Incidence and clinical significance of arterial injury in varicocele repair.

OBJECTIVE: • This study was performed to histologically determine the rate of arterial injury in varicocele ligation surgery and to determine the clinical significance of these arterial injuries. MATERIALS AND METHODS: • 41 men who underwent varicocele ligation surgery, and had segments of each ligated vessel examined histologically. • The patients were followed prospectively to determine the effect of arterial injury on surgical results and clinical complications. RESULTS: • Arterial ligation was identified in 6 of 41 patients (12%), and in 7 of 132 specimens (5%), which is higher than previous reports. • Arterial injury was not associated with testicular atrophy and there was no apparent effect of arterial injury on surgical outcome. CONCLUSION: • The rate of arterial injury during varicocele repair is higher than previously reported, but the clinical significance of these injuries appears to be limited.

Intussusception and colonic ischemia in portal hypertension: a case report.

Intestinal intussusception is a relatively uncommon occurrence in adults in comparison to pediatric patients. While the management of intussusception in children is frequently decompression of the involved segment, adults often require surgical resection secondary to frequent association with neoplastic lead points. A less common reason for surgical removal of an intussuscepted segment in adults is the development of ischemic colitis. The authors present an unusual case of adult intussusception with associated ischemic colitis in a patient with portal hypertension awaiting liver transplantation. Portal hypertension is associated with the development of a microvascular colopathy This condition may serve as the lead point for intestinal intussusception. Furthermore, the vascular changes of portal hypertension leave the bowel unable to respond appropriately to the threat of ischemia. The colopathy of portal hypertension may have predisposed our patient to the development of colonic intussusception by submucosal vascular engorgement; it may have also rendered the intussuscepted segment more susceptible to the development of ischemia.

Infiltrating mammary carcinoma with osteoclast-like giant cells.

Mammary carcinoma with osteoclast-like giant cells is an uncommon variant. The following case examines a 36-year-old woman incidentally found to have a left breast mass on routine physical exam. Initial ultrasound-guided core biopsies revealed infiltrating mammary carcinoma with focal mucinous features, for which a left breast lumpectomy and sentinel lymph node biopsy were performed. The sentinel lymph nodes were positive for metastatic mammary carcinoma with osteoclast-like giant cells on permanent section corresponding to the lumpectomy breast specimen, thus a left completion axillary node dissection was subsequently performed.

Tuberculous tenosynovitis of the tibialis anterior tendon: a case report.

Tuberculous tenosynovitis is an uncommon form of extrapulmonary tuberculosis occurring primarily in the hands and wrists with limited reports involving the lower extremities. We report a rare case of tuberculous tenosynovitis of the tibialis anterior tendon occurring in a 37-year-old Filipino male. The tendon was surgically debrided and the patient was given a six month course of antituberculin chemotherapy. At one year postoperatively, the patient has good function with no evidence of recurrence.