A Simple Guide to Hydrocoele
-----------------------------
What is Hydrocoele?
--------------------
Hydrocoele is the excess accumulation of fluid inside the sac containing your testis.
What causes Hydrocoele?
------------------------
The causes of Hydrocoele are mostly due:
A.Congenital:
----------------------
Children are born with with enlarged testicular sac with fluid which communicate with abdominal cavity through a patent duct which should be closed at birth.
B.Infections:
---------------------
Infections of the testicle can cause inflammation of the cavity surrounding the testicle and its appendages.
c. Obstruction to fluid flow:
Obstruction to lymphatic and venous flow in the testicular cavity prevents the fluid in the testicular cavity from being re-absorbed into the general system.
What are the symptoms of Hydrocoele?
-------------------------------------
The Symptoms of Hydrocoele are:
1.heaviness anf fullness of the scrotum
2.enlargement of scrotum usually on 1 side
3.usually painless except when inflammed or infected
Signs:
1.redness and swelling of the scrotum
2.enlargement of the scrotum on 1 side
5.Inguinal lymph nodes may be swollen and painful if there is severe infection(rare)
What are the complications of Hydrocoele?
-----------------------------------------------
1.Abscess formation
2.torsion of the testicle(rare)
How is diagnosis of Hydrocoele confirmed?
------------------------------------------
1. clinical features and trans-illumination of scrotal swelling
3. Ultrasound scan of the scrotal swelling to exclude any tumors of the testicle or torsion.
What is the treatment of Hydrocoele?
------------------------------------
1. Aspiration of the fluid in the scrotal cavity usually helps to reduce swelling but recurrences are common
2.Rest and support of the scrotum with loose underwear
3. surgery with drainage of fluid from scrotum.
The scrotal cavity is opened up and the fluid drained.
If the testicle is normal it should be left alone.
If the testicle is disease and shrunken, it is usually removed.
What is the Prognosis of Hydrocoele?
------------------------------------
Most cases of Hydrocoele usually will recover with surgical treatment.
Aspiration is a temporary measure as recurrences are common.
Congenital cases of Hydrocoele usually resolve spontaneously
What are the Preventive measures for Hydrocoele?
----------------------------------------------------
Avoid too tight underwear which can obstruct the lymphatic or blood vessels of the scrotum.
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Showing posts with label congenital. Show all posts
Showing posts with label congenital. Show all posts
Friday, August 22, 2008
Thursday, August 21, 2008
A Simple Guide to Inguinal Hernia
A Simple Guide to Inguinal Hernia
-------------------------------------------
What is Inguinal Hernia?
----------------------------------
Inguinal Hernia is protrusion of the part of the viscera(contents in the abdominal cavity) through the inguinal canal which is the tunnel which leads the spermatic duct from the testis to the urethra or seminal vesicles in the abdomen.
What are the different types of Inguinal Hernia?
---------------------------------------------------
1.Indirect:
The abdominal contents such as small intestine enter the the enlarged internal inguinal ring and protrude into the inguinal canal entering the scrotum.
2:Direct:
The abdominal contents find a weak spot in the abdominal wall and enter the the inguinal canal.
What causes Inguinal Hernia?
---------------------------------------
The causes of Inguinal Hernia are mostly due:
A.Congenital :
----------------------
The inguinal canal follows the same route as the descent of the testes from the abdomen out to the scrotum outside the abdomen during the embryonic stage.
If there is partial closure of the internal inguinal ring, then weakness of the of abdominal wall occurs allowing abdominal content to protrude through the inguinal canal.
B.Increased abdominal pressure:
------------------------------------
Increased intra-abdominal pressure can occur as a result of :
1.coughing
2.straining
3.distension
4.obstruction
C.Weakening of the abdominal muscle:
---------------------------------------
1.Obesity
2.muscle wasting diseases
Hernias are more common in men than in women because the inguinal canal is usually closed in women whereas in men the canal carries the spermatic duct.
