scholarly journals Acute Testicular Torsion in Children: A Tertiary Hospital Experience in a Developing Country

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Chukwubuike Kevin Emeka
Keyword(s):  
Pediatric Surgery ◽  
Testicular Torsion ◽  
Undescended Testis ◽  
Tertiary Hospital ◽  
Prior History ◽  
Testicular Pain ◽  
History Of ◽  
The Mean ◽  
Urological Emergency ◽  
The Right

Background: Testicular torsion is a urological emergency in which there is a race against time to salvage the testis. The aim of this study was to evaluate our experience in the management of children who presented with acute testicular torsion. Materials and Methods: This was a retrospective study of children aged 15 years and below who had surgery for acute testicular torsion between January 2013 and December 2017 at the pediatric surgery unit of a teaching hospital in Enugu, Nigeria. Results: Sixty-four children were managed during the study period. The ages of the patients ranged from 2 months to 14 years with a median of 6 years. The right testis was mostly affected and the mean duration from the onset of symptom to presentation was 4 hours. All the patients presented with testicular pain and half of the patients had a prior history of intermittent testicular pain. Four (6.3%) patients had a history of trauma precipitating the testicular torsion and 3 (4.7%) patients had undescended testis. Detorsion and Orchidopexy was the most performed surgical procedure and wound infection was the most common post-operative complication. There was no mortality. Conclusion: Testicular torsion is not uncommon in children and may be associated with testicular loss. The right testis is mostly involved in children. Prior history of intermittent testicular pain, trauma and undescended testis are important considerations. Prompt detorsion and orchidopexy remains the cornerstone of treatment.

Management of pediatric brainstem cavernous malformations: experience over 20 years at the Hospital for Sick Children

2009 ◽  
Vol 4 (5) ◽  
pp. 458-464 ◽  
Author(s):  
Ratan D. Bhardwaj ◽  
Kurtis I. Auguste ◽  
Abhaya V. Kulkarni ◽  
Peter B. Dirks ◽  
James M. Drake ◽  
...  
Keyword(s):  
Conservative Management ◽  
Biological Behavior ◽  
Prior History ◽  
Pial Surface ◽  
Cavernous Malformations ◽  
Maximal Diameter ◽  
History Of ◽  
The Mean ◽  
Sick Children ◽  
The Right

Object Because of their location and biological behavior, brainstem cavernous malformations (CMs) pose a formidable clinical challenge to the neurosurgeon. The optimal management of these lesions requires considerable neurosurgical judgment. Accordingly, the authors reviewed their experience with the management of pediatric brainstem CMs at the Hospital for Sick Children. Methods The authors performed a retrospective chart review of pediatric patients who had received diagnoses of a brainstem CM at the Hospital for Sick Children over the past 20 years. Results Twenty patients were diagnosed with brainstem CMs. The mean age at diagnosis was 10.1 ± 5.4 years, and the patients included 13 boys and 7 girls. The mean maximal diameter of the CM was 14.3 ± 11.2 mm. The lesions were evenly distributed on the right and left sides of the brainstem with 4 midbrain, 13 pontine, and 3 medullary lesions. Seven patients underwent surgery for the management of their CMs, with a mean age at presentation of 5.2 years, and a mean CM size of 21.0 mm. Of note from the surgical group, 2 patients had a family history of CMs, 2 lesions were medullary, the CM reached a pial surface in 6 of 7 patients, and 6 of 7 lesions were located on the right side. The mean age at presentation among the 13 patients in the nonsurgical group was 12.7 years, and the mean CM size was 10.6 mm. Seven of these patients had a prior history of radiation for tumor, and only 3 had lesions that reached a pial surface. Conclusions The management of brainstem CMs in children is influenced by multiple factors. The majority of patients received conservative management and tended to be asymptomatic with smaller lesions. Patients with larger lesions and direct pial contact, in whom symptoms arose at a younger age were more likely to undergo surgical management. A history of familial CM was also a predictor for receiving surgical treatment. No patients with a prior history of radiation therapy underwent surgery for CMs. The presence of multiple lesions seemed to have no impact on the type of management chosen. Patients who underwent surgery did suffer morbidity related to the procedure, and tended to improve clinically over time. Conservative management was associated with new deficits arising in children, some of which improved with time. Consideration of many clinical and radiological parameters is thus prudent when managing the care of children with brainstem CMs.

scholarly journals Atypical presentation of testicular torsion: a case series

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya
Keyword(s):  
Physical Examination ◽  
Testicular Torsion ◽  
Age Groups ◽  
Case Series ◽  
Atypical Presentation ◽  
Testicular Pain ◽  
Future Fertility ◽  
Urological Emergency ◽  
High Index Of Suspicion ◽  
Symptoms And Signs

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.

