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The present case describes successful uterine detorsion and its therapeutic management in a non-descript goat.
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@#Intestinal obstruction secondary to sigmoid colon volvulus in pregnancy is a rare but serious complication of pregnancy with significant maternal and fetal mortality. We report the first case in this institution of volvulus of the sigmoid colon in a pregnant patient on her 30th week age of gestation that was successfully managed conservatively with flexible colonoscopic decompression and detorsion. The presenting signs and symptoms seen in this patient are the same as with a nonpregnant patient and are often nonspecific. Hence, a high level of suspicion is essential for early diagnosis. Fetal and maternal mortality rates are higher during pregnancy if the diagnosis is delayed
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Colonoscopy , DecompressionABSTRACT
@#Sigmoid volvulus is rare in the pediatric population, generally occurring in the adult age group. This is a case report of sigmoid volvulus in a pediatric patient, documenting the clinical presentation, diagnostics, endoscopic and surgical management and outcome in a16 year old male presenting with crampy abdominal pain and difficulty in bowel movement. Abdominal x-ray revealed a dilated sigmoid colon in an inverted-U configuration. Emergency endoscopic detorsion was done with subsequent elective sigmoidectomy. Although sigmoid volvulus may be rare in the pediatric population, the diagnosis should always be considered in patients presenting with abdominal pain, obstruction and abdominal distension.
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Adolescent , ConstipationABSTRACT
Adnexal torsion or other cyst accidents encountered during pregnancy carries a risk to intrauterine foetus. Delays or misdiagnosis can result in the loss of the affected ovary and subsequent reduced reproductive capacity. In this report, a 23-year-old second gravida with viable 9 weeks pregnancy with acute pain abdomen; presented in OPD and sent to labor room. Emergency laprotomy was done with provisional diagnosis of left adnexal torsion. We did detorsion and cystectomy followed by ovarian reconstruction. Repeat scan shows continuing intrauterine pregnancy. So, timely diagnosis and intervention reduces risk to ovary; along with some risk of the antepartum surgical intervention. Also, in place of oophorectomy; de-torsion is more conservative surgical approach that should be considered in all young women with ovarian torsion.
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We aimed to evaluate the effects of detorsion and Allium sativum (garlic oil) treatment on the ovarian reserve in an ovarian torsion model. Ovarian torsion may lead to loss of ovarian tissue and infertility. It is an experimental rat study that was carried out on 16 sets of ovaries each, one for treatment group and a control group. In the control group, the procedure involved only the surgically opening and closing the abdomen. Bilateral adnexal torsion/detorsion was performed after a 3-hour ischemia period for the detorsion-only group. The detorsion + Allium sativum group received a 5 ml/kg dose of Allium sativum intraperitoneally, 2 hours before surgery. After the second surgery, removed ovarian samples were evaluated for follicle counts, damage scores and other parameters. Primordial, preantral, small antral and large antral follicle counts were significantly higher in the detorsion + Allium sativum group. Degeneration, congestion, hemorrhage ,inflammation and total damage scores were significantly elevated in the detorsion only group compared to those for the detorsion + Allium sativum group. Finally, there was a significant correlation between AMH alterations and postoperative, preantral follicle count (p<0.05). As a conclusion detorsion + Allium sativum treatment may be effective in protecting the ovarian reserve after torsion.
Intentamos evaluar los efectos de la detorsión y el tratamiento con Allium sativum (aceite de ajo) en la reserva ovárica en un modelo de torsión ovárica. La torsión ovárica puede ocasionar pérdida de tejido ovárico e infertilidad. Este es un estudio experimental en ratas que se llevó a cabo en 16 sets de ovarios para cada grupo: tratamiento y control. En el grupo control, el procedimiento involucró solamente la apertura y el cierre quirúrgicos del abdomen. La torsión / detorsión anexial bilateral se realizó después de un período de isquemia de 3 horas para el grupo de solo detorsión. El grupo de detorsión + Allium sativum recibió una dosis de 5 ml / kg de Allium sativum por vía intraperitoneal, 2 horas antes de la cirugía. Después de la segunda cirugía, las muestras ováricas eliminadas se evaluaron para recuentos de folículos, puntajes de daño y otros parámetros. Los recuentos de folículos antrales primordiales, preantrales, antrales pequeños y grandes fueron significativamente mayores en el grupo con detorsión + Allium sativum. Los puntajes de degeneración, congestión, hemorragia, inflamación y daño total fueron significativamente elevados en el grupo de solo detorsión, en comparación con los del grupo de detorsión + Allium sativum. Finalmente, hubo una correlación significativa entre las alteraciones de AMH y el recuento de folículos preantrales postoperatorios (p <0,05). Como conclusión, el tratamiento con detorsión + Allium sativum puede ser eficaz para proteger la reserva ovárica después de la torsión.
