Abstract:
BACKGROUND:Due to the variety of differential diagnoses causing acute scrotum and their possible consequences, this finding is a challenge for diagnostic and therapeutic management in the daily clinical practice of paediatric medicine. PATIENTS AND METHODS:Through a defined time period, all consecutive paediatric patients of a tertiary surgical centre aged up to 16 years who were diagnosed with and treated for primary acute scrotum were prospectively registered and retrospectively evaluated for patient, finding and treatment (intervention) associated specifics in this systematic unicentric observational study (design: case series) to reflect daily clinical practice. RESULTS:A total of 141 cases with acute scrotum were enrolled in the study during the 10-year period from January 2000 to December 2009. Eight percent of cases (n = 11) showed bilateral findings. There were two age peaks: newborns and puberty. The most common diagnoses were epididymitis and orchitis (26 %), torsion of the testicular appendix (22 %) and testicular torsion (21 %). Trauma, hydrocele, inguinal hernia, idiopathic scrotal oedema and tumours were rather rare differential diagnoses as possible causes for an acute scrotum. The mean period of discomfort, complaints and symptoms up to presenting in the outpatient clinic was 24 hours. For sixty percent (n = 84, i.e., all patients treated conservatively and 43 % of the operated patients) an imaging study was obtained with ultrasound or Doppler ultrasonography, respectively. Two thirds of the patients underwent an operative exploration. The orchiectomy rate in testicular torsion amounted to 40 %. In one newborn, a bilateral orchiectomy was necessary. In patients with unilateral orchiectomy, a prophylactic fixation of the contralateral testis was performed preferentially at 4-8 weeks after the initial intervention even though a simultaneous procedure is being increasingly used. CONCLUSIONS:In approximately one fifth of registered patients, a testicular torsion is present causing the acute scrotum, and leading to an obligatory surgical intervention. Various causative differential diagnoses can be clarified by precise medical history and exact physical examination. Imaging procedures can be helpful in decision-finding. Finally, the clinical finding is crucial and decisive. If a testicular torsion cannot reliably be excluded by clinical investigation or imaging, an immediate surgical exploration of the testis has to be performed.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Sachwitz D,Haß HJ,Kroker S,Meyer F,Krause Hdoi
10.1055/s-0032-1315189subject
Has Abstractpub_date
2014-12-01 00:00:00pages
621-6issue
6eissn
0044-409Xissn
1438-9592journal_volume
139pub_type
杂志文章abstract::Experience with gastro-restrictive obesity showed the necessity of detailed research in three main tasks: 1. characteristics of morbidly obese people 2. psychological effects of surgery 3. interaction of these characteristics and effects of surgery. We carried out 7 studies with a total of 650 participants. Clinical i...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-36465
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:The outcome volume relationship has been analysed for more than 30 years and debated ever since. For German hospitals minimum volume standards (MVS) have been introduced for some procedures in 2004. Hospitals have to report procedure volumes in their quality reports. This study analyses for the first time ho...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1383371
更新日期:2016-08-01 00:00:00
abstract::In the period between 1968 and 1982 we observed 441 subcapital fractures of the femoral neck, 55 times a tight impaction in valgus position. Including the year 1976 a conservative treatment was employed (group I); from 1977 onwards operations with the Ender-nailing technique were performed (group II). The patients' av...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The therapeutic effect of TGLVP a new hormonogen of vasopression in demonstrated in a pilot study: 9 patients suffering from bleeding oesophageal varices (in total 16) could be sufficiently treated by TGLVP, as well as 9 patients (in total 13) with abdominal haemorrhage of unknown aetiology and localization. Good resu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::V.A.C.-therapy has improved the treatment of extended pressure sores, because of its beneficial effect on the wound surface and the safe microbial barrier. Definitive reconstructive surgery can be performed earlier. Using modern aids fixation of the device will be possible even in difficult locations as the perianal a...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2006-921448
更新日期:2006-04-01 00:00:00
abstract::The Toupet operation (270 degrees posterior fundoplication) has been performed in 99 patients suffering from symptoms of gastro-oesophageal reflux secondary to a hiatal hernia. To assess the effects of the Toupet antireflux procedure, we performed in 20 cases oesophageal manometry, intraoperatively and gastro-oesophag...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:Aortoesophageal fistula (AEF) following open or endovascular operations of the thoracoabdominal aorta is a rare, yet life-threatening condition. In this case, the whole thoracic aorta has to be replaced using a "clamshell approach" because of an AEF following open repair of the ascending aorta after type A...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0713-0457
更新日期:2018-10-01 00:00:00
abstract::Extended liver resections are associated with the risk of postoperative liver dysfunction up to liver failure. For this reason, prior to extended liver resections patients are conditioned in multi-modal therapy regimes. Portal vein embolisation is an essential part of such a multi-modal therapy. The aim of this interv...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1328350
更新日期:2013-08-01 00:00:00
abstract::The Heidelberg University Hospital meets the standards required of medical services in terms of efficiency, optimizing procedures, cost-effectiveness, staff-satisfaction, and reducing infection rates etc., by implementing the Modular concept for quality within hospitals that has now proven its worth in practice. This ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::To reduce the postoperative morbidity different methods of endoscopic carpal tunnel release have been developed since 1989. We report our results and experiences with the method described by Preissler. Since its introduction in our clinic 1995, 1,000 patients have been operated until now. Out of 477 with an electrophy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2000-10658
更新日期:2000-01-01 00:00:00
abstract::Electromyography (EMG) of the pelvic floor musculature is only carried out as a routine method in few clinics. There is a lack of standard patient groups and, correspondingly, standardized values do not exist. Close cooperation between proctologists and neurologists is the exception. Some surgeons use the EMG to evalu...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1996-01-01 00:00:00
