Bilateral testicular luxation

Contribution of a case report of long-standing bilateral testicular luxation, the result of scrotal trauma caused by a soccer ball. Good aesthetic, endocrine and exocrine results were obtained with surgical treatment. Androgenic hormonal profile and spermiogram performed at six months showed values within the normal range.     

Two cases of testicular rupture

Two cases of testicular rupture are presented and 119 cases in Japanese literature are reviewed. A 29-year-old man and a 32-year-old man were admitted to our hospital with the complaint of gradually increasing pains and swelling on the right testicle. Four days and three days before admission they experienced trauma during athletic activities. The diagnosis was established preoperatively by means of ultrasonography in the first one, but not in the other. The necrotic tissue of 1/3-1/2 of testis was removed and tunica albuginea was repaired in both cases. Of 119 cases of testicular rupture in Japanese literature a peak occurs in the 2nd decade and during contact sports. The ultrasonography is an effective diagnostic modality. The rate of orchiectomy has been decreasing. The function of the affected testis is hard to evaluate.     

Two cases of traumatic bladder rupture with multiple organ failure]

We report two cases of traumatic bladder rupture complicated by multiple organ failure (MOF). The first patient had an extraperitoneal bladder rupture and right femoral bone fracture, which were treated conservatively. However, intrapelvic abscess and adult respiratory distress syndrome (ARDS) which was caused by fat embolism resulted in MOF. The second patient who had been under treatment for malignant lymphoma for three years had an intraperitoneal bladder rupture with ruptures of spleen, intestine and diaphragm. We closed the defects in the bladder, intestine, diaphragm and performed splenectomy. We also provided suprapubic cystostomy and a urethral catheter. However, wound abscess and hepatic failure occurred postoperatively. She died of MOF 20 days after the operation. We stress that in the treatment of bladder rupture, intensive chemotherapy for infection must be done when there are complications of other visceral injuries.     

节段性睾丸梗死二例报告

节段性睾丸梗死发病率极低,通常表现为睾丸急性疼痛,需与睾丸肿瘤、睾丸扭转等鉴别,只有少数病例报告。本文报道2例,例1患者13岁,因右睾丸肿大、疼痛3 d,伴呕吐1次于2017年5月5日入院,行右侧阴囊探查+睾丸固定术,术后诊断为右侧睾丸局部梗死。术后第5日睾丸疼痛症状消失出院。术后1年查彩色多普勒超声未见明显异常。例2患者26岁,2018年3月15日因左睾丸肿痛6 d入院,彩色多普勒超声检查提示左睾丸局部梗死可能。入院诊断为左侧睾丸局部梗死,予血塞通、那曲肝素钙、迈之灵片治疗,治疗7 d后患者疼痛症状好转出院。出院后1个月患者无疼痛不适,复查彩色多普勒超声示左睾丸下极团样低-等回声,周边少量星点状血流信号。     

迟发性外伤性骨折2例

1病例资料 病例1：男,43岁。因车祸伤及右小腿上段肿痛15min来我院就诊。急诊摄X线片示胫腓骨骨质未见异常,给予活血止痛等治疗。10d后患肢局部疼痛缓解不明显。复查X线片发现胫骨平台骨折。诊断：外伤性胫骨平台骨折。     

Two delayed cases of traumatic diaphragmatic hernia

This report concerns 2 cases with blunt traumatic hernia of the diaphragm. The diagnosis of these cases had been delayed by 1 month and 6 years, respectively. The former was a left sided case, which had suddenly suffered severe dyspnea. An emergency operation revealed the dislocated stomach into the left thoracic cavity. The latter was a right sided case, which was discovered by chance during the laparoscopic cholecystectomy. The right lobe of the liver dislocated into the right thoracic cavity. The delayed case of traumatic diaphragmatic hernia tends to be overlooked without suspicion. In all patients with thoracoabdominal blunt injury, a rupture of the diaphragm must be suspected.     