What are the symptoms of Inguinal Hernia?
------------------------------------------------
Symptoms:
1.Swelling in the groin area which is worse on coughing, straining or standing up
2.swelling of the groin usually disappear on lying down(abdominal contents is returned to the abdominal cavity).
3.Pain or discomfort may be present
Signs:
1.Swelling in the groin can be felt.
If a finger is pressed into the external inguinal ring, coughing can make the swelling feel more palpable
2.There may gurgling sounds of intestinal gas movement on auscultation of the swelling with the stethoscope.
3.Local tenderness of swelling
What are the complications of Inguinal Hernia?
----------------------------------------------------
1.Irreducible hernia may occur when the abdominal contents cannot be returned to the peritoneal cavity due to adhesions of the inguinal canal of the faecal matter stuck in the protruded intestine.
This complication may be serious
2.Strangulated hernia occur when the blood circulation is cut off due to constriction of the neck of the hernial sac resulting in ischemia and gangrene of the gut.
Signs and symptoms of intestinal obstruction then becomes obvious with increased abdominal pain and local tenderness.
This is a medical emergency and should be treated immediately.
3.Peritonitis - burst abdomen as a result of intestinal obstruction
How is diagnosis of Hernia confirmed?
------------------------------------------
1. clinical features of swelling in the inguinal area
2. CT and Ultrasound scan of the inguinal region and scrotum to exclude hydrocoele and tumors
What is the treatment of Hernia?
------------------------------------
1. At the early stage of inguinal hernia, a truss which press against the internal inguinal ring may help to elevate symptoms and prevent the hernia from bulging out.
They are useful in patients with poor general condition who are unable to tolerate full surgery.
They are seldom used now.
2.All inguinal hernia patients should undergo elective (non-emergency) surgery to repair the hernia before complications such as strangulated hernia sets in.
Such surgery called herniorrhaphy or hernioplasty can be done on a day surgery under local anethesia and using laparoscopy.
It usually involved sewing a wire mesh over the inguinal ring to tighten the inguinal ring and prevent the contents of the abdomen from pushing its way out into the inguinal canal.
Patient is usually asked to cough after the surgery to make sure the abdominal wall is tight enough to prevent any intestine to protrude out.
3.Emergency surgery is required if there is any strangulated inguinal hernia or intestinal obstruction.
4.Most congenital hernia may disappear by the end of the first year.
What is the Prognosis of Hernia?
------------------------------------
Most cases of inguinal hernia usually will recover with proper surgical treatment.
Very rarely there may be complications such as postoperative infections or recurrence.
What are the Preventive measures for Hernia?
----------------------------------------------------
Avoid straining at stools, severe coughing.
Avoid carrying heavy weights.
Lose some weight.
-------------------------------------------
What is Inguinal Hernia?
----------------------------------
Inguinal Hernia is protrusion of the part of the viscera(contents in the abdominal cavity) through the inguinal canal which is the tunnel which leads the spermatic duct from the testis to the urethra or seminal vesicles in the abdomen.
What are the different types of Inguinal Hernia?
---------------------------------------------------
1.Indirect:
The abdominal contents such as small intestine enter the the enlarged internal inguinal ring and protrude into the inguinal canal entering the scrotum.
2:Direct:
The abdominal contents find a weak spot in the abdominal wall and enter the the inguinal canal.
What causes Inguinal Hernia?
---------------------------------------
The causes of Inguinal Hernia are mostly due:
A.Congenital :
----------------------
The inguinal canal follows the same route as the descent of the testes from the abdomen out to the scrotum outside the abdomen during the embryonic stage.
If there is partial closure of the internal inguinal ring, then weakness of the of abdominal wall occurs allowing abdominal content to protrude through the inguinal canal.
B.Increased abdominal pressure:
------------------------------------
Increased intra-abdominal pressure can occur as a result of :
1.coughing
2.straining
3.distension
4.obstruction
C.Weakening of the abdominal muscle:
---------------------------------------
1.Obesity
2.muscle wasting diseases
Hernias are more common in men than in women because the inguinal canal is usually closed in women whereas in men the canal carries the spermatic duct.