abstract::From the new payment system of procedure (covering anesthesia and surgery with all personal and material costs) or case related payment (including all costs of operation and hospital stay, medical as well as room-and-care and administrative), in 1996 for all German hospitals obligatory introduced, 22 respectively 9 co...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:To review the endogenous alterations generating critical illness in bowel obstruction. DATA SOURCES:Own experimental and clinical investigations and relevant articles published in international literature. DATA SYNTHESIS AND CONCLUSIONS:Large bowel obstruction is mostly confined to the colon. Passive dilata...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:We analysed our long-term results with postoperative radiotherapy of the chest wall in male breast cancer patients with respect to local control and survival. METHODS:Twenty-five patients with 26 histological proven carcinomas of the male breast underwent postoperative radiotherapy of the chest wall with ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-981268
更新日期:2007-10-01 00:00:00
abstract:INTRODUCTION:In a prospective trial we analysed the results and the management of complications following a combined endovascular and vascular surgical therapy of peripheral occlusive arterial disease (POAD). PATIENTS AND METHODS:From November 1998 until January 2001 a total number of 61 patients with 64 extremities w...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2002-22030
更新日期:2002-02-01 00:00:00
abstract::Clinical diagnosis has to registrate fresh injuries. These have to undergo immediate operation or further instrumental or radiological procedures respectively. This may be effected in almost all cases by systematic evaluation of informations on the anamnesis and general or special clinical diagnosis. Main symptom of t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1989-01-01 00:00:00
abstract::From January 1986 to December 1995 307 patients with preoperatively as benign classified rectal polyps underwent transanal endoscopic microsurgery or transanal excision at the Hospital of General and Abdominal Surgery, Johannes Gutenberg-University Mainz. Mean polyp size was 3.9 cm in diameter. Postoperatively in 233 ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:The transpalpebral resection of the corrugator and depressor supercilii muscles is a new treatment option for migraine headaches. Hyperactive contractility of these muscles can provoke the peripheral compression of the supratrochlear nerve and induce a neurogenic inflammation triggering the symptoms of migrai...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2005-836786
更新日期:2005-08-01 00:00:00
abstract::Surgical treatment is essential for the prognosis of colon carcinoma. The extension of the lymph node excision depends on several factors, as operative technique and quality of the histopathological examination. In a retrospective analysis of 278 patients who had undergone curative primary resection for colon carcinom...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:UNLABELLED:Peritoneal tumor dissemination has been considered as an incurable condition with fatal outcome. However cytoreductive surgery followed immediately by hyperthermic chemoperfusion has been described both for the treatment and prevention of locoregional cancer spread from various origins. This paper summarizes...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-818764
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Beside non-operative treatment the therapeutic options for proximal fractures of the humerus range from closed reduction and transcutaneous K-wiring to total joint replacement. While the first is regarded as minimally invasive the latter is a rather complex intervention. Plating has been disregarded as combi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-37368
更新日期:2003-01-01 00:00:00
abstract::Stabilisation of pelvic ring fractures by means of external fixation has been found to provide certain advantages over internal fixation. Good results can be achieved, provided that optimum forms and techniques of assembly are used. The authors' indications are reported together with their assembly techniques and form...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract::In an effort to demonstrate and explain the peristalsis and intact pylorus-function of an oesophagus substituted by a transformed stomach-tube and despite total vagotomy, acute tests were undertaken on 14 dogs of mixed breed in the form of electromyographic examinations on the normal stomach, the stomach after vagotom...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:The Masaoka-Koga classification describes the extent and spread of thymic epithelial malignancies. The objective of this study was to evaluate the Masaoka-Koga and the new TNM-staging system regarding differences in stage distributions, clinical implementation and therapeutic consequences. METHODS:Retrospec...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0606-5603
更新日期:2018-08-01 00:00:00
abstract::From 1975-1989 55 patients were operated on for complicated diverticular disease at our unit. Intraoperative we found the following complications: 21 walled of perforations, 22 stenosis of the sigmoid colon combined with obstruction of the small and/or large bowel, 8 free perforations with generalized, faecal peritoni...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Invasive Candida infections following abdominal surgery represent a significant medical problem. This study initiates a benchmarking project to pinpoint the current role and epidemiology of candidemia in this patient group in German hospitals. MATERIAL AND METHODS:During the year 2010 data derived from 47 7...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0033-1350814
更新日期:2015-12-01 00:00:00
abstract::The analysis of the genetic causes of tumor development led to the identification of many genes affected in these diseases, which play a role in the control of cell proliferation and apoptosis. However, these studies also suggested that not all alterations are equal with regard to their effect on tumor growth, and the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::In Germany, medical education is defined and controlled by the medical association; however hospitals are responsible for its implementation. Surgical trainees do not only need to acquire theoretical knowledge, but also practical skills. For years, young surgeons were trained primarily in the operating theatre. Nowada...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/a-0826-5097
更新日期:2019-12-01 00:00:00
abstract::Liver cuts were performed on 21 Mini-Leewe-pigs and than closed with suture and by ultrasonic welding with Ligament-FIMOMED and Gelaspon. The sound pressure leads to the forced penetration of the monomere into performed gaps. The application of the ultrasound is sensible in order to force the polymerisation. The exper...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Reported in this paper is experience obtained since 1978 from surgical removal of the tracheal bifurcation in combination with pneumonectomy in 38 cases. Squamous cell carcinoma centrally growing from the upper lobe was recorded from 24 patients to whom 36 interventions had been applied for bronchial carcinoma. 50 per...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00