Necrosis of Morgagni hydatids and testicular hydatids
Gidatida Morgagni is a rudiment in boys and men; in women, internal genital organs are formed from it. Gidatida Morgania is a pedunculated polyp. It can be located on the testicle, epididymis, appendage, or vas deferens. Testicular and epididymis hydatids were described in 1761 and named after the author. The process of the testicle is located in the area of connection with the head of the epididymis, designated as the embryonic remnant of the Müllerian duct.
And the process of the epididymis located on its head is a rudimentary part of the cranial section of the Wolf's duct. The aberrant Haller ducts act as hydatids in the region of the body and tail of the epididymis, and paradidymis in the region of the distal part of the spermatic cord. Almost all hydatids have a stem-like structure, some are characterized by a wide base, a diameter of 0.2 to 1.5 cm.
Morgagni's hydatids contain cystic inclusions, are covered with a cylindrical epithelium, consist of connective tissue formations, with a delicate and loose stroma, thin and fragile blood vessels. These embryonic formations are easily exposed to various pathologies, among which there is necrosis provoked by injuries - jumping from a height, outdoor games, trauma to the scrotum and many more reasons. Morgania's hydatid necrosis most often occurs as a result of its torsion, in which the work of blood vessels is disrupted by oxygen supply.
This is necessarily accompanied by the development of the inflammatory process, hemorrhage and necrosis. Necrosis develops during infectious processes or after minor injuries. Clinically, necrosis of Morgagni hydatids is manifested by edema, inflammation and impaired blood flow throughout the scrotum, which often leads to testicular degeneration. Hydatid necrosis is developing rapidly, therefore, it belongs to emergency pathologies.
By opening the membranes, an accurate diagnosis is made, its fidelity is confirmed by a turbid, pus-like effusion with fibrin flakes.
But it is not always possible to accurately diagnose it, it can be confused with orchitis, epididymitis, etc. Symptoms of the disease are constant, gradually increasing pain in the groin, lower abdomen, in the testicle. Visually, you can see a nodule of dark blue color, visible through the tissue of the scrotum. Palpation due to the presence of dropsy and severe pain is impossible. In the initial period of development of changes, a diagnosis can be made based on external signs. …
Usually, on about the 2nd day, the testicle is affected by dropsy, edema and redness of the scrotum appear. Scrotal hyperemia and secondary dropsy (hydrocele) are late signs of the disease. Hydatid necrosis causes a condition called scrotal edema syndrome, which has nuances in its development and reflects a picture of deep disorders. If, after elimination of the torsion by warming or blocking the spermatic cord with novocaine, the dark color characteristic of necrosis does not change, then they resort to removing the testicle.
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A timely operation with a pronounced syndrome of edematous scrotum contributes to the preservation of the organ, in the opposite case, testicular atrophy may develop. Torsion-related necrosis can occur in utero, after birth, a painless dense formation is located in the scrotum, the color of the scrotum changes, signs of ecchymosis and edema can be detected. In this case, testicular viability is impaired. In order to prevent the phenomenon of torsion and necrosis in the future, fixation of the second, healthy testicle should be performed.
Hydatid necrosis can occur in any inflammatory process, it is a consequence of erysipelas of the skin, weeping eczema. At the same time, ischemic areas are formed in the tissues of the suspension, aseptic chronic vaginitis develops. The disease is characterized by the severity of the course in the presence of anaerobic infection. In an advanced stage, blisters with serous-hemorrhagic contents appear on the skin, patients complain of headache, high body temperature, chills, shortness of breath, palpitations.
When the bubbles open spontaneously, erosion is formed. The appearance of dark gray spots indicates scrotal necrosis. After a week, the formed demarcation line contributes to the rejection of dead skin of the scrotum and the release of pus with gas bubbles. The process of melting and rejection can last up to 12 days from the onset of the disease. When the testicles are completely exposed, the pain passes, the temperature decreases and the skin regenerates.
For the diagnosis of acute diseases of organs, thermography, radioisotope scanning, ultrasound echotomography, puncture of the scrotum and testicle with a thick needle are used. Ultrasound examinations can accurately determine the degree of functional and structural changes.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
