Open Scrotal Trauma Complicated by Testicular Evisceration: An Unusual Injury after a Brawl in 2 Cases

Background: Scrotal trauma is a rare injury, and can compromise reproductive function. If in closed trauma, a morphological assessment of the lesion is usually necessary before treatment, in open trauma otherwise, namely in the case of testicular evisceration, surgical exploration is the rule. Objective: To present the management of open scrotal trauma. Case Presentation: These were two adults aged 42 and 63, admitted for post-traumatic testicular evisceration. One of the patients presented with signs of infection due to a diagnosis delay. Management consisted on surgical exploration, with scrotal debridement and testicular reintegration. The evolution was favourable. Conclusion: Open scrotal trauma is a rare lesion that can cause testicular evisceration. It requires surgical exploration, which should be systematic.

Enucleation and evisceration: indications, complications and clinicopathological correlations

·AIM: To assess main indications, postoperative complications and clinicopathological correlation of ocular enucleation-evisceration.·METHODS: A total of 107 subjects who underwent enucleation and/or evisceration and received hydroxyapatite implants(Scleral wrap or mesh) were assessed. For each patient clinicopathological data was collected which included demographic information,clinical history, primary clinical diagnosis, main cause of ophthalmic surgery(traumatic, non-traumatic), type of surgical procedure(enucleation, evisceration) and pathological report. Patients’ postoperative clinical visits were checked for procedure-related complications during first year after surgery.·RESULTS: One hundred and seven patients(male:65.4%; mean age: 26y) underwent enucleation(n=100) or evisceration(n =7) due to traumatic(n =41) and non-traumatic(n =66) causes. Disfiguring painful blind eye was the most common indication of surgery(66.4%),followed by leukocoria(19.6%) and endophthalmitis(4.7%). The main types of injury included firecracker,traffic and work accidents, and sharp object perforating injury. In 53(80.3%) subjects in non-traumatic group the initial clinical diagnosis matched the histopathologicalresults. Malignant tumors(retinoblastoma: 47.5%,malignant melanoma: 27.3%) were the most common pathological diagnoses followed by phthisis bulbi(25.8%).The most common procedure-related complications were major eye discharge(39.6%), and implant exposure and discharge(20.8%).·CONCLUSION: Trauma and malignant tumors are the leading causes of enucleation-evisceration. Despite developing new techniques and materials, enucleation is still associated with considerable postoperative complications.

Autologous sclera-muscle flaps technique in evisceration with hydroxyapatite implantation

·AIM: To provide superior cosmetic results and reduce complications, unlike traditional evisceration coupled with implant insertion technique and its modifications,we have developed a novel and simple technique for anophthalmic patients.·METHODS: All patients who underwent the scleral-muscle flaps procedure in evisceration with the placement of hydroxyapatite implant were included in the study. Main outcome measures were complications such as exposure, infection, chemosis, conjunctival inclusion cysts, granulomas. Meanwhile, implant motility was indirectly measured and the results were collected and analyzed.· RESULTS: A total of twenty-eight patients were enrolled in the study. Eighteen were men(64.29%) and ten were women(35.71%). Ages ranged from 18 to 65y(mean age, 32 years old). Mean follow-up was 12.32mo(range, 9-16mo). All patients received a hydroxyapatite implant. The average diameter of the implant was 19.29 ±1.36 mm(range, 18-22 mm). Minor complications occurred in 3 patients, and a major complication was observed in 1 patient. Mean motility were 11.04 ±1.45 mm horizontally(range, 7-14 mm) and 8.57 ±1.50 mm vertically(range, 5-12 mm).·CONCLUSION: The sclera-muscle flaps technique in evisceration with hydroxyapatite implantation is simple and practical that eases the surgical procedure, enables a proper size hydroxyapatite implantation, distinctively reduces complications and provides superior surgery results, especially the motility of the implant.

Strangulated Transanal Evisceration of Small Bowel Complicating Rectal Prolapse of the Child: An Observation of the University Hospital Center of Parakou, Benin

Transanal intestinal evisceration is an extremely rare and dramatic digestive surgical emergency. The cases reported in the literature are few and concern much more elderly patients. We report the case of a 3-year-old boy admitted in very general poor condition to the emergency department, late for transanal evisceration complicating rectal prolapse that the parents tried to reduce. The fatal outcome of this case is probably related to strangulation and delay in consultation. We learn from this that parents should avoid inopportune prolapse reduction and early consultation.

