Sonographic Discovery of Segmental Testicular Infarction

2021 ◽  
pp. 875647932110649
Author(s):  
Kelly Pham
Keyword(s):  
Conservative Treatment ◽  
Testicular Torsion ◽  
Treatment Process ◽  
Surgical Intervention ◽  
Treatment Approach ◽  
Accurate Diagnosis ◽  
Sonographic Diagnosis ◽  
Testicular Infarction ◽  
Segmental Testicular Infarction

The prevalence of segmental testicular infarction is extremely uncommon and very few cases have been reported in literature. Clinical and sonographic presentation of this condition can mimic testicular neoplasms or testicular torsion. Therefore, accurate diagnosis of segmental testicular infarction is imperative in the treatment process. This case study presents the sonographic diagnosis of testicular infarction in a 49-year-old man who reported mild testicular tenderness. A conservative treatment approach was used, saving the patient unnecessary surgical intervention.

scholarly journals Acute Appendicitis in Pregnancy: a Diagnostic and Management Challenge

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Zainur Rashid Z ◽  
Sulaiha SA ◽  
Azmi MN
Keyword(s):  
Acute Appendicitis ◽  
Maternal Death ◽  
Surgical Intervention ◽  
Accurate Diagnosis ◽  
Sonographic Diagnosis ◽  
Appropriate Treatment ◽  
Open Laparotomy ◽  
Management Challenge ◽  
Prompt Diagnosis ◽  
In Pregnancy

Acute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy.

scholarly journals Case Report: Segmental Testicular Infarction

2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Aumeerally MI
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Testicular Torsion ◽  
Radical Surgery ◽  
Rare Condition ◽  
Surgical Exploration ◽  
Testicular Pain ◽  
Testicular Infarction ◽  
Segmental Testicular Infarction ◽  
Australian Hospital

Segmental testicular infarction is a rare condition that presents with acute testicular pain. The diagnosis can be clinically challenging and include important differential diagnoses such as testicular torsion, testicular tumour and infection. This case report describes a 27-year-old male presenting to a regional Australian hospital with acute left testicular pain. The diagnosis was made intra-operatively during surgical exploration and on histopathologic assessment after the patient underwent a partial orchidectomy. While segmental testicular infarction is a rare condition, it should be considered in the differential diagnosis for acute testicular pain as awareness may help to avoid unnecessary radical surgery.

scholarly journals Torsion Testis: Surgical Management

2020 ◽  
Vol 15 (1) ◽  
pp. 3-5
Author(s):  
Md Nasir Uddin ◽  
Kazi Rafiqul Abedin ◽  
Kazi Zakirul Razzaque ◽  
Md Serajul Hoque ◽  
Md masum Hasan ◽  
...  
Keyword(s):  
Surgical Management ◽  
Spermatic Cord ◽  
Testicular Torsion ◽  
Private Hospital ◽  
Surgical Intervention ◽  
Accurate Diagnosis ◽  
Dhaka City ◽  
Surgical Exploration ◽  
Urological Emergency ◽  
Age Range

Objective: Acute testicular torsion is a urological emergency that require quick accurate diagnosis and timely surgical intervention to salvage the testis. Nature of surgical management depending on viable or non viable testis during surgical exploration. Materials and methods: This retrospective study was conducted at some private hospital in Dhaka city and Comilla from June 2006 to February 2011. The study enrolled 36 patients with age range 7 to 23 years, mean age was 14 years. Twenty one (58.33%) patients reached hospitals within 4 to 6 hours from onset of pain, 7(19.44%) patients within 12 hours, 3(8.33%) patients within 24 hours, 2(5.55%) patients within 2 days and 3(8.33%) patients after 5 days of onset pain. All patients underwent surgical exploration. Results: Twenty four (66.66%) patients showed viable testis on exploration and orchidopexy were done on ipsilateral testis with prophylactic orchidopexy on contralateral site. Another 12 (33.33%) patients had nonviable testis, required orchidectomy on involved testis and prophylactic orchidopexy on opposite testis. Conclusion: Spermatic cord torsion represents a commonly encountered urological emergency where accurate diagnosis and timely intervention are essential for functional and nonatrophied testicular salvage. Bangladesh Journal of Urology, Vol. 15, No. 1, Jan 2012 p.3-5

Sonographic Diagnosis of Unilateral Synchronous Testicular Tumors

2019 ◽  
Vol 2 ◽  
pp. 2
Author(s):  
Allison Forrest ◽  
Numbereye Numbere ◽  
Jerome Jean-Gilles ◽  
Thomas Frye ◽  
Vikram Dogra
Keyword(s):  
Testicular Cancer ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Histological Type ◽  
Synchronous Tumors ◽  
Testicular Tumors ◽  
Sonographic Diagnosis ◽  
Histological Types ◽  
Common Cancer

Testicular cancer accounts for 1% of all male cancers yet is the most common cancer affecting men aged 15–44 years. Most testicular cancers are seminomas or non-seminomatous germ cell tumors. Rarely, multiple testicular cancers may occur simultaneously, most often of the same histological type. However, synchronous tumors of different histological types may occur, although rarely. In this case study, we present the sonographic features with histopathologic correlation in a case of unilateral synchronous testicular tumors of discordant histology.