What are the symptoms of Inguinal Hernia?
------------------------------------------------
Symptoms:
1.Swelling in the groin area which is worse on coughing, straining or standing up
2.swelling of the groin usually disappear on lying down(abdominal contents is returned to the abdominal cavity).
3.Pain or discomfort may be present
Signs:
1.Swelling in the groin can be felt.
If a finger is pressed into the external inguinal ring, coughing can make the swelling feel more palpable
2.There may gurgling sounds of intestinal gas movement on auscultation of the swelling with the stethoscope.
3.Local tenderness of swelling
What are the complications of Inguinal Hernia?
----------------------------------------------------
1.Irreducible hernia may occur when the abdominal contents cannot be returned to the peritoneal cavity due to adhesions of the inguinal canal of the faecal matter stuck in the protruded intestine.
This complication may be serious
2.Strangulated hernia occur when the blood circulation is cut off due to constriction of the neck of the hernial sac resulting in ischemia and gangrene of the gut.
Signs and symptoms of intestinal obstruction then becomes obvious with increased abdominal pain and local tenderness.
This is a medical emergency and should be treated immediately.
3.Peritonitis - burst abdomen as a result of intestinal obstruction
How is diagnosis of Hernia confirmed?
------------------------------------------
1. clinical features of swelling in the inguinal area
2. CT and Ultrasound scan of the inguinal region and scrotum to exclude hydrocoele and tumors
What is the treatment of Hernia?
------------------------------------
1. At the early stage of inguinal hernia, a truss which press against the internal inguinal ring may help to elevate symptoms and prevent the hernia from bulging out.
They are useful in patients with poor general condition who are unable to tolerate full surgery.
They are seldom used now.
2.All inguinal hernia patients should undergo elective (non-emergency) surgery to repair the hernia before complications such as strangulated hernia sets in.
Such surgery called herniorrhaphy or hernioplasty can be done on a day surgery under local anethesia and using laparoscopy.
It usually involved sewing a wire mesh over the inguinal ring to tighten the inguinal ring and prevent the contents of the abdomen from pushing its way out into the inguinal canal.
Patient is usually asked to cough after the surgery to make sure the abdominal wall is tight enough to prevent any intestine to protrude out.
3.Emergency surgery is required if there is any strangulated inguinal hernia or intestinal obstruction.
4.Most congenital hernia may disappear by the end of the first year.
What is the Prognosis of Hernia?
------------------------------------
Most cases of inguinal hernia usually will recover with proper surgical treatment.
Very rarely there may be complications such as postoperative infections or recurrence.
What are the Preventive measures for Hernia?
----------------------------------------------------
Avoid straining at stools, severe coughing.
Avoid carrying heavy weights.
Lose some weight.
Tuesday, August 12, 2008
A Simple Guide to Hypothyroidism
A Simple Guide to Hypothyroidism
-----------------------------------
What is Hypothyroidism (Underactive Thyroid) ?
------------------------------------------------
Hypothyroidism is a condition caused by insufficient production of the thyroid hormones, usually more common in females.
What are the causes of Hypothyroidism?
-------------------------------------------
Primary causes:
1.Congenital:
Aplasia(no thyroid), Hypoplasia(small thyroid), ectopic(not at normal site) thyroid gland
2.Autoimmune Thyroiditis(hashimoto thyroiditis):
inflammation cause insuffient production of thyroid hormones
3.Iodine deficiency can cause less production of thyroxine
Secondary Causes:
1.Radioactive iodine reduces production of thyroid hormones
2.Excess removal of thyroid gland causes reduced production of thyroid hormones.
3.Hypothyroidism during or after pregnancy.
These women develop antibodies to their own thyroid gland resulting in underproduction of thyroid hormones.
Other rarer causes include
4. radiation treatment for cancers of the head and neck,
5.pituitary problems
What are the symptoms and signs of Hypothyroidism?