Evisceration of the Small Bowel in the Vagina Following Endo-Uterine Maneuvers for Clandestine Abortion (APC) at CHU Gabriel Touré, Bamako, Mali

Intra-uterine manual aspiration is the recommended maneuver for abortive endo-uterine evacuation. It must be performed in a medical setting for therapeutic purposes, while respecting its contraindications and asepsis rules essential for its implementation. The ignorance of anatomical structures by the authors of clandestine abortions is marked by the presence of utero-adnexal lesions, digestive lesions and vesical lesions or evisceration by the vagina. Vaginal evisceration of the small bowel is a rare and serious complication of manual intrauterine aspirations and induced abortions. Their late diagnosis and clandestine practice are responsible for unpredictable severe secondary complications and remain an important cause of morbidity and mortality. The development of a policy of continuous training of agents on the technique of manual intrauterine aspiration, broad information on contraceptive methods and a multidisciplinary, rapid and adequate management of complications will provide minimum morbidity and mortality. Conclusion: Abortion is a serious source of life-threatening complications.

Small Bowel Evisceration Following Vaginal Hysterectomy is a General Surgical Emergency–A Case Report and Review of the Literature

Small bowel evisceration through the vagina is a rare condition, which tends to affect post-menopausal women who have undergone vaginal hysterectomy. It is a surgical emergency with a favourable outcome if diagnosed and treated in a timely fashion. Delay in diagnosis can precipitate infarction of small bowel loops with associated morbidity and mortality. Treatment involves laparotomy, reduction of the incarcerated loops (plus/minus small bowel resection) and repair of the vaginal rupture. The purpose of this paper is to report a case of small bowel evisceration through the vagina, to review the literature pertaining to this topic and to raise awareness of this condition in the general surgical community.

Post-Operatory Acute Eviscerations in Teaching Hospitals of Bamako (Mali)

Introduction: Post-operative acute evisceration is defined as a total dehiscence of the abdominal wall of all the constituents of the abdominal wall. The objective is to determine hospital frequency, identify favorable factors and key etiologies, and assess the rate of morbi-mortality. Patients and Method: This is a retrospective and descriptive study carried out in the general surgery departments of the Teaching Hospitals of Point “G”, Gabriel TOURE and the pediatric surgery department of the Gabriel TOURE University Hospital in Bamako, involving 53 patients. The study ran from January 1, 2005 to December 31, 2007. Inclusion Criteria: All cases of postoperative acute evisceration operated. Non-Inclusion Criteria: All cases of evisceration of other etiologies. Results: The average age was 34.2 years with extremes of 6 and 75 years, the sex ratio was 1.12 in favor of women. The initial clinical picture was peritonitis in 26 cases or 49.1%, occlusion in 16 cases or 30.2% and tumors in 6 cases or 11.3%. The post-operative complications responsible for evisceration were: parietal suppuration 28 cases or 52.8%;digestive fistulas 15 cases or 28.3%;post-operative ascites 4 cases or 7.5%. Conclusion: Post-operative acute evisceration is a rare but serious condition due to morbidity and mortality.

Proteomic analysis provides insights into the function of Polian vesicles in the sea cucumber A postichopus japonicus post-evisceration

The Polian vesicle is the main accessory structure in the water vascular system of sea cucumbers.It can function to hold water vascular fluid under slight pressure and act as a hematopoiesis,excretory,and inflammatory response organ.Being the only organ to remain after evisceration,the Polian vesicle may function in the survival and regeneration of sea cucumber.We performed Tandem Mass Tag(TMT)-based proteomics to identify how proteins in the Polian vesicle of Apostichopus japonicus respond to evisceration.Among the 8453 proteins identified from vesicle samples before evisceration(PVOh)and at 6-h post-evisceration(PV6h)and 3-d post-evisceration(PV3d),we detected 222 differentially abundant proteins(DAPs).Most of the annotated DAPs were associated with cell growth and proliferation,immune response and wound healing,substance transport and metabolism,cytoskeleton/cilia/flagella,extracellular matrix,energy production and conversion,protein synthesis and modification,and signal recognition and transduction.Compared with PVOh,fewer DAPs were identified at PV6h,and more DAPs were found at PV3d,and these DAPs were widely distributed among multiple biological processes.Our results indicate that a wide range of biological processes was induced in Polian vesicles in response to evisceration.In particular,Polian vesicles may play important roles in the re storation of coelomocyte s,immune defense,and wound healing in sea cucumber.We propose that the Polian vesicle may be involved in visceral regeneration through nutrition and energy supply and by promoting dedifferentiation and migration.Together,these results provided new insights into the function of the Polian vesicle in A.japonicus post-evisceration.

