RESUMO
INTRODUCTION: Outcomes of orchidopexy for undescended testes may be disappointing. The aim of our study was to identify predictive factors of testicular atrophy and orchidopexy failure. METHODS: It was a prospective monocentric study including all boys operated for undescended testes between January 2009 and December 2014. We have recorded for all boys: age at surgery, testes volume and position, epididymo-testicular fusion and spermatic vessels abnormalities, surgical technique, need for extensive cord dissection and tension-free orchidopexy. RESULTS: We have included 688 boys operated for undescended testes. The whole number of undescended testes was 816. Predictive factors for postoperative testicular atrophy in univariate analysis were: testicular position in deep inguinal orifice, intra-abdominal testes, hypotrophic preoperative testes, epididymo-testicular fusion and spermatic vessels abnormalities, laparoscopic orchidopexy, complete testicular vessels skeletonization and under-tension orchidopexy. In multivariate analysis, peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. Predictive factors for testicular reascension in univariate analysis were: intra-abdominal testis position, scrotal orchidopexy and under-tension orchidopexy. In multivariate analysis, no independent factor was identified. CONCLUSION: Peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. There was no independent predictive factor for postoperative testicular reascension. LEVEL OF PROOF: 2.
Assuntos
Criptorquidismo , Atrofia/patologia , Criança , Criptorquidismo/cirurgia , Feminino , Humanos , Lactente , Masculino , Orquidopexia/métodos , Estudos Prospectivos , Estudos Retrospectivos , Testículo/patologia , Testículo/cirurgiaAssuntos
Doenças das Glândulas Suprarrenais/etiologia , Calcinose/etiologia , Doença de Wolman/diagnóstico , Doenças das Glândulas Suprarrenais/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Feminino , Febre/etiologia , Hepatomegalia/etiologia , Humanos , Lactente , Esplenomegalia/etiologiaAssuntos
Neoplasias Encefálicas/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Epilepsia/etiologia , Lipoma/diagnóstico por imagem , Neoplasias Encefálicas/complicações , Córtex Cerebral/patologia , Criança , Humanos , Lipoma/complicações , Imageamento por Ressonância Magnética , MasculinoRESUMO
Primary hyperparathyroidism, widely prevalent in women after menopause, remains rare in children and adolescents. Sporadic forms are the most frequent. Clinical manifestations are general, renal, gastrointestinal, cardiac, or bony. Diagnosis is biological and radiological. The imaging modalities allow assessment of the disease impact and identification of the parathyroid adenoma.
Assuntos
Adenoma/diagnóstico por imagem , Fraturas Espontâneas/etiologia , Hiperparatireoidismo Primário/etiologia , Vértebras Lombares/lesões , Neoplasias das Paratireoides/diagnóstico por imagem , Fraturas da Coluna Vertebral/etiologia , Adenoma/complicações , Adolescente , Feminino , Humanos , Hiperparatireoidismo Primário/diagnóstico , Neoplasias das Paratireoides/complicaçõesAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hiponatremia/complicações , Imageamento por Ressonância Magnética , Mielinólise Central da Ponte/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Pré-Escolar , Confusão/etiologia , Meios de Contraste , Gadolínio , Humanos , Hipotonia Muscular/etiologia , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Hiponatremia/complicações , Imageamento por Ressonância Magnética , Mielinólise Central da Ponte/etiologia , Mielinólise Central da Ponte/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Pré-Escolar , Confusão/etiologia , Meios de Contraste , Dispneia/etiologia , Gadolínio , Humanos , Imageamento por Ressonância Magnética/métodos , Hipotonia Muscular/etiologia , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
Wegener's granulomatosis is a necrotizing granulomatous vasculitis with a strong affinity for the upper respiratory tract, lung and kidney. The ophthalmologic manifestation most often presents as inflammatory orbital pseudotumor or scleritis. We report a case of a 27-year-old woman with an orbital-meningeal presentation leading to a diagnosis of Wegener's granulomatosis.