Subject(s)
Animals , Female , Rats , Ovarian Diseases/drug therapy , Ovary/drug effects , Sulfides/administration & dosage , Allyl Compounds/administration & dosage , Garlic/chemistry , Torsion Abnormality , Oxidative Stress/drug effects , Protective Agents , Disease Models, Animal , Ovarian Reserve/drug effectsABSTRACT
OBJECTIVE: Prompt diagnosis and management are essential for saving the adnexal organs from infarction in cases of ovarian torsion (OT). This study aimed to determine the diagnostic significance of signal peptide, complement C1r/C1s, Uegf, and Bmp1 (CUB), and epidermal growth factor-like domain-containing protein-1 (SCUBE-1) levels in cases of OT, an emergent ischemic condition, and the relationship of SCUBE-1 with oxidative stress parameters. METHODS: This prospective study was conducted among 15 OT patients and 20 age- and gravidity-matched healthy women. SCUBE-1 serum concentrations were determined by using enzyme-linked immunosorbent assays. In addition, oxidative stress was evaluated by measuring the serum levels of advanced oxidation protein products (AOPP), ferric reducing ability of plasma (FRAP), and glutathione (GSH). RESULTS: The SCUBE-1 titers were significantly higher in the patients with OT than in the controls (p=0.008). In addition, serum FRAP and GSH levels were significantly lower in the OT patients than in the controls (p 0.05). Furthermore, there were no correlations between SCUBE-1 levels and age, gravidity, parity, cyst size, and AOPP, FRAP, or GSH levels (p>0.05). CONCLUSION: We believe that SCUBE-1 may be a promising biomarker for the early diagnosis of OT.
Subject(s)
Female , Humans , Advanced Oxidation Protein Products , Complement System Proteins , Diagnosis , Early Diagnosis , Enzyme-Linked Immunosorbent Assay , Glutathione , Gravidity , Infarction , Ischemia , Oxidative Stress , Parity , Plasma , Prospective Studies , Protein Sorting SignalsABSTRACT
Etoricoxib features antioxidant and anti-inflammatory properties concomitantly, suggesting that it may be beneficial in testicular ischemia reperfusion (I/R) damage. Our aim is to investigate the effects of etoricoxib on testicular I/R damage induced with torsion-detorsion (TD). The etoricoxib + torsion-detorsion (ETD) groups of animals were given etoricoxib in 50 and 100 mg/kg of body weight (ETD-50 and ETD-100), while the testes torsion-detorsion (TTD) and sham operation rat group (SOG) animals were given single oral doses of distilled water as a solvent. TTD, ETD-50 and ETD-100 groups were subjected to 720° degrees torsion for four hours, and detorsion for four hours. The SOG group was not subjected to this procedure. Biochemical, gene expression and histopathological analyses were carried out on the testicular tissues. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) were significantly higher, and the levels of total glutathione (tGSH) and glutathione reductase (GSHRd) were significantly lower in the TTD group, compared to the ETD-50, ETD-100 and SOG groups. Etoricoxib at a dose of 100 mg/kg better prevented I/R damage than the 50 mg/kg dose. Etoricoxib may be useful in clinical practice in the reduction of I/R damage on testes caused by torsion-detorsion.
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Animals , Rats , Body Weight , Gene Expression , Glutathione , Glutathione Reductase , Interleukin-1beta , Ischemia , Malondialdehyde , Peroxidase , Reperfusion , Testis , Tumor Necrosis Factor-alpha , WaterABSTRACT
Quercetin (QE) and resveratrol (RSV) are powerful antioxidants with the potential to protect the testes against ischemia/reperfusion (I/R) injury. We compared their effects in testicular torsion/detorsion (T/D) in adult rats. Twenty-four male Wistar rats were divided into four groups: sham (group A), T/D (group B), T/D treated with QE (group C), and T/D treated with RSV (group D). QE (20 mg kg-1 ) and RSV (20 mg kg-1 ) were injected intra-peritoneally at 60 min of torsion. After 90 min of surgically induced torsion, the testicular cord was restored to its anatomical position. Twenty-four hour after torsion, blood and tissue samples were obtained for further examination. Testicular tissue malondialdehyde (MDA) and nitric oxide (NO) levels and serum total oxidant status (TOS) were higher in group B than in group A (P 0.05). Group A had normal testicular architecture (grade 1). Groups C (mean grade 2.60) and D (mean grade 3.00) had lower testicular injury grades than group B (mean grade 3.45) (P < 0.05). Group C had lower testicular injury grade than group D (P < 0.05). Treatment with QE and RSV protects against I/R injury after testicular T/D. QE may exhibit better function than RSV at the doses tested in this study.
