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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

32 boys with symptoms of an acute scrotum had testicular sonography with color flow imaging (CFI). Patients ranged in age from 4-15 years (avg = 11 yrs). Symptoms were present from 12 h to 5 days (avg = 42 hrs). CFI correctly predicted presence or absence of testicular perfusion in 11 boys who had surgical exploration of the scrotum. 8 of these 11 patients had hemorrhagic infarction of the testicle, 1 had torsion of the appendix epididymis, 1 had epididymitis, and 1 had bilateral incomplete torsions with normal testicular perfusion. The remaining 21 patients did not have an operation. At least a 1 year follow-up of all patients has shown no clinical evidence of testicular atrophy to suggest a missed diagnosis of torsion. Absence or markedly decreased testicular flow was easily identified and indicates testicular ischemia/infarction. Conversely, hyperemia of the testis and/or epididymis is usually associated with trauma or infection. However, incomplete torsion or spontaneous detorsion may demonstrate normal testicular flow on CFI. Only close correlation of clinical symptomatology and gray scale findings with CFI can identify these patients, who remain at high risk for subsequent complete torsion and infarction.
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PMID:Color flow imaging in children with clinically suspected testicular torsion. 140 49

Three patients developed severe ischemia of the penis or scrotum from acute arterial occlusion. In one case, nonhealing ulceration of the glans developed after atheroembolism to the dorsal penile artery. One patient had penile ischemia after ligation of pelvic and femoral collateral circulation during repair of an aorto-bilateral-iliac artery aneurysm. A third patient had ischemia of the penis and scrotum from thromboembolism to the iliac arteries during repair of an aortoenteric fistula. Only seven patients have been described with acute arterial occlusion and severe ischemia of the male genitalia. A rare phenomenon because of rich collateral circulation, acute ischemia of the genitalia nevertheless must be recognized as a sign of severe vascular disease and a consequence of major arterial ligation or occlusion in the pelvis and groins.
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PMID:Acute arterial insufficiency of the male genitalia. 187 96

Color Doppler sonography was performed in 32 patients with a painful scrotum in whom testicular ischemia from torsion or postherniorrhaphy was clinically suspected. Surgical correlation was available in 15 patients, and scintigraphic correlation was available in 17 patients. Seven of the 32 patients were diagnosed as having testicular ischemia from torsion. Color Doppler flow imaging demonstrated a lack of intratesticular flow in six of the seven testes with torsion and relatively normal intratesticular flow in one of the patients with acute torsion. Normal or increased intratesticular flow was demonstrated by color Doppler in all 57 of the nonischemic testes. Using the single criterion of presence or absence of identifiable intratesticular flow, the authors found that color Doppler was 86% sensitive, 100% specific, and 97% accurate in the diagnosis of torsion and ischemia in the painful scrotum. Color Doppler sonography is an accurate, noninvasive means of rapidly assessing perfusion of the testis in the painful scrotum.
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PMID:Suspected testicular torsion and ischemia: evaluation with color Doppler sonography. 218 1

The ischemic effects of prolonged testicular torsion have been well documented; however, prevention or arrest of the damaging effects of prolonged ischemia has been incompletely studied. Two groups of Sprague-Dawley rats were subjected to varying lengths of bilateral testicular ischemia. Group I underwent normothermic ischemia for two, four, and six hours. Likewise, Group II underwent similar time periods of ischemia, however, after thirty minutes of normothermic ischemia the scrotum of each animal was placed into an ice bath maintained at 4C. Two weeks postoperatively, bilateral orchiectomy was performed. Histology of the testes of the two groups was compared. Neither group revealed significant destruction of the germinal epithelium after two hours of ischemia. Group I revealed only 25% preservation of the germinal epithelium at four hours and only 8% preservation at six hours of ischemia. In contrast, Group II which received ice showed 90% preservation of germinal epithelium at four hours and 85% preservation at six hours of ischemia. We conclude that external ice application significantly preserves seminiferous tubules at four and six hours of ischemic injury in the rat testicle.
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PMID:Effects of hypothermia on testicular ischemia. 232 95

