ABSTRACT
This study was conducted to compare the clinicopathologic characteristics of incidentally found and symptomatic cases of Meckel’s diverticulum with the aim of arriving at a recommendation regarding the management of incidental cases. A retrospective chart review was performed over a period of 24 years. Incidental group had 52 patients and symptomatic group had 128 patients(71%). Obstruction (42.9%) was the most common presentation, followed by diverticulitis (41.4%). Gastrointestinal hemorrhage was found in 33.6% and was commonly associated with obstruction. If the diverticulum has umbilical connection, mesodiverticular band or heterogeneous on palpation, and if patient has no contraindication for diverticulectomy, we advocate prophylactic resection to avoid future life threating complications.
ABSTRACT
OBJECTIVE: Acute scrotal pain is a common urological emergency. Urgent exploration is the standard means of management, since no investigation can confidently exclude torsion of testis from the differential diagnosis. METHODS: A review of all boys presenting with acute scrotal pain who underwent emergency scrotal exploration between January 1983 and March 2003 was performed. RESULTS : 195 boys were included in this study. They were divided into 3 groups: group 1-73 with epididymo-orchitis, group 2-63 with torsion of testicular appendages and group 3- 57 with spermatic cord torsion. The patients in group 2 were older than group 1, also patients in group 1 were older than group 3. During neonatal period the most common pathology was spermatic cord torsion, whereas in prepubertal period torsion of appendages was more common. In all boys, mean duration of pain at presentation was 2.11 days. Epididymo-orchitis was diagnosed in 37% of patients, with torsion of the appendages being the next most common entity. Testicular torsion was diagnosed in 29% of patients. In the group with testicular torsion salvage rate of testis was 37% because of late admission. The perioperative morbidity and mortality was not seen in any of the groups. CONCLUSION: We believe that any boy with acute scrotal pain and any suspicion of testicular torsion in physical examination must be applied routine surgical exploration.