Appendix ◽  
Right Iliac Fossa Pain

Background: A case study of a presentation of a mucocele appendix, a rare condition accounting for 0.2% of appendicectomies. The case and operative management are discussed along with the possible progression to pseudomyxoma peritoneii and its differing management. Case: A 15-year-old girl had two presentations with atypical Right Iliac Fossa pain over 2 months. This was investigated with ultrasound and CT which revealed a calcified, intussusepting mucocele of the appendix. This was surgically resected with partial Right Hemicolectomy. The patient was discharged on day 3 with no complications. Discussion: The presentation, malignant potential, investigation and management of the mucocele appendix are discussed. The rare presentation of a mucocele appendix necessitates care to eliminate the risk of pseudomyxoma peritoneii. The operative management should minimise disturbance of the peritoneum in this presentation. In this case, due to an intersussepting nature a limited Right Hemicolectomy had to be performed. This is compared to the literature.

scholarly journals Leucocyte count and oral temperature are a useful guide to selecting women with right iliac fossa pain for diagnostic laparoscopy

2010 ◽  
Vol 92 (5) ◽  
pp. 425-428 ◽  
Author(s):  
D Singh-Ranger ◽  
A Ogadegbe
Keyword(s):  
Leucocyte Count ◽  
Diagnostic Laparoscopy ◽  
Postoperative Morbidity ◽  
Iliac Fossa ◽  
Scoring Systems ◽  
Normal Appendix ◽  
Fold Reduction ◽  
Perforated Appendix ◽  
Right Iliac Fossa Pain ◽  
Negative Appendicectomy

INTRODUCTION In women, negative appendicectomy rates can be as high as 34%. A 5-fold reduction is possible with diagnostic laparoscopy. A selective policy is favoured as indiscriminate use may increase postoperative morbidity. Scoring systems are helpful but not used widely du to their complexity. The value of leucocyte count and temperature in selecting women with right iliac fossa pain for diagnostic laparoscopy is investigated. PATIENTS AND METHODS Over a 12-month period, admission leucocyte count and temperature data were obtained from women undergoing appendicectomy. Cohorts were sub-categorised by age (< 20, 21–40 and > 40 years) and the proportion of negative (normal appendix) and positive (inflamed, gangrenous or perforated appendix) appendicectomies compared. RESULTS In 100 women, 11% had leucocyte counts and temperature ≥ 11 × 109/l and 38°C, respectively; all had appendicitis. In 50%, leucocyte counts and temperature were ≥ 11 × 109/l and < 38°C; negative appendicectomies occurred in 13.8% < 20 years, 10% > 40 years (P < 0.01) and 27.3% aged 21–40 years (P = 0.086). In 39%, the negative appendicectomy rate was ≥ 36.8% when leucocyte count and temperature were < 11 × 109/l and 38°C (P = 0.1). CONCLUSION Diagnostic laparoscopy should be considered in all women when leucocyte counts and temperature are ≥ 11 × 109/l and 38°C and for females aged 21–40 years when these values are ≥ 11 × 109/l and < 38°C.

scholarly journals An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix

2012 ◽  
Vol 94 (7) ◽  
pp. 476-480 ◽  
Author(s):  
SS Jaunoo ◽  
AL Hale ◽  
JPM Masters ◽  
SR Jaunoo
Keyword(s):  
Endoscopic Surgery ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
International Survey ◽  
French Society ◽  
Normal Appendix ◽  
International Consensus ◽  
Operative Strategy ◽  
The Us ◽  
Right Iliac Fossa Pain

INTRODUCTION The use of imaging and laparoscopy in patients with right iliac fossa pain as tools to make or exclude a diagnosis of appendicitis is at the discretion of the clinician. We sought to establish a consensus of opinion on this matter by surveying professional bodies for laparoscopic surgery in France, Italy and the US. METHODS A survey was sent to members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), as well as the French Society for Endoscopic Surgery (SFCE) and the Italian Society for Endoscopic Surgery (SICE). The survey asked about management of both male and female patients presenting with right iliac fossa pain and what operative strategy the respondents would pursue should they find a macroscopically normal appendix at laparoscopy. RESULTS A total of 364 responses were returned from the three groups. The responses from SAGES showed computed tomography to be the preferred modality for investigating patients with right iliac fossa pain, irrespective of sex. Both SFCE and SICE preferred the use of diagnostic laparoscopy, especially in the female patient group. The majority of all respondents stated that they would remove a macroscopically normal appendix at laparoscopy. CONCLUSIONS Laparoscopy remains a potent tool in the management of appendicitis. However, the dilemma of when to remove a macroscopically normal appendix remains. Our study shows that removal of the appendix in this instance would be supported by an international consensus.

