Testicular morphological damage in young rats after inguinotomy with vascular trauma.

BACKGROUND/PURPOSE: Operations for the treatment of inguinal diseases are the most frequent in childhood. Bleeding owing to trauma to the spermatic vessels is frequent and can cause testicular atrophy. The goal of this work was to determine the effects of the trauma to the spermatic vessels in the prepubertal and postpubertal histopathologic alterations in an experimental model in Wistar rats. METHODS: Eighty albino Wistar rats were divided in 4 groups for the histopathologic analysis. In group A, they were submitted to digital compression of the spermatic vessels for 45 seconds; in group B, the spermatic vessels were clamped with hemostats for 5 seconds; in group C, the spermatic vessels were cauterized for 2 seconds. Group D was the control group, in which the animals were submitted to inguinotomy solely. RESULTS: The prepubertal histopathologic alterations were significantly decreased in group A for testicular weight (0.97 +/- 0.10); in group B, for testicular weight (0.81 +/- 0.24), testicular volume (0.522 +/- 0.192), and mean testicular biopsy score (7.2 +/- 2.7); and in group C, for the 5 parameters studied, testicular weight (0.69 +/- 0.28), testicular weight per 100 g of body weight (0.498 +/- 0.188), testicular volume (0.765 +/- 0.308), mean seminiferous tubular diameter (236.6 +/- 62.5), and mean testicular biopsy score (6.9 +/- 3.1). The postpubertal histopathologic alterations were not significant for any of the 5 parameters studied, in the 3 groups. CONCLUSIONS: The prepubertal histopathologic alterations were more intense in the group submitted to cauterization of the spermatic vessels, intermediate in the group submitted to clamping of the spermatic vessels with hemostats, and less severe in the rats submitted to digital compression of the spermatic vessels. The postpubertal histopathologic alterations demonstrated the capability of the young testicle to recuperate from a vascular trauma.

Estenose hipertrófica de piloro associada com malrotaçäo: relato de caso / Hipertrophic pyloric stenosis associated with malrotation: two cases

Dois casos de estenose hipertrófica de piloro associado com malrotaçäo intestinal säo apresentados. Em nenhum deles o diagnóstico foi feito sincronicamente. A partir do 3§/4§ dias pós operatório de pilomiotomia ambos reiniciaram o quadro com vômitos biliosos e distensäo abdominal. Na investigaçäo o diagnóstico de malrotaçäo intestinal e um segundo procedimento foi justificado pelo resultado do estudo radiológico. No caso 1, o RX simples com imagem de pneumoperitônio sugestiva de perfuraçäo de viscera oca indicou a laparotomia. Alèm da enterorrafia obrigatória, uma exploraçäo da cavidade abdominal mostrava a presença de brida de Ladd, rotaçäo parcial do colon e um divertículo de Meckel há mais ou menos 30cm da válvula íleo cecal. No caso 2, o RX contrastado (trânsito) mostrava um desvio de alças intestinais com dificuldade de passagem do contraste além do duodeno e igualmente indicou a laparotomia, durante a qual foi liberada a brida de Ladd e melhorada a reposiçäo das alças. A recuperaçäo pós operatória foi rápida e sem intercorrências com estabilizaçäo e ganho de peso no seguimento ambulatorial, em ambas as crianças