RESUMO
We report a case of deferred acute scrotum in a young teenager. Even though initially the aetiological diagnosis seemed clear (partially treated epididymo-orchitis), glandular viability remained uncertain due to ultrasound findings and the time elapsed since initial diagnosis. Colour Doppler Ultrasound is examined as the most useful ancillary method in differential diagnosis in this setting, as well as the different ultrasound findings in subsequent stages of spermatic cord torsion and epididymo-orchitis. Possible testicular ischaemia in this clinical setting is emphasized, explaining its pathophysiology.
Assuntos
Epididimite/diagnóstico por imagem , Isquemia/diagnóstico por imagem , Orquite/diagnóstico por imagem , Testículo/irrigação sanguínea , Criança , Diagnóstico Diferencial , Humanos , Masculino , Testículo/diagnóstico por imagem , UltrassonografiaRESUMO
Experimental studies have shown that verapamil inhibits pancreatic exocrine secretion. In order to determine whether verapamil has any effect on acute pancreatitis (AP), we undertook an experimental study in Wistar rats. We used 72 animals divided into two groups. In all animals of both experimental groups, AP was induced by ligation of the biliary duct at its entrance in the duodenum. Animals were given saline (NaCl 0.9%), or 0.30 mgrs/hour verapamil. Subgroups of 9 animals, were treated for 6, 12, 18 and 24 hours; 6 animals group were then sacrificed, for biochemical studies (serum amilase, lipase, and calcium; and trypsin and chemotrypsin in the homogenized pancreas); the other 3 animals were used for morphologic study of the pancreas. Verapamil treatment decreased significantly tissue activity of trypsin (p less than 0.001) and chemotrypsin (p less than 0.0001) and increased serum lipase (p less than 0.05), and calcium. There was no statistical difference in serum amylase. Morphological findings include oedema, acinar necrosis, hemorrhage and vasculitis in non treated animals. Only oedema was observed in animals treated with verapamil. These results suggest a beneficial effect of verapamil on experimental AP induced by ligation of the bile duct in the rat.
Assuntos
Pancreatite/tratamento farmacológico , Verapamil/uso terapêutico , Doença Aguda , Animais , Avaliação Pré-Clínica de Medicamentos , Feminino , Masculino , Pâncreas/patologia , Pancreatite/sangue , Pancreatite/patologia , Ratos , Ratos EndogâmicosRESUMO
To discover the biochemical alterations occurring in the first 24 hours of acute pancreatitis (PA), we made an experimental study using rats. We used 90 animals in which necrosis and hemorrhage were induced by closing the choledochus. Animals underwent evolutive periods of 1, 2, 3, 4, 5, 6, 12, 18 and 24 hours. They were sacrificed and plasma (to determine amylase, lipase, creatinine and calcium), urine (amylase and creatinine), ascitic and pleural liquid (amylase and lipase) were obtained from 6 animals of each evolutive period. We made a post-mortem study of the pancreas of three animals of each subgroup. There was a significant increase in the amylasemia from the third hour (p less than 0.005) and of plasmatic lipase from the first hour (p less than 0.0001). Creatinine values remained in normal range and calcemia fell after the sixth hour (p less than 0.001). There was an increase in amylase concentration in urine and in ascitic and pleural liquids, and of the lipase in the last two. These changes correlated with the duration of the disease and with the histologic changes of the gland, which consist in edema, acinar necrosis, vasculitis and hemorrhage, which are present from the first hour and increase as time passes.