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Purpose: The aim of this study is to evaluate the potential effect of varicocele in the hormonal and clinical profile of adolescents.Methods: Twenty adolescents at Tanner stage 4-5 with left varicocele were studied and compared with a control group of 20 healthy adolescents. All patients underwent ultrasonographic testicular volumetry as well as hormonal evaluation of inhibin B, testosterone, baseline and gonadotropin-releasing hormone stimulated, follicle-stimulating hormone as well as luteinizing hormone. Statistical analysis was performed using the student's t test with p value <0.05 taken as statistical significant.Results: Patients with varicocele showed reduced levels of inhibin B compared to controls and a significant reduction in the testicular volume on the affected side. The response of luteinizing hormone to gonadotropin-releasing hormone stimulation was significantly higher in the varicocele group compared to the control group. Furthermore a significant inverse relationship of inhibin B compared to follicle-stimulating hormone was noted.Conclusion: Serum inhibin B levels could represent a useful marker of Sertoli cell damage caused by varicocele. [ABSTRACT FROM AUTHOR]

Purpose: Rectus sheath hematoma (RSH) represents an unusual abdominal wall pathology, frequently confounded as acute abdomen, with high mortality rates reported especially among elderly patients. The purpose of this retrospective study was to delineate characteristics of the patients diagnosed with RSH at the First Surgery Department of the Saint George General Hospital of Chania, Greece over a 5-year period.Methods: Seven patients with a median age of 62 years (range 51–85) were included in the study. Clinical features, demographics, management and outcome are summarized.Results: The most common predisposing risk factor was anticoagulation. Acute onset abdominal pain and painful palpable abdominal mass, located more often on the right lower abdominal quadrant, were the most frequent initial symptoms. Management was mostly conservative [6 (85.7 %)] with disruption of anticoagulation, analgesia and bed rest. Blood transfusion was performed in hemodynamic compromised patients [2 (28.5 %)]. One patient was not appropriately diagnosed. On admission, the patient presented severe hemodynamic compromise and for this reason underwent emergency explorative laparotomy. The majority of the patients [6 (85.7 %)] experienced an uncomplicated clinical recovery and were discharged home after a mean hospital stay of 10 days (range 7–12).Conclusions: Surgeons as well as primary care physicians have to be aware of the clinical diagnostic tests and include the condition in the differential diagnosis of acute onset abdominal pain. Prompt recognition will prevent unnecessary surgical intervention and potential complications. [ABSTRACT FROM AUTHOR]

dominoscrotal hydrocele represents an uncommon condition, especially in childhood, resulting from the communication of a large scrotal hydrocele with the abdominal cavity through the inguinal canal. The disorder has been associated with a variety of pathological entities such as hydronephrosis, lymphedema, and malignancy of the tunica vaginalis. Diagnosis is made by physical examination and confirmed by abdominal ultrasound scan. Surgical correction, although complex, remains the optimal therapeutic option. The present article reports the case of a 9-month infant from Greece with abdominoscrotal hydrocele. Regardless of rarity, the disorder should be included in the differential diagnosis of scrotal and abdominal masses, as early diagnosis and surgical intervention may prevent the development of potential complications. The difficulty in establishing a preoperative diagnosis highlights the necessity for a physician to have a high level of familiarity with abdominoscrotal hydrocele and its possible complications. Awareness of this abnormality will ensure its prompt recognition and optimal management. [ABSTRACT FROM AUTHOR]