1/4. Xanthogranulomatous funiculitis and epididymo-orchitis in a tetraplegic patient.STUDY DESIGN: A case report of xanthogranulomatous funiculitis and epididymo-orchitis. Xanthogranulomatous inflammation is an uncommon, non-neoplastic process characterised by destruction of tissue, which is replaced by a striking cellular infiltrate of lipid-laden macrophages. CASE REPORT: A 21-year male sustained complete tetraplegia at C-6 level, after a fall in 1998. The neuropathic bladder was managed with an indwelling urethral catheter. He had many unsuccessful trials of micturition. Sixteen months after the cervical injury, he noticed swelling of the left side of the scrotum following removal of a blocked catheter. He was prescribed antibacterial therapy. Four weeks later, physical examination revealed a hard and irregular swelling encompassing the testis, epididymis and spermatic cord. The clinical diagnosis was epididymo-orchitis progressing to pyocele. Through a scrotal incision, the swollen testis, epididymis and diseased segment of the spermatic cord were removed en masse. Histopathology showed extensive areas of necrosis, with xanthogranulomatous inflammation in the spermatic cord and to a lesser extent in the testis/epididymis. CONCLUSION: Repeated episodes of high-pressure urinary reflux along the vas deferens during dyssynergic voiding, and subsequent interstitial extravasation of urine together with chronic, low-grade, suppurative infection possibly led to development of xanthogranulomatous inflammation in the testis and the epididymis. Since tissue destruction is a feature of xanthogranulomatous inflammation, the definite and curative treatment is either complete (or, where applicable, partial) excision of the affected organ in most of the cases.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/4. Testicular torsion or acute epididymitis? diagnosis and treatment.The differentiation between torsion and epididymitis can be extremely difficult because only 50% or less of cases involving testicular torsion exhibit the classically expected findings. Therefore a careful history and complete analysis of the physical and laboratory findings are warranted. When needed, the judicious use of collaborative tests will point the clinician toward the appropriate diagnosis.- - - - - - - - - - ranking = 0.052035095571528keywords = physical (Clic here for more details about this article) |
3/4. Liquid crystal thermography of the testicles in the diagnosis of infertility.The use of liquid crystal thermography (LCT) of the testicles in diagnosis of infertility was investigated. varicocele, the most common cause of male infertility, is easily detectable by LCT. The technique may be used as a control after surgical treatment. In the majority of patients with oligo-azoospermia, LCT corresponded to physical examination of the testicles. In patients with oligo-azoospermia and both testicles normal to palpation, LCT is useful method for determining the colder testicle for biopsy purposes.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/4. Epididymo-orchitis in an infant resulting from escherichia coli urinary tract infection.Epididymo-orchitis (EO) is said to be extremely rare in infants and children. It is usually diagnosed after scrotal exploration for symptoms which mimic manifestations between EO and torsion of the cord and its appendage. The pathophysiologic mechanisms for the development of EO are not well known. Although some causative agents of EO have been reported, in most cases there was no clear etiology. We report a 3-month-old male infant who had been well until the day prior to admission when irritability, left testicular swelling, scrotal erythema with a hot sensation were noted by his mother. He was treated medically after excluding the possibility of an emergent surgical condition (such as torsion of the cord and its appendage, or incarcerated hernia) by means of physical examinations, abdominal and inguino-scrotal sonography, laboratory studies, and testicular radionuclide scintigraphy. A catheterized sample of urine for culture yielded escherichia coli. There was the possibility that the EO was caused by hematogenous rather than local spread from an infection of the urinary tract. He was treated with a 10-day course of intravenous cefazolin and amikacin. Following this, he improved clinically and a repeat catheterized urine sample remained sterile on culture. In addition, a bilateral inguinal hernia and hydrocele were detected by inguino-scrotal sonography and were operated on the 11th hospital day. He was discharged on the 16th day of hospitalization and remained well 11 months after discharge.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |