Torsion of Appendix of Testis - Masquerading as Acute Epididymitis

A case of torsion of the appendix of testis is described in a 11 years old boy. He presented with sudden onset of severe pain in the left testis of 2 hour duration. Emergency exploration of the left testis revealed a torsion appendix of the left testis. The appendix of the testis was excised and the wound was closed. The patient made a smooth post-operative recovery

Inferior Pelvicalyceal Anatomy – An Important Determinant of Residual Stone Clearance after Shock Wave Lithotripsy.

Background: Shock wave lithotripsy (SWL) has revolutionized the treatment of renal stones. Clearance of stones after SWL depends upon a multitude of factors. The purpose of this study was to evaluate the effect of inferior calyceal anatomy on the stone clearance after SWL for renal stones. Methods: The study included a total 52 patients with age between 21 and 81 years admitted in our hospital with renal stones who were treated with SWL. The factors studied were- Infundibulo-pelvic angle (IPA), Infundibular length (IL), Infundibular width (IW) and their affect on stone clearance. Results: In the lower caliceal system three factors for stone clearance were studied; patients with an infundibulo-pelvic angle (IPA) of more than 89.3 degree had a statistically significant clearance as compared an angle less than that ( p=0.0000 ; 95% confidence interval [CI] , 0.774 to 1.1036 ); patients with an infundibular length (IL) of less than 26mm had a statistically significant clearance ( p=0.0004; 95% confidence interval [CI] , 0.616 to 0.0945 ); the infundibular width did not have a significant role in stone clearance in our study. Conclusion: In the lower calyceal system, the infundibulo-pelvic angle (IPA) and the infundibular length (IL) play a significant role in stone clearance.

Complicated UTI – A Rare Cause of Spontaneous Perirenal Hematoma.

Spontaneous renal hemorrhage is an unusual complication of urinary tract infection. A 56-year-old man, diabetic with single functional kidney was admitted with fever and abdominal pain for one day. He had pyuria and an obstructed renal moiety due to a lower ureteric stone. On evaluation, he was found to have a left perirenal hemorrhage. Drainage of the obstructed system was performed and hemorrhage was managed conservatively; in the postoperative period patient remained stable and was discharged. In conclusion, complicated urinary tract infection is a rare cause of the spontaneous perirenal hematoma and needs a high vigilance for diagnosis and management.