Testicular Torsion in Cerebropalsy Patient with Undescended Testis: Do Not Misdiagnose it!

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.

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TESTICULAR TORSION OF UNDESCENDED TESTIS IN A CHILD

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.03.2389 ◽

2011 ◽

Vol 18 (03) ◽

pp. 535-537

Author(s):

MAQSOOD AHMAD ◽

MUMTAZ AHMAD ◽

MUHAMMAD SAQIB

Keyword(s):

Differential Diagnosis ◽

Early Diagnosis ◽

Physical Examination ◽

Blood Supply ◽

Spermatic Cord ◽

Testicular Torsion ◽

Undescended Testis ◽

Accurate Diagnosis ◽

Acute Scrotum ◽

Prompt Treatment

The children presenting with acute scrotum have many diseases in differential diagnosis and testicular torsion in undescended testis and normal testis is an important consideration. Torsion of the testis, or more correctly, torsion of the spermatic cord, is a surgical emergency because it causes strangulation of gonadal blood supply with subsequent testicular necrosis and atrophy. In most of cases history and physical examination are sufficient to make an accurate diagnosis. While other causes may require simple treatment but torsion require immediate exploration to save the testis. Early diagnosis and prompt treatment is essential to help such children.

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Case of primary hepatic leiomyosarcoma successfully treated with laparoscopic right hepatectomy

BMJ Case Reports ◽

10.1136/bcr-2019-233567 ◽

2020 ◽

Vol 13 (2) ◽

pp. e233567 ◽

Cited By ~ 1

Author(s):

Stephanie Vella ◽

Kelvin Cortis ◽

David Pisani ◽

James Pocock ◽

Luca Aldrighetti

Keyword(s):

Physical Examination ◽

Surgical Resection ◽

Epigastric Pain ◽

Large Mass ◽

Disease Recurrence ◽

Right Hepatectomy ◽

Liver Lobe ◽

Laparoscopic Right Hepatectomy ◽

The Right

We describe the case of a 77-year-old woman, presenting with non-specific epigastric pain. Physical examination and subsequent imaging revealed the presence of a large mass in the right liver lobe. This was shown to be a leiomyosarcoma on biopsy histology. Further investigation confirmed this to be a primary hepatic leiomyosarcoma with no evidence of metastases. The patient underwent successful surgical resection. She is currently under imaging follow-up, with no evidence of disease recurrence.

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Phaeohyphomycotic osteomyelitis in the femur of a cat

Journal of Feline Medicine and Surgery ◽

10.1016/j.jfms.2009.04.003 ◽

2009 ◽

Vol 11 (10) ◽

pp. 878-880 ◽

Cited By ~ 2

Author(s):

Michal O. Hess

Keyword(s):

Physical Examination ◽

Distal Femur ◽

Lytic Lesion ◽

High Dose ◽

Dimorphic Fungus ◽

Cytological Examination ◽

The Right ◽

Lost To Follow Up ◽

Deep Fungal Infection

A 4-month-old castrated male domestic shorthair cat was presented for a right hind leg lameness of 1-week duration. Physical examination revealed a painful swelling over the right distal femur. A radiograph of the right stifle revealed an extensive lytic lesion involving the distal metaphysis of the right femur. Cytological examination of a needle aspirate was consistent with a deep fungal infection. A pigmented dimorphic fungus was isolated in pure culture from a representative needle aspirate from the lesion. The patient improved substantially after 5 weeks of high-dose itraconazole therapy, although it was subsequently lost to follow-up.

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Perineal Hernia in a Bitch

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.100110 ◽

2020 ◽

Vol 48 ◽

Author(s):

Ângela Valentina De La Porta Machado ◽

Gabriela Lugoch ◽

Ana Paula Ibarra dos Santos ◽

Maria Eduarda Pons Gonçalves ◽

Marília Teresa De Oliveira ◽

...

Keyword(s):