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Aim: Isolated tubal torsion is a rare entity in young women. To represent a case of conservative laparoscopic treatment in isolated tubal torsion in a young patient. Presentation of Case: A 20-year-old virgin woman who had acute right lower quadrant of abdominal pain and nausea underwent diagnostic laparoscopy with subsequent detorsion of the involved fallopian tube in a tertiary care medical center. Discussion: The treatment modality of tubal torsion in most of the reported cases during initial surgery or at the time of recurrent torsion after detorsion was salpingectomy. Conclusion: Conservative treatment option that is laparoscopic detorsion which should be preferred especially in young patients to preserve the tubo-ovarian function.
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Testicular torsion is a disorder involving the scrotum that results in a compromise of its blood supply. The aim was to investigate the effect of Pausinystallia macroceras (PM) on testicular histology following torsion-detortion at different time intervals ranging from 1 to 4 hours 65 mature male Wister rats allotted randomly into seven groups (A to G; E& F further divided into 4-subgroups). Each group/subgroup comprised 5 rats. Testis maintained in the torted position (T) for 1, 2, 3 and 4 hours in Groups A (AT1+PM), B (BT2+PM), C (CT3+PM) and D (DT4+PM). Group E subgroups (E1+PM, E2+PM, E3+PM, E4+PM -) were sham operated, without torsion served as the sham control. Group F subgroups (F1T1, F2T2, F3T3 and F4T4) were torted as in A. All animals (except groups F & G) treated with PM extract (0.1 g/kg.b.w/day) for 56 days. Group G rats (normal control). Testes processed for histological studies. In AT1+PM showed preserved seminiferous tubules. BT2+PM, revealed varying number of necrosed and apoptotic seminiferous tubules. Group CT3+PM rats were similar to BT2+PM although with a slightly higher proportion of seminiferous tubules had undergone necrosis. In DT4+PM, sections showed few viable spermatozoa within the seminiferous tubules. When compared to the torted group F; showed extensive areas of seminiferous tubular necrosis (F3T3) as well as damage to the interstitium; while in F4T4 there were no viable testicular tissues seen. In conclusion, PM significantly prevented the cellular changes and cell death observed especially in group AT1+PM and BT2+PM.
La torsión testicular es un trastorno que involucra el escroto resultando en un compromiso del suministro sanguíneo. El objetivo fue investigar el efecto de Pausinystallia macroceras (PM) en la histología testicular tras torsión-detorsión a intervalos de tiempo diferentes que van desde 1 a 4 horas en 65 ratas macho Wistar maduras, asignando aleatoriamente en siete grupos (desde A a G, mientras que E y F se dividieron en 4 subgrupos). Cada grupo/subgrupo estuvo compuesto por 5 ratas. Los testículos se mantuvieron en posición torsionada (T) durante 1, 2, 3 y 4 horas en los grupos A (AT1 + PM), B (BT2 + PM), C (CT3 + PM) y D (DT4 + PM). El grupo E, subgrupos (E1 + PM, E2 + PM + PM E3, E4 + PM) fueron operados por modelo sham sin torsión, que sirvió de control. El grupo F, subgrupos (F1T1, F2T2, F3T3 y F4T4) fueron torsionados como en A. Todos los animales (excepto los grupos F y G) fueron tratados con extracto de AM (0,1 g/kg peso corporal/día) durante 56 días. El grupo G fueron ratas control (control normal). Los testículos fueron procesados para el estudio histológico. En AT1 + PM se observó preservación de los túbulos seminíferos. BT2 + PM, reveló un número variable de túbulos seminíferos con necrosis y apoptosis. El grupo de ratas CT3 + PM fue similar a BT2 + PM, aunque un porcentaje ligeramente superior de los túbulos seminíferos mostraron necrosis. En DT4 + PM, los cortes mostraron pocos espermatozoides viables dentro de los túbulos seminíferos. En comparación con el grupo F torsionado mostró extensas áreas de necrosis tubular (F3T3), así como daños en el intersticio; mientras que en F4T4 no hubo tejido testicular viable. En conclusión, PM previno significativamente cambios celulares y la muerte celular observada, especialmente en el grupo AT1 + PM y BT2 + PM.