Role of laparoscopic in diagnosis and treatment of undescended testis in children at Viet Duc Hospital

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Viet Hoa Nguyen
Keyword(s):  
Laparoscopic Surgery ◽  
Undescended Testis ◽  
Correct Diagnosis ◽  
Diagnosis And Treatment ◽  
Highly Sensitive ◽  
The Mean ◽  
The Right ◽  
Time Of Operation

Abstract Introduction: Evaluating the role of laparoscopic for diagnosis and treatment of undescended testis in children. Material and Methods: Restrospective study, between 6/ 2014 and 6/2017. All the patients are aged from 1 to 16 years with undescended testis underwent laparoscopic surgery for diagnosis and treatment in Deparment of pediatric surgery – Viet Duc hospital enrolled. Results: Of 95 patiens in total had 106 undescended testis diagnosed and treated by laparoscopy. The mean age of patients was 7,5 ± 3,8 years. 44,2% undescended were on the left side, 44,2% were on the right and 11,6% were undescended bilateral. The correct diagnosis by ultrasound accounted in 79,4%. The locations of testis diagnosed by laparoscopic are : intra abdomen in 45,3%, deep inguinal orifice in 16,9%, extra inguinal orifice in 26,4%, no testicle found in 11,4%. The mean time of operation were 67,33± 28,01 pht. Scrotal positions were achieved 74,5%, remove atrophic testis accounted in 7,6%. Stephen- Flowler technique including step I were in 4,7%, step II in 1,9%. The outcome evaluated by testicular positions following 3 months after operation are : good in 79,2%, moderate 13,2%, poor in 7,6%; By classification of Aubert are : good in 81,1%, moderate in 11,3% and poor in 7,6 %. Conclusion: Laparoscopic surgery is not only a highly sensitive diagnostic method to find accurately the location and size of the testes, but also the most effective method to treat impalpable undescended testes.

scholarly journals THE USE OF HYDROXYETHYL STARCH 200/0,5 AS PLASMA SUBTITUTES IS SAFE IN HYPOVOLEMIC PATIENTS AS INDICATED IN CHANGES OF N-ACETYL--GLUCOSAMINIDASE AND CREATININ SERUM PARAMETERS

2016 ◽  
Vol 51 (4) ◽  
pp. 228
Author(s):  
Dewi Wara Shinta ◽  
Junaidi Khotib ◽  
Eddy Rahardjo ◽  
Mahardian Rahmadi ◽  
Budi Suprapti
Keyword(s):  
Hydroxyethyl Starch ◽  
Elective Surgery ◽  
Prior History ◽  
Creatinine Ratio ◽  
Urine Creatinine ◽  
Tissue Edema ◽  
History Of ◽  
The Mean ◽  
Baseline Characteristics ◽  
Two Parameters

Hydroxyethyl Starch (HES) is a compound that improves intravascular volume effectively and rapidly without causing tissue edema. However, HES also has renal safety profile which is still being debated. Based on clinical experience in Dr. Soetomo Hospital, the frequency of acute renal failure following HES 200/0.5 administration at a dose of less than 20 ml/kg (maximum dose) is very rare. The purpose of this study was to evaluate the effect of HES 200/0.5 at a dose of less than 20 ml/kg in patients undergoing surgery. N-acetyl-b-D-Glucosaminidase (NAG) per urine creatinine ratio and creatinine serum were used as main parameter to assess renal injury. This research was observational and prospective design in patients undergoing elective surgery at Gedung Bedah Pusat Terpadu, Dr. Soetomo Hospital, who requiring resuscitation therapy with HES 200/0.5 and met the inclusion and exclusion criteria. NAG was measured prior to surgery and 12 hours after administration of fluid therapy, while creatinine serum was observed before surgery and 48 hours after resuscitation. This study was conducted for three months, and obtained 50 subjects divided into 2 groups, crystalloid group and HES 200/0.5 group. Demographic and baseline characteristics did not differ between groups, except the total bleeding volume. Total bleeding in HES 200/0.5group was higher than crystalloid group (p <0.0001). The mean volume of fluid received in HES 200/0.5 group was 2042.0 ± 673.9 mL, higher when compared with that of crystalloid group (910.0 ± 592.0 ml). Doses of HES 200/0.5 received was 8.31 ± 4.86 ml/kg. Measurement of the of NAG/creatinine ratio and creatinine serum showed significant increase in both groups, but still within the normal range. In addition, the value of these two parameters did not differ between groups. In conclusion, HES 200/0.5 in a dose of less than 20 ml/kg is safe to use in patients who suffered from hypovolemic hemorrhage, without prior history of renal impairment.

