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PubMed · 6770325

Acute bleeding emergencies.

R R Montgomery·W E Hathaway
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Abstract

The successful management of acute bleeding depends on the ability to make a rapid diagnosis so that specific hemostatic therapy can be used whenever possible. Three kinds of manifestations--acute hemorrhage in a child with a known or suspected hereditary bleeding disorder; the bleeding tendency that occurs secondary to a specific disease process; and an unexpected and isolated episode in an otherwise well child--are discussed.

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Acute DiseaseAspirinBlood Coagulation DisordersBlood Platelet DisordersBlood VesselsChildChild, PreschoolEmergenciesFactor VIIIFemaleHemorrhageHemostatic TechniquesHumansMalePlatelet AggregationPlatelet CountPlateletpheresisPostoperative ComplicationsSplenectomyUremiaCase ReportsJournal Article

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R R Montgomery, W E Hathaway. 1980. Acute bleeding emergencies.. https://doi.org/10.1016/s0031-3955(16)33854-8

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Acute spermatic cord torsion alters the microcirculation of the contralateral testis.

PURPOSE: The purpose of this study was to characterize the hemodynamic changes in the contralateral testis during acute spermatic cord torsion in anesthetized rats. MATERIALS AND METHODS: We used videomicroscopy to examine the microcirculation of the contralateral testis following acute torsion. Specifically, we examined the effect on vasomotion, a rhythmic dilation and constriction of the arterioles that is involved in fluid and nutrient exchange and modulation of local vascular resistance. In a separate set of experiments, blood flow in the contralateral internal spermatic artery was measured with an ultrasonic flow probe during acute torsion. RESULTS: Following 720 degrees torsion, the amplitude of vasomotion in the contralateral testis increased 121% (29.0 +/- 3.9% versus 13.0 +/- 1.7%) compared with controls. Blood flow in the contralateral internal spermatic artery decreased 43% after 2 hours' torsion. CONCLUSIONS: Acute spermatic cord torsion altered the microcirculation by increasing the amplitude of vasomotion and decreased total blood flow to the opposite testis. Because the hydraulic resistance of a blood vessel exhibiting vasomotion is always less than a vessel with the same average but static diameter, the observed microcirculatory changes may be an adaptive response to preserve local flow in the presence of decreased total flow. The long-term consequences of these changes in the microcirculation may affect testicular function and ultimately fertility.

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