Two cases of testicular infarction: the usefulness of enhanced MRI for preoperative diagnosis]

The differential diagnosis in acute scrotum, particularly torsion of spermatic cord and epididymitis, is sometimes difficult. An erroneous diagnosis may result in unnecessary and improper treatment. We report two cases of testicular infarction including torsion of spermatic cord, preoperatively diagnosed by enhanced magnetic resonance imaging (MRI). Case 1: A 16-year-old boy presented with a 3-day history of left scrotal swelling and left lower abdominal pain. He had fever and leukocytosis. Antibiotics for 2 days failed to relieve the symptoms. Enhanced MRI showed absence of blood flow in the left testis. Scrotal exploration revealed hemorrhage and necrosis in the left testis. Left orchiectomy and right orchiopexy were performed. Case 2: A 12-year-old boy visited with scrotal swelling and fever 30 hours after an acute onset of left scrotal pain. Enhanced MRI showed absence of blood flow in the left testis. Exploration revealed left necrotic testis with torsion of spermatic cord. Left orchiectomy and right orchiopexy were performed. Our two cases suggested that enhanced MRI, by which the intratesticular blood flow can be evaluated, may be useful for the diagnosis of testicular infarction.     

Metacarpophalangeal luxation of the thumb. Apropos of 30 cases]

A retrospective study of a series of 30 cases of metacarpo-phalangeal luxation of thumb (18 dorsal and 12 palmar) showed the relatively high frequency of the palmar variety both in adults and children. Prognosis was better for dorsal than for palmar luxations, the latter being associated with other lesions; cutaneous, tendinous and/or bony, these constituting the severity factor.     

Congenital knee luxation]

The authors discuss the frequency, etiology, symptoms and classification as well as treatment of congenital dislocation of the knee. 8 own cases are reported in the article. The authors suggest that congenital dislocation of the may be well influenced by non-operative methods. Etappe redressement by means of plaster does not interfere with the functional treatment of the hip dislocation usually treated with the Pavlik braces. Associated foot deformities may be easily corrected at the same time. The so called "earliest treatment" is most important in all the three deformities (knee-hip dislocation, club foot), the authors emphasise.     

Bilateral traumatic testicular dislocation

We report on bilateral traumatic testicular dislocation with pelvic injury. Both testes were dislocated in the superficial perineal region and 1 of 2 testes had prolapsed at the perineal region. To our knowledge, this type of bilateral traumatic testicular dislocation has not been previously described.     

Two cases of spermatocytic seminoma]

Two cases of spermatocytic seminoma are reported. The first case was a 58-year-old man who visited our hospital with a complaint of painless swollen left scrotal content. Left orchiectomy was performed under the diagnosis of testicular tumor. Since the pathological diagnosis first made was anaplastic seminoma, he was treated with combined chemotherapy (PVB, 1 course). However, since the pathological diagnosis after re-examination of the specimen, was spermatocytic seminoma, he underwent prophylactic radiation therapy. The second case was a 64-year-old man who visited our hospital with a complaint of painless swelling of right scrotal content. Right orchiectomy was performed under the diagnosis of testicular tumor. The pathological diagnosis was spermatocytic seminoma. He underwent prophylactic radiation therapy. Postoperatively these two patients have been well with no evidence of recurrence. These are the 14th and 15th cases of spermatocytic seminoma reported in Japan.     

Two cases of renal oncocytoma]

Two cases of renal oncocytoma are reviewed. A 67-year-old man and a 21-year-old man with a right renal mass were incidentally revealed by echography. Selective renal angiogram showed no spoke-wheel configuration of vessels in either case. Both cases were pathologically diagnosed as oncocytomas, constructed of large eosinophilic cells with granular cytoplasm and small regular nuclei. The electron micrograph showed cytoplasm packed abundantly with mitochondria. The two patients are in good condition 2.5 and 1.5 years after diagnosis.     

Two cases of traumatic-diaphragmatic hernia]

We report two cases of traumatic-diaphragmatic hernia caused by blunt injury. In case 1, abdominal findings were discovered on the 2nd day after the patient fell on the bottom from a horse, and in case 2, an emergency laparotomy was carried out due to the respiratory dysfunction which appeared immediately after a labor injury. The diaphragmatic ruptures at the left side observed in both cases, were closed directly. The prolapsed organs which shifted into the thoracic cavity were the stomach and colon in case 1, and the spleen and the tail part of the pancreas in case 2. In both cases, the organs were easily repositioned into the abdominal cavity without a hernial sac, but a splenectomy had to be performed because of splenic lacerations. In case 2, right rib fractures and lacerations of the left adrenal gland with retroperitoneal hematoma were observed. In the case of thoraco-abdominal blunt injuries, it is important to perform an early diagnosis and to consider the possibility of diaphragmatic hernia.