Assuntos
Oftalmopatias/diagnóstico , Granulomatose com Poliangiite/diagnóstico , Meninges/patologia , Órbita/patologia , Vasculite do Sistema Nervoso Central/diagnóstico , Adulto , Diagnóstico Diferencial , Exoftalmia/diagnóstico , Exoftalmia/etiologia , Feminino , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/patologia , Humanos , Pseudotumor Orbitário/diagnóstico , Pseudotumor Orbitário/etiologia , Vasculite do Sistema Nervoso Central/etiologia , Vasculite do Sistema Nervoso Central/patologiaRESUMO
Although rare, spontaneous intra-orbital hematoma can quickly jeopardize vision. It usually presents with painful proptosis. It can result from multiple etiologies, and the diagnosis is based on imaging studies in the absence of known causes. We describe two cases of spontaneous intraorbital hematoma. The first, of unknown etiology, required needle drainage. The second was associated with a subperiosteal hematoma of the orbital roof complicating a periorbital bone infarction in a patient with sickle-thalassemia.
Assuntos
Exoftalmia/diagnóstico , Hematoma/diagnóstico por imagem , Doenças Orbitárias/diagnóstico por imagem , Idoso , Criança , Exoftalmia/diagnóstico por imagem , Exoftalmia/etiologia , Exoftalmia/cirurgia , Hematoma/complicações , Hematoma/cirurgia , Humanos , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Doenças Orbitárias/complicações , Doenças Orbitárias/cirurgia , RadiografiaAssuntos
Abdome Agudo/etiologia , Duodeno/anormalidades , Pâncreas , Doença Aguda , Criança , Feminino , HumanosRESUMO
Sickle cell anemia is the most common hemoglobinopathy worldwide; its musculoskeletal complications consist more often of medullary infarctions involving long bones. Orbital infarction is uncommon. We report on a case of orbital subperiosteal hematoma in a 9-year-old male with a medical history of sickle cell thalassemia.
Assuntos
Anemia Falciforme/complicações , Antidrepanocíticos/uso terapêutico , Hematoma/complicações , Hidroxiureia/uso terapêutico , Doenças Orbitárias/complicações , Talassemia/complicações , Anemia Falciforme/diagnóstico por imagem , Anemia Falciforme/tratamento farmacológico , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/tratamento farmacológico , Criança , Olho/patologia , Lateralidade Funcional , Hematoma/diagnóstico por imagem , Hematoma/tratamento farmacológico , Humanos , Masculino , Doenças Orbitárias/diagnóstico por imagem , Doenças Orbitárias/tratamento farmacológico , Radiografia , Talassemia/diagnóstico por imagem , Talassemia/tratamento farmacológicoRESUMO
A generalized ichthyosis with an associated spastic syndrome of the lower extremities, clinically suggestive of Sjögren-Larsson syndrome, was observed in a Tunisian boy. The fatty acid analysis of the serum phospholipids revealed significant abnormalities in the fatty acid pattern of phospholipids. However, the alterations observed were different from those reported in Sjögren-Larsson syndrome. We report light and electron microscopic changes in the ichthyotic skin of this patient, which have not been previously reported in lamellar ichthyosis and in Sjögren-Larsson syndrome. The epidermis was moderately hyperplastic and covered with a thick, compact, orthokeratotic stratum corneum. The stratum spinosum was strikingly altered in some areas. Varying numbers of keratinocytes contained big vacuoles, measuring often up to the size of the nuclei; the vacuoles, were well limited but only partially lined by a membrane, they were empty or contained small amounts of a flaky material. Attempts to stain the vacuoles with PAS, Alcian blue and Fettrot were negative. Etretinate treatment produced a marked shedding of the horny layer without significant improvement of the clinical appearance. The described microscopical alterations of the epidermis remained mostly unchanged during treatment, but, in addition, a marked oedema and vacuolisation of the upper stratum granulosum was observed.