ABSTRACT
Acute colonic perfusion impairments (thrombosis, infarction, and ischemia) have evident clinical manifestations and are reasonably well described in the literature. At the same time, the problems of chronic peripheral circulatory disorder in the large bowel and the impact of the disorder on its motility are inadequately considered. By summarizing the data available in the literature and their findings, the authors consider the etiology and pathogenesis of organic and functional colostasis in the context of changes in the colonic angioarchitectonics.
Subject(s)
Colon/blood supply , Colon/pathology , Colonic Diseases/pathology , Ischemia/pathology , Child , Child, Preschool , Colonic Diseases/physiopathology , Female , Humans , Infant , Infant, Newborn , Ischemia/physiopathology , Male , Regional Blood Flow , Thrombosis/pathology , Thrombosis/physiopathologyABSTRACT
The authors studied 520 patients with left-sided varicocele by left-sided phleborenotesticulography of Doppler ultrasonography, tensiometry of the left renotesticular venous system, blood gas composition, hormonal parameters, and etc. They present rationale for and evidence illustrations of aortomesenteric compression of the left renal vein, left-sided phleborenal hypertension prior to and after surgery for endovascular occlusion of the left testicular vein, before and following intervenous proximal testiculoiliac venous bypass surgery. The data of andrological dysfunction in patients with varicosis of the pampiniform plexus and spermatic cord (varicocele) are presented. An algorithm of examination and treatment of this cohort of patients, by using both miniinvasive techniques (for X-ray endovascular occlusion of the temporal veins under local anesthesia) and high tech operations using microsurgical techniques (testiculoiliac venous anastomosis), is outlined.
Subject(s)
Varicocele/diagnostic imaging , Varicocele/surgery , Adolescent , Age Factors , Algorithms , Child , Cohort Studies , Humans , Male , Microsurgery , Phlebography , Testis/blood supply , Ultrasonography, DopplerABSTRACT
Selective phleborenotesticulography, ++tensiometry of the left iliac, right and left renal veins, vena cava inferior, duplex scanning of the left renal vein were performed in 356, 296 and 57 patients, respectively, of a total of 356 examinees aged 8-17 years with left-side varicocele. Among other tests were measurements of hormones in the blood from the left and right testes (n = 24), pO2, pCO2. Stenosis, aortomesenteric compression (AMC) of the left renal vein, left-side venous renotesticular hypertension (RTH) of the left renal vein were diagnosed in 12, 342 and 158 patients, respectively. Secondary genesis of left varicocele has been proved. The diagnosis of left-side phlebohypertensive nephropathy was made preoperatively. Estradiol content in the blood of the left testis was 1.7 times higher than from the right one. 4 groups of patients were formed: group 1 patients (n = 142) had stenosis, AMC, dilatation of the testicular vein (DTV) and RTH; group 2 patients (n = 18) had AMC, DTV, borderline high pressure; group 3 patients (n = 18) had AMC, RTH, multiple thin testicular veins; group 4 patients (n = 174) had moderate AMC without hypertension. 160 patients of group 1 and 2 have undergone two-direction venous testiculo-iliac anastomosis operation. 193 patients of groups 3 and 4 have undergone Ivanissevich's operation. After Ivanissevich's operation 2 patients with secondary varicocele of the third degree retained varicocele of the first degree. After establishment of anastomoses, neither varicocele recurrences nor anastomosis thrombosis were registered.