Transanal Evisceration of Small Bowel about One Case at the University Hospital Yalgado Ouédraogo of Ouagadougou

Introduction: Transanal evisceration of small bowel is an extremely rare condition that can occur spontaneously or after trauma. Objective: To report a case of Transanal evisceration of small bowel to describe the circumstances of occurrence and our therapeutic attitude. Observation: An 80-year-old female patient was received at the visceral Emergency of University Hospital Yalgado Ouédraogo for the outcome of the small intestine by the anus with the waning of a defecation effort. The physical examination of the patient accustomed to evacuation purgation noted, eviscerated the small bowel through the anus, edematous but viable. The preoperative laboratory tests were normal. In emergency, under general anesthesia, a laparotomy was possible to objectify the incarceration of intestinal loops through linear perforation of 5 cenimeter from the anterior surface of the rectosigmoid hinge. We conducted an ileo-ileal resection anastomosis, a suture rectosigmoid breach and anal extraction of small bowel incarcerated measuring 200 centimeter. The evolution was simple. Conclusion: The weakening of the rectal mucosa by repeated purges has certainly been the contributory factor. The surgical treatment must be precocious to avoid extensive intestinal resection.

眼内容物剜除术后病人病耻感现状及影响因素

目的:分析眼内容物剜除术后病人病耻感水平,并分析其影响因素。方法:采用便利抽样的方法选取2019年1月—2021年12月在中山大学中山眼科中心海南眼科医院接受眼内容物剜除术治疗的202例病人作为研究对象,采用一般资料调查表、社会影响量表(SIS)、社会支持评定量表(SSRS)对病人进行调查。结果:眼内容物剜除术后病人SIS得分为(70.43±15.23)分,SSRS得分为(25.15±5.20)分。线性逐步回归分析结果显示,年龄、学历、是否已婚、月收入和社会支持5个因素进入回归方程。结论:眼内容物剜除术后病人病耻感水平处于中等偏上,社会支持水平较低。年龄、学历、是否已婚、月收入和社会支持为眼内容物剜除术后病人病耻感水平的影响因素。

腹腔镜辅助下结直肠外翻托出式手术治疗结直肠癌的价值探讨

目的 分析结直肠癌患者接受以腹腔镜辅助的结直肠外翻托出式手术的治疗效果。方法 随机选取2020年1月—2022年12月于江苏省连云港市赣榆区人民医院普外科接受手术治疗的80例结直肠癌患者为研究对象,采用信封法随机分成两组,对照组40例开展腹腔镜直肠前切除手术,观察组40例开展腹腔镜辅助下结直肠外翻托出式手术。比较两组各项手术指标、术后并发症,留意患者疾病复发情况。结果 两组患者手术时间指标对比,差异无统计学意义(P>0.05),而在手术其他指标对比中,观察组术中出血量少,日均排便次数多,肠道恢复时间和住院时间均短,与对照组相比,差异有统计学意义(P均<0.05);观察组术后并发症发生率明显较对照组更低,差异有统计学意义(P<0.05);5个月的随访过程中,观察组仅有5.00%的患者复发,比对照组的22.50%低,差异有统计学意义(χ^(2)=5.165,P<0.05)。结论 腹腔镜辅助下结直肠外翻托出式手术应用在结直肠癌患者中的效果确切,患者术中出血量较少,可促使患者早期恢复肠道功能,降低术后不良并发症发生概率和疾病复发风险,可作为理想的手术治疗方案。

