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Lorenzo E. Derchi - One of the best experts on this subject based on the ideXlab platform.

  • Nonscrotal Causes of Acute Scrotum
    Journal of Ultrasound in Medicine, 2020
    Co-Authors: Irene Campo, Massimo Valentino, Paul S. Sidhu, Luca Magi Meconi, Sandy Van Nieuwenhove, Maria Assunta Cova, Lorenzo E. Derchi, Michele Bertolotto
    Abstract:

    Acute Scrotum is characterized by intense Acute scrotal pain, which may be associated with other symptoms and signs such as abdominal pain, inflammation, and fever. Many pathologic conditions can present in this way, most which involve the scrotal contents. Nonscrotal conditions, however, can rarely present clinically only as Acute Scrotum: among them, renal colic, aneurysm rupture or other causes of retroperitoneal hemorrhage, primary abdominal or pelvic tumors and metastases, pancreatitis, pelvic inflammation, and muscle injuries. The pathophysiologic characteristics of the clinical presentation, clues for diagnosis, and imaging features of a series of nonscrotal lesions presenting clinically with Acute scrotal pain are herein reported and illustrated. In patients presenting with Acute scrotal symptoms and normal scrotal ultrasound findings, nonscrotal causes of Acute scrotal pain should be considered in the differential diagnosis. Therefore, an ultrasound investigation of the abdomen, groin, and thighs is indicated.

  • tension hydrocele as an additional cause of Acute Scrotum case series and literature review
    Abdominal Radiology, 2020
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.

  • Tension hydrocele as an additional cause of Acute Scrotum: case series and literature review
    Abdominal Radiology, 2019
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    Purpose To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. Methods and materials We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. Results All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. Conclusion To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.

Jeries P Zawaideh - One of the best experts on this subject based on the ideXlab platform.

  • tension hydrocele as an additional cause of Acute Scrotum case series and literature review
    Abdominal Radiology, 2020
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.

  • Tension hydrocele as an additional cause of Acute Scrotum: case series and literature review
    Abdominal Radiology, 2019
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    Purpose To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. Methods and materials We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. Results All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. Conclusion To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.

B Goldwasser - One of the best experts on this subject based on the ideXlab platform.

  • Acute Scrotum caused by henoch schonlein purpura with immediate response to short term steroid therapy
    Journal of Pediatric Surgery, 1995
    Co-Authors: Jacob Benchaim, Endu Korat, Ofer Z Shenfeld, Ariyeh Shelhav, P Jonas, B Goldwasser
    Abstract:

    The authors report a case of Acute Scrotum caused by Henoch-Schonlein purpura. It involved bilateral swelling of the epididymis and testes, which was documented by scrotal ultrasonography and which responded immediately to systemic steroid treatment.

  • etiology of Acute Scrotum at surgical exploration in children adolescents and adults
    European Urology, 1992
    Co-Authors: Jacob Benchaim, Ilan Leibovitch, Jacob Ramon, D Winberg, B Goldwasser
    Abstract:

    Between January 1970 and December 1989, 171 patients underwent scrotal exploration for Acute Scrotum (an Acute painful swelling of the Scrotum or its content), at our hospital. Of 70 children scrotal explorations, torsion of appendages was found in 33 cases (47%). Torsion of testis was found in 24 patients (34%). Of the 84 adolescent scrotal explorations performed, 72 (86%) had torsion of testis, and 8 (9%) had torsion of appendages. Of 17 adults, torsion of testis was found in 15 cases (88%). These results clarify that unnecessary explorations are much more common in children (66%) than in adolescents and adults (14%). We therefore suggest using radionuclear scans and/or Doppler ultrasound to facilitate clinical diagnosis in the children group.

Emma Sanchez - One of the best experts on this subject based on the ideXlab platform.

  • transscrotal near infrared spectroscopy as a diagnostic test for testis torsion in pediatric Acute Scrotum a prospective comparison to gold standard diagnostic test study
    The Journal of Urology, 2017
    Co-Authors: Bruce J Schlomer, Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma Sanchez
    Abstract:

    Purpose: A rapid test for testicular torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular torsion.Materials and Methods: This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular torsion. The gold standard for torsion diagnosis was standard clinical care. From 2013 to 2015 males with Acute Scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose testis torsion was described with ROC curves.Results: Of 154 eligible patients 121 had near infrared spectroscopy read...

Felice Durand - One of the best experts on this subject based on the ideXlab platform.

  • tension hydrocele as an additional cause of Acute Scrotum case series and literature review
    Abdominal Radiology, 2020
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.

  • Tension hydrocele as an additional cause of Acute Scrotum: case series and literature review
    Abdominal Radiology, 2019
    Co-Authors: Jeries P Zawaideh, Michele Bertolotto, Massimo Giannoni, Giovanni Piaggio, Felice Durand, Lorenzo E. Derchi
    Abstract:

    Purpose To describe the correlation between Acute Scrotum pain and tension hydrocele, focusing on US and Doppler features. Methods and materials We evaluated retrospectively a series of five patients with a long history of hydrocele who were referred to our institutions for increasing Acute scrotal pain. Patients were approached with gray scale US of both testes, as well as with color-Doppler and spectral analysis, comparing the results with those after aspiration and symptoms relief. Results All patients had a “simple” hydrocele with no internal septa; the involved testicles had a “flattened” appearance and parenchymal Doppler signals showed increased intratesticular vascular resistance. One patient had a low diastolic flow, compared to the contralateral testis, with an increased RI value, one had no diastolic flow, two patients had retrograde diastolic flow, and the remaining one had no intratesticular flow visible. After decompression, there were disappearance of pain and improved flow with normalization of testicular vascularity; post-ischemic hyperemia was appreciated in the two patients examined immediately after fluid aspiration, while normal flow was seen in three studies carried out the day after. Conclusion To conclude, tension hydrocele is a rare condition that produces alterations of form and circulation of testicles, increase of intraparenchymal vascular resistances and strong and continuous pain, mimicking a testicular torsion. The increase in pressure produces an effect similar to that observed in a compartment syndrome. US findings, together with clinical assessment, indicate when emergency decompression may be appropriate to relieve testicular ischemia.