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Humans , Male , Rats , Plant Extracts/administration & dosage , Pausinystalia/chemistry , Spermatic Cord Torsion/pathology , Spermatic Cord Torsion/drug therapy , Palliative Care , Rats, Wistar , Reperfusion Injury , Time Factors , Testis , Testis/pathologyABSTRACT
In this study, we evaluated the ultrastructural findings of testis with systemic administration of different doses of melatonin during ischemic period in a rat model of testicular torsion/detorsion (T/D). Testis ischemia-reperfusion (I/R) injury was induced by torsion of the left testis, with a 720 degrees twisting of the spermatic cord so as to produce a total occlusion of testis for 2.5 hours. Subsequently, the same testis was then detorsioned. According to surgical procedure in each group, unilateral orchiectomies were performed for histopathologic examination. The groups were labelled as control group, torsion group (T), torsion and detorsion group (T/D), torsion-detorsion and melatonin group (T/D+20,50 and 100 mg/kg melatonin). For the histological examination, testicular tissues were fixed in 2.5 percent glutheraldehyde and postfixation 1 percent osmic acid solutions. They were examined under transmission electron microscopy after application of contrast stained. In torsion group testis cross-sections, cytoplasm residues of mature sperms and large vacuole-like structures were noticeable. In detorsion group testis cross-sections, dissociations in spermatocide nuclei, many vacuoles and residual particles resulting from organelle degeneration, local voids in cytoplasms of spermatogonia, dilatation in granulated endoplasmic reticulum, large lipid droplets, chromatid particles, along with mitochondrial crystalisis were determined. In the testis cross-sections of the group of T/D+50 mg/kg melatonin administration, sertoli and spermatogonia cells that showed membrane-like structures and cytoplasmic voids were observed. Testis cross-sections of rats that were administered with T/D+50 mg/kg melatonin showed small mitochondrions and vacuole-like structures placed on the edge. Testis cross-sections of rats that were administered with T/D+100 mg/kg melatonin resulted in views similar to those of controls in the microstructural level. As a result, the most effective...
Se evaluaron, en un modelo de torsión/detorsión (T/D) testicular en rata, los cambios ultraestructurales producidos en los testículos, posterior a la administración sistémica de diferentes dosis de melatonina, durante el período de isquemia. La lesión de isquemia-reperfusión (I/R) testicular fue inducida por la torsión del testículo izquierdo, con un giro de 720 grados del cordón espermático con el fin de producir una oclusión total de los testículos durante 2,5 horas. Posteriormente, los mismos testículos fueron detorsionados. De acuerdo con el procedimiento quirúrgico en cada grupo, fueron realizados exámenes histopatológicos de las orquiectomías unilaterales. Los grupos fueron divididos en grupo control, grupo torsión (T), grupo torsión/destorsión (T/D), y grupo torción/destorsión con melatonina (T/D +20, 50 y 100 mg/kg de la melatonina). Para el examen histológico, los tejidos testiculares fueron fijados en soluciones de glutaraldehído al 2,5 por ciento y postfijados al 1 por ciento en ácido ósmico. Luego fueron examinados, después de la aplicación de contrastes de colores, a través de microscopía electrónica de transmisión. En las secciones transversales del grupo con torsión testicular, fueron visibles residuos citoplas-máticos de espermatozoides maduros y grandes estructuras vacuolares. En las secciones transversales del grupo con destorsión testicular, se observaron disociaciones en los núcleos espermáticos, numerosas vacuolas y partículas residuales derivadas de la degeneración de organelos; además de espacios localizados en el citoplasma de las espermatogonias, dilatación en el retículo endoplasmático rugoso, grandes gotas de lípidos y partículas de cromátidas, junto con cristálisis mitocondrial. En las secciones transversales del grupo T/D +50 mg/kg de administración de melatonina, células sustentaculares y espermatogonias mostraron estructuras tipo membrana y vacíos citoplasmáticos. Las secciones transversales del grupo con torsión en la que fue ...