QNZ15型家禽自动取内脏机设计与试验

设计了一种扒取式家禽自动取内脏机,可按屠宰加工工艺要求将内脏一次全部取出。对该机的链轮传动系统、取内脏机械手、凸轮控制及高度调节机构等主要组成部件的设计进行了阐述,肉鸭取内脏加工试验表明,禽体质量为2.5～3.5 kg,挂拍底部到机械手末端的最大距离为310～320 mm时,取内脏加工效果较好。内脏残留主要是心脏,残留率5.6%,内脏破损情况综合评价指标为8.3。

不同术式羟基磷灰石义眼座植入术的比较

目的:观察羟基磷灰石义眼座(HA)植入术不同手术方法的临床效果。方法:根据HA植入时机及包裹方式,共分为7种手术方法,其中方法1～3为HAⅠ期植入,方法4～7为HAⅡ期植入。方法1(n =7)为眼内容剜除术后Ⅰ期植入,自体双层巩膜包裹HA前部;方法2(n =1)为眼内容剜除术后Ⅰ期植入,自体巩膜包裹HA后部;方法3(n =1)为眼球摘除术后Ⅰ期植入,自体巩膜包裹HA前部;方法4(n =2)眼内容剜除术后Ⅱ期植入,萎缩的自体巩膜包裹HA前部;方法5(n =2)眼球摘除术后Ⅱ期植入;方法6(n =3)为眼球摘除术后Ⅱ期植入,异体巩膜包裹整个HA;方法7(n =2)为眼球摘除术后Ⅱ期植入,异体巩膜包裹HA前部。观察7种术式患者的结膜伤口及HA情况。结果:所有18例中,方法1有2例结膜伤口哆开,方法5有1例HA暴露,方法7有1例巩膜溶解,HA暴露,其余14例Ⅰ期愈合。结论:采用不同术式HA植入中,Ⅰ期植入术后并发症轻,HA活动好,手术时机是提高HA植入成功的重要因素。

不同贮藏温度下鲐鱼生物胺变化的研究

为探究不同温度和预处理对鲐鱼生物胺含量变化的影响,用高效液相色谱法分析了整鱼和去内脏鱼在不同贮藏温度下8种生物胺以及总生物胺含量的变化,结果发现,鲐鱼中主要的生物胺为组胺、腐胺、尸胺、酪胺。随着温度的升高,鲐鱼中总生物胺含量的增加迅速变快。在0、4、10、15、20、25和30℃贮藏1 d后,整鱼中总生物胺的积累量分别为40.34、93.44、107.95、73.39、119.99、4649.90、6446.43 mg/kg。在0、4、10、15、20、25和30℃贮藏条件下,整鱼中组胺的含量超过国家规定的高组胺鱼类安全限量(400 mg/kg)的时间分别为12、5、4 d和48、36、15、14~16 h,-18℃贮藏6个月,组胺积累量仅为13.45 mg/kg。另外,去内脏能减少生物胺的生成,在-18、0、4、10、15、20、25和30℃贮藏条件下,去内脏后总生物胺最终积累量减少程度分别为14.22%、39.79%、13.83%、29.06%、22.60%、13.56%、26.13%、21.26%。因此,低温冷冻和去内脏处理能够有效控制鲐鱼中生物胺的生成,防止腐败。本研究为有效控制鲐鱼生物胺的产生提供了参考依据。

尸体腹部多器官联合切取(TAE)技术的改进及临床应用

目的 :探讨尸体多器官联合切取的最佳方法。方法 :1998～ 2 0 0 2年采用改进后的多器官联合切取技术进行了 65例次多器官联合切取术 ,主要改进点有 :①采用纱布填塞导尿管内腔用以灌注腹主动脉 ;②气囊注水 ,堵塞腹主动脉上段 ;③回血由下腔静脉肾静脉开口以下引入 3升袋内 ;④优先灌注腹主动脉而后灌注肝门静脉 ;⑤体内整块切取肝、胰、脾、肾、十二指肠等器官。结果 :建立腹主动脉灌注的时间为(1.0± 0 .3 )min ,建立肝门静脉灌注的时间为 (1.0± 0 .7)min ,腹腔多器官联合切取时间为 (10 .0± 3 .0 )min ,热缺血时间 (2 .0± 1.2 )min。本院行肝移植 4例 ,肝肾联合移植 2例 ,供外院行肝移植 12例 ,所有肝移植病人肝功能在 3周内恢复正常 ;胰肾联合移植 1例 ,术后 2周脱离胰岛素和透析治疗 ;肾移植 12 7例 ,术后肾功能恢复时间 (4 .82± 3 .73 )d ,急性肾小管坏死 4例 (3 .2 % )。结论 :优先灌注腹主动脉优于优先灌注肝门静脉 ;改进后的尸体腹部多器官联合切取技术能快速优质切取供器官 ,适于临床推广使用。

