Polyorchidism a report of two cases with torsion

Abstract

popliteal division descends more obliquely in the thigh and is angulated and relatively securely fixed at both the sciatic notch and the neck of the fibula. Therefore when this nerve undergoes violent lateral displacement as the result of a ' near miss ' by a high-velocity missile or explosive bullet, the sudden stretch to which the nerve is subjected involves a length of nerve which is strung between two relatively fixed points. There is consequently less slack to take up the displacement and the nerve is therefore subjected to greater stretch. This in turn means a more severe injury, particularly when the nerve contains a small amount of supporting connective tissue. SUlMMARYI. The observation that in injuries of the sciatic nerve the lateral popliteal division is more frequently involved and more often suffers greater damage than the medial is confirmed.2. It has been argued that the large size of the funiculi which are also fewer in number and the relatively smaller amount of supporting connective tissue in the lateral popliteal, as opposed to the reverse arrangement in the medial division, is the principal factor contributing to the greater susceptibility to injury of this division of the sciatic nerve.3. An additional anatomical feature concerns the course taken by the two divisions in the thigh. T h e lateral division is fixed and angulated at the sciatic notch and neck of the fibula. When the nerve is subjected to violent lateral displacement it is stretched between these two unyielding points and in this way is damaged. The medial division is less securely fixed inferiorly where its relations are such that during lateral displacement the stretch can be dissipated over a greater length of the nerve.

Sonographic findings in polyorchidism

“…4 Another suggests that polyorchidism results from faulty disappearance or division of the mesonephric tubules during descent, with upper and lower tubules remaining and the middle section di~appearing.~ Peritoneal bands may be responsible for separation of the mesonephric tubules into two groups.…”

Polyorchidism: a case report and classification

“…About 75% of cases have been left-sided [2]. The attachment of the supernumerary testis to its vessels and draining structures varies.…”

“…Polyorchidism has been classified mainly according to embryological theories: longitudinal or transverse division of the genital ridge before the eighth week of gestation, duplication of the genital ridge, incomplete degeneration of a portion of the mesonephros, and the development of peritoneal bands [2,8,9]. Although generally accepted, every classification lacks categorization for some cases described in the literature [1,[10][11][12].…”

Polyorchidism: evaluation by MR

“…is an unusual anomaly that does not have added risk except for torsion in rare cases [6][7]. Accurate preoperative assessment of this benign condition is required to avoid surgery to exclude tumor or abscess.…”