scholarly journals The morbidity of negative appendicectomy

2014 ◽  
Vol 96 (7) ◽  
pp. 517-520 ◽  
Author(s):  
M Lee ◽  
T Paavana ◽  
F Mazari ◽  
TR Wilson
Keyword(s):  
Diagnostic Laparoscopy ◽  
District Hospital ◽  
Iliac Fossa ◽  
Complication Rates ◽  
Electronic Patient Records ◽  
Retrospective Audit ◽  
Significant Difference ◽  
Right Iliac Fossa Pain ◽  
Negative Appendicectomy ◽  
Invasive Intervention

Introduction The increased use of diagnostic laparoscopy for management of right iliac fossa pain may have lowered the threshold for removing normal appendices, particularly as there is a perception that this practice carries little additional morbidity. The aim of this retrospective audit was to determine the negative appendicectomy rate after laparoscopic appendicectomy (LA) in our busy district hospital, and to compare the relative incidence and severity of complications after removal of an inflamed or non-inflamed appendix. Methods Adult patients who underwent LA in 2011–2012 were identified from theatre registers. Histology results were reviewed to differentiate between inflamed and normal appendices. Postoperative complications and events following discharge were identified via electronic patient records. Complication severity was stratified using the Clavien–Dindo classification. Results Over 2 years, 467 LAs were performed, of which 143 (30.6%) were for normal appendices. Significantly more negative appendicectomies were performed in women (43%) than in men (17%) (p<0.0001). Complications were seen in 62 patients (13.3%). There was no significant difference between the complication rates for those who had an inflamed (16.6%) or non-inflamed (11.9%) appendix (p=0.141). Similarly, there was no difference in the severity of complications between these groups. Reoperation or invasive intervention was required after four negative appendicectomies (2.8%). Conclusions LA carries a similar morbidity regardless of whether the appendix is inflamed. Negative appendicectomy should not be undertaken routinely during laparoscopy for right iliac fossa pain.

DIAGNOSTIC LAPAROSCOPY FOR CHRONIC RIGHT ILIAC FOSSA PAIN: A PILOT STUDY

1997 ◽  
Vol 67 (11) ◽  
pp. 789-791 ◽  
Author(s):  
Ken Chao ◽  
Stephen Farrell ◽  
Paul Kerdemelidis ◽  
Bruce Tulloh
Keyword(s):  
Pilot Study ◽  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Right Iliac Fossa Pain

scholarly journals Analysis of diagnostic laparoscopy in chronic right iliac fossa pain

2017 ◽  
Vol 4 (4) ◽  
pp. 1259
Author(s):  
Umesh Vaishnav ◽  
Harshad S. Patel
Keyword(s):  
Diagnostic Laparoscopy ◽  
Iliac Fossa ◽  
Laboratory Finding ◽  
Radiological Finding ◽  
Minimal Invasive ◽  
General Surgeon ◽  
Positive Finding ◽  
Surgical Department ◽  
Right Iliac Fossa Pain

Background: Chronic right iliac fossa pain with normal radiological and laboratory finding is common indication for diagnostic laparoscopy by general surgeon. Most common cause of chronic right iliac fossa pain is appendicitis. Laparoscopic appendectomy is commonly done in diagnostic laparoscopy if other cause is not found.Methods: Patients of all the age group and either gender, undergone diagnostic laparoscopy for chronic right iliac fossa pain longer than 3 months with normal radiological finding in the surgical department. Diagnostic and therapeutic role of laparoscope was assessed.Results: 83% patients were showing visible positive finding on diagnostic laparoscopy. On follow up after 1 month, 90% patients show reliving of pain.Conclusions: Diagnostic laparoscopy is minimal invasive surgical procedure. It is useful when other pathological and radiological investigations are inclusive.

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