The acute scrotum remains a difficult clinical challenge because of numerous etiologies including inflammatory processes, testicular torsions, traumas, and tumors that can justify early surgery. Ultrasound study appears to be the imaging modality of choice to confirm the clinical assessment. We reviewed 825 scrotal scans performed with high-resolution scanners; 283 were considered pathologic and classified as follows: 27 tumors (9.5%), 21 traumas including torsions (7.4%), 142 infectious diseases (50.1%), 99 dystrophic diseases (29.2%), and 16 miscellaneous (5.6%). Acute scrotal pain was the only symptom in 83 cases (29.3%). In this paper, we emphasize the different roles of ultrasound depending on the initial clinical presentation, which determines the clinician's questions. In the typical cases, ultrasound has a major role in the prognosis, as it allows evaluation of the severity of the lesions. On the other hand, in atypical cases, ultrasound has a decisive role in planning the management, which will be immediate surgery when sonographic findings highly suspicious for testicular torsion or acute ischemia of the testis are found. Based on our experience, we believe that ultrasound is a highly reliable modality for guiding medical or surgical treatment of an acute scrotum.
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PMID:Ultrasonography of the acute scrotum. 310 22

To our knowledge there has been no report to date of successful testis replantation after complete traumatic severance of the funiculus within the scrotum. We report a case in which both funiculi were cut completely (one of which was severed 0.8 cm. proximal to the upper pole of the testis, and the other just at the junction of the funiculus and the testis). We successfully rejoined the testis with the funicular stump to the proximal cut end of the right side using a microsurgical technique. The total ischemia period of the replanted testis was 6 hours. The penis was erect 4 days postoperatively and blood testosterone level was within the normal range. At testicular biopsy 120 days postoperatively the germ cells could be seen in various stages of development and the appearance of the Leydig cells was normal.
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PMID:Replantation of the testis: report of a case. 334 50

Abdominal testes represent 15 to 25% of all cases of cryptorchidism. In 5% the testis is so high in the abdomen that it is impossible to perform a conventional orchidopexy. The authors report an experience of 5 cases of testicular autotransplantation achieved by temporarily severing the testicular vessels and then reanastomosing them to the inferior epigastric vessels using a microsurgical technique with an operating microscope at 25 times magnification. Compared to traditional methods, autotransplantation permits an easy replacement of an ectopic testis into the scrotum and a more physiological blood supply to the testis. The authors discuss surgical and microsurgical techniques, testicular ischemia time and follow-up of patients who have undergone autotransplantation.
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PMID:Microsurgical testis autotransplantation. A critical review. 613 19

A 58-year-old man was admitted to a community hospital following an overdose of nifedipine. Military antishock trousers (MAST) were applied to combat severe hypotension. Blood pressure was restored to 110/50 mm Hg three hours after admission, but the patient remained comatose. Subsequent to MAST garment removal, ischemia of both legs and scrotum was observed; at surgery, both iliofemoral systems were occluded from the aortic bifurcation to the feet. The patient never regained consciousness and died from recurrent ventricular tachycardia. The possible contributing role of the MAST garment in producing lower extremity ischemia is discussed.
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PMID:Lower extremity ischemia associated with use of military antishock trousers. 650 75

The author reports the case of a patient presenting with a recurrent right hydrocele after tapping, associated with an infectious syndrome resulting in a swollen and painful right compartment of the scrotum, which failed to respond to antibiotic treatment. A right scrotal incision revealed a vaginal empyema and a swollen and enflamed testicle and epididymis. After a right ochiectomy, an anatomopathological examination showed a severe ischemia of the testicle and epididymis associated with arteriosclerotic stenosis of the testicular artery.
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PMID:[Spontaneous orchi-epididymitis due to necrosis of ischemic vascular origin]. 652 90

The clinical courses in 39 children with NEC were studied to answer questions about pathogeny and the indication for surgical treatment. Anamnestic, clinical and hematological findings show an ischemia to be the "conditio sine qua non". Disseminated intravascular coagulation does not seem to be the primary cause of the disease. Whether bacterial infections of the intestinal wall are of importance in the pathogeny cannot sufficiently be proven on the available findings. The clinical symptoms, the number of platelets and the level of serum-sodium make it possible to classify NEC in four stages with typical morphologic appearance. The results of an early and of a late treatment by operation are compared and it is deduced that the best moment for surgical intervention will be the change from stage II to stage III. Symptoms of stages II/III are the progressive clinical course with increasing intestinal bleeding, edema of the abdominal wall and scrotum, thrombopenia and low sodium level.
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PMID:[Necrotizing enterocolitis (NEC) - pathogenesis and therapy (author's transl)]. 728 80


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