TREATMENT OF MUNICIPAL SEWAGE BY THE COMBINATION OF ANAEROBIC AND FACULTATIVE TREATMENT PROCESS - A CASE STUDY

2006 ◽  
Vol 5 (5) ◽  
pp. 1085-1094
Author(s):  
Sudheer Kumar Shukla ◽  
Prerana Tripathi ◽  
Mukesh Pandey ◽  
Amit Dubey ◽  
Misra Shiv Mangal ◽  
...  
Keyword(s):  
Treatment Process ◽  
Municipal Sewage

Clinical outcomes and prognostic factors for cavernous hemangiomas of the spinal cord: a retrospective cohort study

2019 ◽  
Vol 31 (2) ◽  
pp. 271-278 ◽  
Author(s):  
Narihito Nagoshi ◽  
Osahiko Tsuji ◽  
Daisuke Nakashima ◽  
Ayano Takeuchi ◽  
Kaori Kameyama ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Surgical Intervention ◽  
Lesion Size ◽  
Sudden Onset ◽  
Neurological Function ◽  
Neurological Injury ◽  
Prognostic Indicators ◽  
Asymptomatic Patients ◽  
Surgical Data ◽  
Unstable Gait

OBJECTIVEIntramedullary cavernous hemangioma (CH) is a rare vascular lesion that is mainly characterized by the sudden onset of hemorrhage in young, asymptomatic patients, who then experience serious neurological deterioration. Despite the severity of this condition, the therapeutic approach and timing of intervention for CH remain matters of debate. The aim of this study was to evaluate the clinical characteristics of CH patients before and after surgery and to identify prognostic indicators that affect neurological function in these patients.METHODSThis single-center retrospective study included 66 patients who were treated for intramedullary CH. Among them, 57 underwent surgery and 9 patients received conservative treatment. The authors collected demographic, symptomology, imaging, neurological, and surgical data. Univariate and multivariate logistic regression analyses were performed to identify the prognostic indicators for neurological function.RESULTSWhen comparing patients with stable and unstable gait prior to surgery, patients with unstable gait had a higher frequency of hemorrhagic episodes (52.4% vs 19.4%, p = 0.010), as assessed by the modified McCormick Scale. The lesion was significantly smaller in patients who underwent conservative treatment compared with surgery (2.5 ± 1.5 mm vs 5.9 ± 4.1 mm, respectively; p = 0.024). Overall, the patients experienced significant neurological recovery after surgery, but a worse preoperative neurological status was identified as an indicator affecting surgical outcomes by multivariate analysis (OR 10.77, 95% CI 2.88–40.36, p < 0.001). In addition, a larger lesion size was significantly associated with poor functional recovery in patients who had an unstable gait prior to surgery (8.6 ± 4.5 mm vs 3.5 ± 1.6 mm, p = 0.011).CONCLUSIONSOnce a hemorrhage occurs, surgical intervention should be considered to avoid recurrence of the bleeding and further neurological injury. In contrast, if the patients with larger lesion presented with worse preoperative functional status, surgical intervention could have a risk for aggravating the functional deficiencies by damaging the thinning cord parenchyma. Conservative treatment may be selected if the lesion is small, but regular neurological examination by MRI is needed for assessment of a change in lesion size and for detection of functional deterioration.

scholarly journals A rare presentation of ovarian fibrothecoma: a diagnosing dilemma

2018 ◽  
Vol 7 (4) ◽  
pp. 1654
Author(s):  
Kalaivani Logesh ◽  
Latha Prasanna
Keyword(s):  
Postmenopausal Woman ◽  
Stromal Cell ◽  
Surgical Intervention ◽  
Pelvic Mass ◽  
Accurate Diagnosis ◽  
Female Gonad ◽  
Rare Presentation ◽  
Ovarian Tumours ◽  
Benign Tumours

Ovarian Fibrothecoma are uncommon tumors of gonadal stromal cell origin accounting for 3-4% of all ovarian tumours. Ovarian fibrothecoma are composed of an admixture of fibrous and the comatous elements. The stromal cell tumors are probably the most inaccurately diagnosed tumor of the female gonad, clinically and histologically. Rarely benign tumours can present with elevated CA125. Here we discuss a rare presentation of Ovarian Fibrothecoma in a 52 years postmenopausal woman with large pelvic mass with ascites and elevated CA125 which we mistook for malignancy. Hence accurate diagnosis is more important before extensive surgical intervention.