Rectal carcinoma metastatic to the thyroid gland

1996 ◽  
Vol 110 (2) ◽  
pp. 192-195 ◽  
Author(s):  
Thomas W. Mesko ◽  
Julie Friedman ◽  
Harry Sendzischew ◽  
Daniel D. Nixon
Keyword(s):  
Thyroid Gland ◽  
Rectal Carcinoma ◽  
Secondary Malignancy ◽  
Prior History ◽  
Low Back ◽  
Metastatic Adenocarcinoma ◽  
History Of ◽  
Right Lobe ◽  
The Right ◽  
History Of Cancer

AbstractClinically evident metastases to the thyroid gland are rarely found antemortem. A case of a 59-year-old woman with a history of rectal carcinoma, who presented with low back pain and a mass in the right lobe of her thyroid gland, is presented. The tumour of the thyroid was found to be metastatic adenocarcinoma from her previous rectal cancer. Other synchronous metastases were noted in her lumbar spine and kidneys.The clinical finding of metastases to the thyroid gland is rare, particularly from a colorectal primary. One must consider, however, the possibility of a tumour of the thyroid gland representing a secondary malignancy in any patient with a prior history of cancer.

Intermittent Testicular Torsion

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 908-911
Author(s):  
Thomas J. Stillwell ◽  
Stephen A. Kramer
Keyword(s):  
Primary Care Physicians ◽  
Testicular Torsion ◽  
Separate Entity ◽  
Scrotal Pain ◽  
Young Males ◽  
Testicular Pain ◽  
Acute Scrotal Pain ◽  
History Of ◽  
Scrotal Swelling ◽  
Physical Findings

Testicular torsion is the most common cause of acute scrotal pain in prepubertal and adolescent boys and should be foremost in the minds of primary care physicians evaluating these children. Intermittent testicular torsion is a separate entity that should be considered in all young males with a history of scrotal pain and swelling. Acute and intermittent sharp testicular pain and scrotal swelling, interspersed with long intervals without symptoms, are characteristic. Physical findings may include horizontal or very mobile testes, an anteriorly located epididymis, or bulkiness of the spermatic cord from partial twisting. Awareness of this entity and early elective orchiopexy will improve testicular salvage in patients with intermittent testicular torsion.

scholarly journals Isolated right testicular pain for six days: an unusual presentation of occult abdominal aortic aneurysm leak

2011 ◽  
Vol 93 (4) ◽  
pp. e1-e2 ◽  
Author(s):  
Rachael O Forsythe ◽  
Victoria Lavin ◽  
Simon CA Fraser ◽  
Alan McNeill
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Case Reports ◽  
Haemodynamic Instability ◽  
Older Patient ◽  
Testicular Pain ◽  
Lower Back ◽  
Abdominal Aortic ◽  
History Of ◽  
The Right

Abdominal aortic aneurysm (AAA) rupture commonly presents with abdominal or lower back pain and haemodynamic instability. There have been case reports of co-existing left testicular pain; however, very few cases describe right testicular pain as the sentinel symptom. We discuss the case of a 75-year-old man who presented to the on-call urologists with a 6-day history of right testicular pain. On examination, a painless AAA was detected. The patient was stable and a CT scan demonstrated a large AAA extending into the right iliac vessels, with suggestion of leakage. Attempted emergency repair was unsuccessful and the patient died in theatre. This atypical presentation of occult aneurysm leak highlights the need for clinical vigilance in the older patient with seemingly benign groin symptoms, including isolated right testicular pain.

