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PubMed · 3945849

Negative appendix with suspected appendicitis: an update.

J S Levine·G A Gomez·D B Dove
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Abstract

We report a retrospective study of 282 consecutive patients who had appendectomy for suspected acute appendicitis at the University of Miami/Jackson Memorial Medical Center during a 15-month period. The overall incidence of negative explorations of 7.4% was significantly lower than that reported in the literature, and occurred without a significant increase in the incidence of perforation (22%). Since no sophisticated diagnostic tests were used, we suggest that a decrease in the presently accepted negative exploration rate of 15% to 20% can be achieved on the basis of a careful history, detailed physical examination, and basic laboratory and x-ray studies.

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Acute DiseaseAdolescentAdultAge FactorsAgedAppendicitisChildChild, PreschoolDiagnosis, DifferentialFalse Negative ReactionsFemaleHumansInfantInfant, NewbornIntestinal PerforationMaleMiddle AgedPelvic Inflammatory DiseaseRetrospective StudiesComparative StudyJournal Article

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BibTeXRIS

J S Levine, G A Gomez, D B Dove. 1986. Negative appendix with suspected appendicitis: an update.. https://doi.org/10.1097/00007611-198602000-00010

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Acute spermatic cord torsion alters the microcirculation of the contralateral testis.

PURPOSE: The purpose of this study was to characterize the hemodynamic changes in the contralateral testis during acute spermatic cord torsion in anesthetized rats. MATERIALS AND METHODS: We used videomicroscopy to examine the microcirculation of the contralateral testis following acute torsion. Specifically, we examined the effect on vasomotion, a rhythmic dilation and constriction of the arterioles that is involved in fluid and nutrient exchange and modulation of local vascular resistance. In a separate set of experiments, blood flow in the contralateral internal spermatic artery was measured with an ultrasonic flow probe during acute torsion. RESULTS: Following 720 degrees torsion, the amplitude of vasomotion in the contralateral testis increased 121% (29.0 +/- 3.9% versus 13.0 +/- 1.7%) compared with controls. Blood flow in the contralateral internal spermatic artery decreased 43% after 2 hours' torsion. CONCLUSIONS: Acute spermatic cord torsion altered the microcirculation by increasing the amplitude of vasomotion and decreased total blood flow to the opposite testis. Because the hydraulic resistance of a blood vessel exhibiting vasomotion is always less than a vessel with the same average but static diameter, the observed microcirculatory changes may be an adaptive response to preserve local flow in the presence of decreased total flow. The long-term consequences of these changes in the microcirculation may affect testicular function and ultimately fertility.

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