Orchiectomy as a result of ischemic orchitis after inguinal hernia repair

Ischemic orchitis is an established complication after open and laparoscopic inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the surgical approach is very rare. We reported a case of healthy 47 year-old man, with no previous surgery or history of trauma, who presented with right direct inguinal hernia. He is a thin, muscular male with a narrow pelvis who underwent right extraperitoneal mesh implantation with open inguinal hernia repair. The patient was discharged on the same day and doing well with minimal pain and swelling until the fifth day after surgery. That night he presented with sudden-onset of pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Scintigraphy and ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy

Investigating the clinical significance of twinkling artifacts in patients with urolithiasis smaller than 5 mm

Purpose: Our aim was to evaluate the effectiveness of twinkling artifacts (TA) in detecting calculi <5 mm in diameter in patients with renal colic pain who had undergone urinary grayscale ultrasonography (US) and computed tomography (CT) imaging assays. Materials and methods: In this retrospective study, a total of 76 calculi <5 mm detected in 60 patients were evaluated. Whole data were established using an ultrasound (US) probe at frequencies 1.5-4.5 MHz and noncontrast CT. In US, echogenicity and posterior-shadow (PS) parameters were evaluated and compared with color-Doppler ultrasonography (CDUS) and CT signs. Results: The mean size of measured calculi was 3.9 ± 0.8 mm (range 2-5 mm). The calculus localization rates detected by CT imaging were as follows: kidneys (n = 61, 80.3 %), proximal ureter (n = 4, 5.3 %), middle ureter (n = 3, 3.9 %) and distal ureter (n = 8, 10.5 %). CT detected the calculus in all 76 cases. There was a statistically significant difference in US-CT and CDUS-CT comparisons (p < 0.001 and p = 0.023, respectively); however, no difference was found when comparing both US methods with CT (p = 0.083). Conclusions: TA can be regarded as a significant marker of urolithiasis, and co-operative usage of Doppler and grayscale methods can yield satisfactory results comparable with CT. © 2014 Japan Radiological Society