刺参吐脏再生的组织学研究

以中国山东地区的养殖刺参（Apostichopus jalxmicus）为研究材料，将体长10～15cm的刺参，通过注射KCI（0．35mol／L）诱导吐脏。采用组织学方法对刺参吐脏和再生过程进行观察，结果表明，刺参吐脏后便开始再生，吐脏后的第2天可观察到呼吸树主干及分支结构。腹部肠系膜在吐脏后逐渐增厚，第5天可观察到肠上皮与肌肉组织，再生出具有功能的新肠管的时间大约为2周。本研究旨为刺参再生的进一步研究以及刺参的养殖生产提供基础理论依据。

刺参机械去脏工艺的试验研究

刺参(Stichopus aponicus)去脏是刺参前处理加工的重要环节。目前刺参去脏加工多采用手工开腔去脏的方式。为提高刺参前处理加工效率,实现机械化加工,以辽宁大连、浙江嵊泗出产的刺参为试验对象,利用刺参特有的排脏生理特性,设计机械模拟装置(滚筒机构和振动机构)对刺参进行刺激。试验结果显示,滚动和振动刺激都能使刺参排脏,排脏率达到90%。刺激强度是刺参机械去脏的重要工艺指标,直接影响刺参机械去脏的效率。

海参纲动物的吐脏再生

随着现代生命科学的迅猛发展,海参表现出的极强生命现象———再生,引起了生物学家的广泛兴趣、并被作为器官再生的模型来研究。当前,在我国迅速发展的刺参养殖业中,吐脏现象给养殖者造成了很大困惑。为了搞清刺参吐脏的原因、过程及影响因子,结合对中国北方养殖刺参的吐脏再生过程研究结果、参考国内外有关文献,综述了海参再生器官的细胞起源、迁移与增殖机理,以为刺参养殖提供理论参考。

感染性眼内炎导致眼球丧失的流行病学调查

目的 探讨感染性眼内炎导致眼球丧失的相关危险因素。方法 对 1993年 2月～ 2 0 0 2年 12月收治的116例 (117眼 )感染性眼内炎患者进行回顾分析。结果 2 1例 (2 1眼 )行眼球摘除或眼内容物剜出 ,发生率为17 95 % ;其中视力无光感的眼内炎病例中眼球丧失的发生率是 80 % (P =0 .0 0 0 1OR =73.6 ) ;内源性眼内炎的发生率是 4 5 .4 5 % (P =0 .0 12 5OR =4 .6 9) ;眼球破裂伤的发生率是 4 1.6 7% (P =0 .0 0 31OR =6 .78) ;女性眼内炎的发生率是 35 .2 9% (P =0 .0 0 2OR =4 .4 8) ;前、后 5年眼球摘除或眼内容物剜出的发生率分别是 2 6 .5 3%和11 76 % (P =0 .0 4 0 )。结论 眼内炎病例中视力无光感、内源性眼内炎、眼球破裂伤及女性是导致眼球摘除或眼内容物剜出的危险因素 ;眼球摘除或眼内容物剜出的发生率逐年减少。

家禽净膛机械手末端执行器的设计及运动学分析

针对家禽净膛过程中末端执行器操作空间小、抓取灵活等特点,对家禽净膛机械手末端执行器进行总体设计,并设计三指三关节家禽自动净膛末端执行器的结构。通过对机械手末端执行器手指腱绳伸缩量与关节角度的变化规律、手指的工作姿态、手指干涉分析等进行分析研究,获得家禽末端执行器净膛抓取时的最佳指节倾斜倒角。应用D-H矩阵通过齐次矩阵变换建立家禽机械手末端执行器的模型,对末端执行器进行运动学求解,验证所建立的末端执行器模型的正确性与可行性。