-------------------------------------------------------
Symptoms
Congenital Hypothyroidism:
---------------------------
1.puffy face
2.enlarged protruberant tongue
3.hypotonia
4.sluggish reflexes
5.enlarged fontanelle
6.retardation of development
Adult Hypothyroidism:
------------------------
1.Slowness of movement
2.slowness of thought
3.unexplained weight gain
4.cold intolerance
5.dry coarse skin
6.hair loss
7.puffy face
8.menorrhagia
9.constipation
10.depression
11.husky voice
12.bradycardia(slow heart beats)
How is the diagnosis of Hypothyroidism made?
-----------------------------------------------
1.blood test is done for TSH (thyroid stimulating hormone) levels.
TSH is usually high for Hypothyroidism
2.blood test for T4 and T3 levels.
Low levels of T4 and T3 usually means HYpothyroidism
3.Thyroid ultrasound scan for ectopic and congenital hyothyroids
What is the Treatment of Hypothyroidism?
-------------------------------------------
1.Hormone replacement with daily doses of synthetic thyroxine
2.Blood is taken regularly to test the level of TSH.
3.thyroxine dosage is adjusted until there is a normal TSH level.
4.Life long treatment of patients with thyroid hormones
What is the Prognosis of Hypothyroidism?
-------------------------------------------
Dramatic response and very good reaction to treatment occurs in most cases.
Mental retardation and slow physical development occurs in congenital hypothyroidism
-----------------------------------
What is Hypothyroidism (Underactive Thyroid) ?
------------------------------------------------
Hypothyroidism is a condition caused by insufficient production of the thyroid hormones, usually more common in females.
What are the causes of Hypothyroidism?
-------------------------------------------
Primary causes:
1.Congenital:
Aplasia(no thyroid), Hypoplasia(small thyroid), ectopic(not at normal site) thyroid gland
2.Autoimmune Thyroiditis(hashimoto thyroiditis):
inflammation cause insuffient production of thyroid hormones
3.Iodine deficiency can cause less production of thyroxine
Secondary Causes:
1.Radioactive iodine reduces production of thyroid hormones
2.Excess removal of thyroid gland causes reduced production of thyroid hormones.
3.Hypothyroidism during or after pregnancy.
These women develop antibodies to their own thyroid gland resulting in underproduction of thyroid hormones.
Other rarer causes include
4. radiation treatment for cancers of the head and neck,
5.pituitary problems
What are the symptoms and signs of Hypothyroidism?
-------------------------------------------------------
Symptoms
Congenital Hypothyroidism:
---------------------------
1.puffy face
2.enlarged protruberant tongue
3.hypotonia
4.sluggish reflexes
5.enlarged fontanelle
6.retardation of development
Adult Hypothyroidism:
------------------------
1.Slowness of movement
2.slowness of thought
3.unexplained weight gain
4.cold intolerance
5.dry coarse skin
6.hair loss
7.puffy face
8.menorrhagia
9.constipation
10.depression
11.husky voice
12.bradycardia(slow heart beats)
How is the diagnosis of Hypothyroidism made?
-----------------------------------------------
1.blood test is done for TSH (thyroid stimulating hormone) levels.
TSH is usually high for Hypothyroidism
2.blood test for T4 and T3 levels.
Low levels of T4 and T3 usually means HYpothyroidism
3.Thyroid ultrasound scan for ectopic and congenital hyothyroids
What is the Treatment of Hypothyroidism?
-------------------------------------------
1.Hormone replacement with daily doses of synthetic thyroxine
2.Blood is taken regularly to test the level of TSH.
3.thyroxine dosage is adjusted until there is a normal TSH level.
4.Life long treatment of patients with thyroid hormones
What is the Prognosis of Hypothyroidism?
-------------------------------------------
Dramatic response and very good reaction to treatment occurs in most cases.
Mental retardation and slow physical development occurs in congenital hypothyroidism
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