Physical Examination ◽

Surgical Procedure ◽

Perineal Hernia ◽

Inguinal Region ◽

Ultrasound Scan ◽

Hernia Sac ◽

Pelvic Diaphragm ◽

Perineal Region ◽

The Right ◽

Left Inguinal Region

Background: Perineal hernia is characterized by the displacement of abdominal organs to the perineal region after rupture or weakening of the pelvic diaphragm muscles. This condition is common among middle-aged and elderly unneutered male dogs. Considering the severity of the condition and its rarity among bitches, this paper reports on a case of perineal hernia caused by hydrometra in a 12-year-old pinscher bitch.Case: The patient was a 12-year-old Pinscher bitch, weighing 3 kg, suffering from anuria and constipation in the 36 h prior to treatment, without reported trauma. She was unspayed, and her last estrus had occurred approximately thirty days previously. The physical examination revealed an increase in volume in the right perineal region, increased volume in the left inguinal region, increased body temperature (39.8ºC), pale mucous membranes, tachycardia, tachypnea, abdominal pain and increased popliteal lymph nodes. The diagnosis was determined based on her medical history, clinical signs and an ultrasound scan, which revealed dilated uterine horns displaced unilaterally in the left inguinal region, with evidence of hydrometra, full urinary bladder inside the hernia sac in the right dorsolateral perineal region and right kidney pyelectasis. After evaluating the animal’s physical condition, surgery was recommended, involving ovariohysterectomy associated with inguinal and perineal herniorrhaphy.Discussion: Perineal hernia, a common condition in male dogs, is characterized by the displacement of organs towards the perineal region. However, in this case, this condition occurred in female dog. Unlike males, the main causes of perineal hernia in females are trauma, chronic coughing related to heart disease, bronchitis, and tracheal collapse. Increased intra-abdominal pressure associated with a weak pelvic diaphragm predisposes for herniation of abdominal contents, such as occurred through hydrometra. In this case, other factors that could pertain to the etiology of perineal hernia were excluded, given the absence of trauma or secondary diseases. The diagnosis was made based on a physical examination and ultrasound scan. Pre-surgical biochemical blood tests were also performed. The chosen treatment was ovariohysterectomy followed by inguinal and perineal herniorrhaphy. The traditional surgical procedure to reduce the perineal hernia was employed, using approximation sutures due to the easy apposition of wound edges. The structures and soft tissues involved showed no changes in color or texture, thus obviating the need for more elaborate techniques, which are employed in the case of relapse or muscle atrophy. The patient showed clinical evolution after surgical correction, with decreased perineal volume and recovery of urinary function (normuria). The patient was discharged after 72 h, and six months after the surgical procedure, she presented no clinical alteration, according to information provided in a telephone call by her owner. It is believed that the increase in volume caused by the presence of hydrometra was the determining factor for the development of inguinal and perineal hernias. It is suggested that alterations causing uterine enlargement be investigated in order to include perineal hernia in female dogs as a differential diagnostic tool.

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Bilateral Simultaneous Testicular Torsion in a Newborn: Report of a Case

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.4 ◽

2017 ◽

Vol 60 (3) ◽

pp. 120-123 ◽

Cited By ~ 1

Author(s):

Zenon Pogorelić ◽

Miro Jukić ◽

Veselin Škrabić ◽

Ivana Mrklić ◽

Vesna Fridl Vidas ◽

...

Keyword(s):

Testicular Torsion ◽

Acute Ischemia ◽

Left Testis ◽

Ischaemic Injury ◽

Left Testicle ◽

Blood Flow Signal ◽

Scrotal Swelling ◽

Urological Emergency ◽

The Right

Introduction: Testicular torsion is a urological emergency. If not recognized in time, this condition may result in ischaemic injury and loss of testis. Simultaneous bilateral neonatal testicular torsion is extremely rare and is usually misdiagnosed. Case report: We report a case of a male newborn, who presented with bilateral scrotal swelling and redness of the scrotum. Doppler ultrasound supported the diagnosis of bilateral testicular torsion, with an absent blood flow signal on the right side and a weak signal on the left side. Testicular exploration through scrotal incision was performed and bilateral testicular torsion was found. Right testis was grossly gangrenous, and right orchiectomy was performed. Left testicle was dark but showed recovery after detorsion with some bleeding from incised tunica albugenia. Fixation of the left testicle was performed. At six month follow-up, the left testis showed signs of atrophy and hormonal assay showed very low testosterone and elevated LH and FSH, suggesting hypogonadism. Conclusions: Management of neonatal testicular torsion is a matter of controversy. Testicular torsion results into acute ischemia and urgent surgical exploration is the key point of management. Although the possibility of salvaging the involved testicles is usually very low it is hard to justify a passive approach to a bilateral torsion resulting in such a devastating condition as anorchia.

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Experiences with surgical management of undescended testis at a tertiary care hospital in north-western Tanzania

Tanzania Journal of Health Research ◽

10.4314/thrb.v17i4.8 ◽

2015 ◽

Vol 17 (4) ◽

Author(s):

Steven Kadilo ◽

Mange Manyama ◽

Neema M. Kayange ◽

Phillipo L. Chalya

Keyword(s):