scholarly journals Relative Efficacy of Three of Nonsurgical Treatments for Calcific Tendinitis: Physical Therapy vs Steroid Injection vs Ultrasound-Guided Aspiration

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Mauricio Drummond ◽  
Caroline Ayinon ◽  
Albert Lin ◽  
Robin Dunn
Keyword(s):  
Physical Therapy ◽  
Rotator Cuff ◽  
Conservative Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Corticosteroid Injection ◽  
Calcific Tendinitis ◽  
Ultrasound Guided ◽  
Calcium Deposits

Objectives: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC) that accounts for up to 7% of cases of shoulder pain1. The most common conservative treatments typically include physical therapy (PT), corticosteroid injection (CSI), or ultrasound-guided aspiration (USA). When conservative management fails, the patient may require arthroscopic surgery to remove the calcium with concomitant rotator cuff repair. The purpose of this study was to characterize the failure rates, defined as the need for surgery, of each of these three methods of conservative treatment, as well as to compare post-operative improvement in patient-reported outcomes (PROs) – including subjective shoulder values (SSV) and visual analog scale (VAS) pain scores – based on the type of pre-operative conservative intervention provided. A secondary aim was to compare post-operative range of motion (ROM) outcomes between groups that failed conservative management. We hypothesized that all preoperative conservative treatments would have equivalent success rates, PROs, and ROM. Bosworth B. Calcium deposits in the shoulder and subacromial bursitis: a survey of 12122 shoulders. JAMA. 1941;116(22):2477-2489. Methods: A retrospective review of all patients who were diagnosed with calcific tendinitis at our institution treated among 3 fellowship trained orthopedic surgeons between 2009 and 2019 was performed. VAS, SSV, and ROM in forward flexion (FF) and external rotation (ER) was abstracted from the medical records. Scores were recorded at the initial presentation as well as final post-operative follow-up visit for those who underwent surgery. The conservative treatment method utilized by each patient was recorded and included PT, CSI, or USA. Failure of conservative management was defined as eventual progression to surgical intervention. Statistical analysis included chi-square, independent t test and ANOVA. Descriptive statistics were used to report data. A p<0.05 was considered to be statistically significant. Results: 239 patients diagnosed with calcific tendinitis were identified in the study period with mean age of 54 years and follow up of at least 6 months. In all, 206 (86.2%) patients underwent a method of conservative treatment. Of these patients, 71/239 (29.7%) underwent PT, 67/239 (28%) attempted CSI, and 68/239 (28.5%) underwent USA. The overall failure rate across all treatment groups was 29.1%, with injections yielding the highest success rate of 54/67 (80.6%). Physical therapy saw the highest failure rate, with 26/71 (36.7%) proceeding to surgical intervention. Patients undergoing physical therapy were statistically more likely to require surgery compared to those undergoing corticosteroid injection (RR 1.88, p= 0.024). Of all 93 patients who underwent surgery, VAS, SSV, ROM improved significantly in all groups. On average, VAS decreased by 4.02 points (6.3 to 2.3), SSV increased by 33 points (51 to 84), FF improved by 13.8º, and ER improved 8.4º between the pre- and post-operative visits (p<0.05). The 33 patients who did not attempt a conservative pre-operative treatment demonstrated the largest post-operative improvement in VAS (-6.00), which was significantly greater than those who previously attempted PT (-3.33, p<0.05). There was a trend towards greater improvement in SSV in the pre-operative PT group (45 to 81) compared to others, but this did not reach statistical significance (p=0.47). Range of motion was not significantly affected by the method of pre-operative conservative intervention. Conclusions: Conservative treatment in the form of physical therapy, corticosteroid injection, and ultrasound-guided aspiration is largely successful in managing calcific tendinitis of the shoulder. Of these, PT demonstrated the highest rate of failure in terms of requiring surgical management. PRO improvement varied among the conservative modalities used, however patients who did not attempt conservative management experienced the greatest improvements following surgery. If surgery is necessary following failed conservative treatment, excellent outcomes can be expected with significant improvements in ROM and PROs. This information should be considered by the surgeon when deciding whether to recommend conservative treatment for the management of calcific tendinitis, as well as which specific method to employ.

A COMPREHENSIVE STUDY ON ACUTE NON-TRAUMATIC ABDOMINAL EMERGENCIES

2021 ◽  
pp. 14-16
Author(s):  
Md. Quamar Zubair ◽  
A. K. Jha Suman
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Surgical Intervention ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Accurate Diagnosis ◽  
Postoperative Patient ◽  
Correct Treatment ◽  
Abdominal Emergencies ◽  
Comprehensive Study

Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of nontraumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.

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