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) with painful erythematous nodules

2020 ◽  
Vol 13 (4) ◽  
pp. e234197
Author(s):  
Nicholas Kevin Laidler ◽  
Thomas Delaney
Keyword(s):  
Tertiary Hospital ◽  
Acute Onset ◽  
General Malaise ◽  
Metastatic Adenocarcinoma ◽  
Cutaneous Manifestations ◽  
Hands On ◽  
History Of ◽  
Recent Diagnosis ◽  
The Right ◽  
Pitting Edema

Remitting seronegative symmetric synovitis with pitting edema (RS3PE) is an uncommon syndrome characterised by acute onset severe synovitis of the radiocarpal and small joints of the hands, with associated pitting edema. Discussed here is the case of a 69-year-old man who presented to the emergency department of a tertiary hospital with acute bilateral hand swelling. This was on a background of a recent diagnosis of metastatic adenocarcinoma of the caecum and subsequent hemicolectomy. There was a history of general malaise, fever and lethargy for 5 days prior to the swelling of the hands. On examination, the upper limbs were swollen to the elbow bilaterally. Painful erythematous nodules were noted on the dorsal and palmar aspects of the hands and violaceous periungual discolouration was observed on the right fourth and fifth fingers. Prednisolone was commenced resulting in a dramatic resolution of the articular and cutaneous manifestations within 3 weeks.

scholarly journals Resistance to Boscalid Fungicide in Alternaria alternata Isolates from Pistachio in California

Plant Disease ◽  
2007 ◽  
Vol 91 (10) ◽  
pp. 1345-1350 ◽  
Author(s):  
Herve F. Avenot ◽  
Themis J. Michailides
Keyword(s):  
Spore Germination ◽  
Alternaria Alternata ◽  
Hyphal Growth ◽  
Conidial Germination ◽  
Prior History ◽  
In Vitro Tests ◽  
Fitness Parameters ◽  
History Of ◽  
The Mean

Boscalid is a new carboxamide fungicide recently introduced in a mixture with pyraclostrobin in the product Pristine for the control of Alternaria late blight of pistachio. In all, 108 isolates of Alternaria alternata were collected from pistachio orchards with (59 isolates) and without (49 isolates) prior exposure to boscalid. The sensitivity to boscalid was determined in conidial germination assays. The majority of isolates from two orchards without a prior history of boscalid usage had effective fungicide concentration to inhibit 50% of spore germination (EC50) values ranging from 0.089 to 3.435 μg/ml, and the mean EC50 was 1.515 μg/ml. Out of 59 isolates collected from an orchard with a history of boscalid usage, 52 isolates had EC50 values ranging from 0.055 to 4.222 μg/ml, and the mean EC50 was 1.214 μg/ml. However, in vitro tests for conidial germination and mycelial growth also revealed that seven A. alternata isolates, originating from the orchard exposed to boscalid were highly resistant (EC50 > 100 μg/ml) to this fungicide. Furthermore, in vitro tests showed no significant differences between wild-type and boscalid-resistant mutants in some fitness parameters such as spore germination, hyphal growth, sporulation, or virulence on pistachio leaves. Experiments on the stability of the boscalid-resistant phenotype showed no reduction of the resistance after the mutants were grown on fungicide-free medium. Preventative applications of a commercial formulation of boscalid (Endura) at a concentration which is effective against naturally sensitive isolates failed to control disease caused by the boscalid-resistant isolates in laboratory tests. To our knowledge, this is first report of field isolates of fungi resistant to boscalid.

Incarcerated inguinal hernia? No, acute pancreatitis

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 770-772 ◽  
Author(s):  
Jose Ramia-Angel ◽  
Eloy Sancho ◽  
Rafael Lozoya ◽  
Andrej Gasz ◽  
Jose Santos
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Pancreatitis ◽  
Incarcerated Hernia ◽  
Intravenous Antibiotic ◽  
Incarcerated Inguinal Hernia ◽  
Testicular Pain ◽  
Inguinal Area ◽  
History Of ◽  
The Right

AbstractA 62-year-old man presented to the Emergency Department with a 2-day history of right testicular pain. The initial diagnosis was orchiepididymitis (later found to be mistaken), and intravenous antibiotic treatment was started. Twenty-four hours later, the patient had mild pain in the right inguinal area and right infra-abdominal area. We performed an inguinal ultrasound that showed an incarcerated mass of mixed echogenicity in the right inguinal area. Surgery was performed because we thought the patient had an inguinal incarcerated hernia. Two days after the surgical procedure, the patient began to have fever and erythema and pain in the back. Abdominal computed tomography (CT) showed an acute pancreatitis with a peripancreatic collection from the pancreas to right inguinal area. We have reviewed similar cases in the literature and note that, infrequently, an inguinal mass can be the first sign of mostly asymptomatic acute pancreatitis.

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