Undescended Testis ◽

Tertiary Care ◽

Single Stage ◽

Published Data ◽

Care Hospital ◽

Awareness Campaign ◽

Early Presentation ◽

Birth Attendants ◽

The Right

Background: Undescended testes (UDT) are prone to a lot of complications but early detection and correction give good results. There is paucity of published data on UDT in our setting. This study describes the clinical presentation, management and outcome of this condition at Bugando Medical Centre (BMC) in northwestern TanzaniaMethods: This was a retrospective study of patients who were admitted and operated for undescended testis at BMC between July 2006 and June 2014. Results: A total of 84 patients with 102 UDT were studied. Forty-six (54.9%) patients were aged above 5 years. Majority (72.5%) UDT were non-palpable. The right side was involved in 54.8%; left side in 23.8% while 21.4% were bilateral. Associated inguinal hernia was reported in 48 (77.4%) patients. Ultrasonography was performed in 34 (45.9%) patients with non-palpable testes and was used to locate 12(35.3%) testes. Laparoscopy was not used in any patient. At surgery, 54 (52.9%) testes were found in the inguinal canal, 28 (27.5%) in the superficial inguinal pouch, 10 (9.8%) in the abdomen and 10 (9.8%) testes were not found. Out of the 92 (90.2%) visible testes, 69 (75.0%) underwent orchidopexy (single stage in 54 (78.3%) testes and multistage in 15 (21.7%) testes) and 23 (25.0%) orchidectomy. Single stage procedures were more likely in patients less than 5 years, with palpable testes and those with testes located at the superficial inguinal pouch (p < 0.001). Postoperative complications were recorded in 8(9.5%) patients. The overall success rate of treatment was 95.7%. In this study, only 12 (14.3%) patients were available for follow up at 12 months after discharge.Conclusion: Patients with UDT presented late in our hospital because diagnosis by birth attendants was rarely made even though the anomaly was obvious at birth. The parents, patients themselves and development of complications drew attention to undescended testis. Health awareness campaign, thorough genital examination after birth and regular screening of toddlers for UDT may result in early presentation

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Intraosseous Stab Wound of Scapula: A Case Report

Journal of Orthopedic and Spine Trauma ◽

10.18502/jost.v5i4.4383 ◽

2020 ◽

Author(s):

Mohsen Rezaei Nosrati ◽

Salar Baghbani ◽

Yousef Fallah ◽

Babak Siavashi ◽

Mohammad Reza Golbakhsh

Keyword(s):

Quality Of Life ◽

Case Report ◽

Physical Examination ◽

Stab Wound ◽

Stab Wounds ◽

Iatrogenic Injuries ◽

Physical Examinations ◽

The Right

Background: Intraosseous stab wounds are extremely rare. Only a few cases have been reported in the upper extremity. Case Report: In this report, we presented a case of stab wound to the right shoulder with penetration to the scapula. The patient was successfully managed in a team-based approach. During a 12-month follow-up, he showed no abnormality in passive and active movements or physical examination. Conclusion: Relying on the physical examinations and paraclinical studies may be an appropriate substitution for exploration surgery when possible iatrogenic injuries may affect the patient's quality of life.

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Endoscope-Assisted Microsurgical Removal of an Optic Foramen Meningioma through a Frontolateral Minicraniotomy

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0037-1620246 ◽

2018 ◽

Vol 79 (S 02) ◽

pp. S227-S228 ◽

Cited By ~ 2

Author(s):

Peter Kurucz ◽

Holger Opitz ◽

Michael Buchfelder ◽

Oliver Ganslandt

Keyword(s):

Male Patient ◽

Visual Disturbance ◽

Skin Incision ◽

Optic Canal ◽

Visual Recovery ◽

Microsurgical Technique ◽

The Right

AbstractA 72-year-old male patient with visual disturbance of the right eye was diagnosed with a small meningioma of the right optic foramen extending to the carotid cistern. The operation was performed through an individually tailored frontolateral minicraniotomy via a curvilinear skin incision behind the hairline. Endoscope-assisted microsurgical technique was used to resect the lesion. The roof of the optic canal was partly removed to get access to the intraforaminal tumor parts. The lesion could be completely removed and the patient showed a satisfactory visual recovery in the follow-up examinations.The link to the video can be found at: https://youtu.be/p8EZx7aryeQ.

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Corneal crosslinking in a case with Axenfeld–Rieger syndrome and unilateral pellucid marginal degeneration

Therapeutic Advances in Ophthalmology ◽

10.1177/2515841418822288 ◽

2019 ◽

Vol 11 ◽

pp. 251584141882228 ◽

Cited By ~ 1

Author(s):

Mustafa Koc ◽

Pinar Kosekahya ◽

Merve Inanc ◽

Kemal Tekin

Keyword(s):

Visual Acuity ◽

Male Patient ◽

Vision Loss ◽

Slit Lamp ◽

Slit Lamp Examination ◽

Corneal Crosslinking ◽

Rieger Syndrome ◽

Corrected Distance Visual Acuity ◽

The Right

A 31-year-old male patient presented with the complaint of progressive vision loss in his left eye. Slit-lamp examination showed posterior embryotoxon, iris hypoplasia, and iridocorneal adhesion in both eyes, corectopia in the right, and peripheral inferior thinning and ectasia in the left eye. Corneal topography showed slightly asymmetric bowtie pattern in the right eye and crab-claw pattern in the left eye. Topographic examination was compared with his previous topography. The comparison showed 1.6-D steepening of maximum keratometry ( Kmax) and 22-µm decrease of thinnest corneal pachymetry. Corneal crosslinking treatment was performed on the left eye. At the postoperative 28-month follow-up visit, Kmax decreased from 54.1 to 53.0 D and corrected distance visual acuity improved to 20/20 with scleral lens. This is the first reported a case with Axenfeld–Rieger syndrome and pellucid marginal degeneration association. We suggest that corneal crosslinking can be useful for management of pellucid marginal degeneration and longer follow-up might be needed in order to corroborate the effectiveness of the corneal crosslinking procedure.

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