Congenital malformations of the seminal vesicle are uncommon, and most of them are cystic malformations. If an insult occurs during the first trimester of gestation, the embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens could be altered. The mutual embryological origins of the seminal vesicle and ureteral bud from the mesonephric (Wolffian) duct result in association between ipsilateral renal agenesis and seminal vesical cysts. Zinner syndrome is a rare condition comprising a triad of unilateral renal agenesis, ipsilateral seminal vesicle obstruction and ipsilateral ejaculatory duct obstruction. This syndrome were first described by Zinner in 1914, and 200 cases have been reported in the literature. Most patients with this anomaly are asymptomatic until the second or third decade of life. Some cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. In this paper, we present a uncommon case of a 21-year-old patient which the initial presentation of this condition was intermittent scrotal pain. A brief review of the literature is undertaken, regarding the main clinical, imaging implications, and the developmental anomalies that are involved in this congenital anomaly.

IntroductionTorsion of the omentum is a rare cause of abdominal pain. It is clinically similar to common causes of acute surgical abdomen and is often diagnosed during surgery. Inguinal hernia is a common condition but not frequently related with torsion of the omentum.Case presentationA 40-year-old Caucasian man came to our emergency department with abdominal pain of the left quadrant and abdominal distension for 2 days. His medical history included an untreated left inguinal hernia in the last year. Computed tomography revealed densification of mesocolon with left omentum “whirl” component and other signs of omental torsion. During an exploratory laparoscopy, a wide twist of his omentum with necrotic alterations that extended to the bilateral inguinal hernial content was observed. Omentectomy and surgical repair of bilateral inguinal hernia were performed.ConclusionsTorsion of the omentum is a rare entity and usually presents a diagnostic challenge. The use of abdominal computed tomography can help diagnosing torsion of the omentum preoperatively and, thus, prevents a surgical approach. Nonetheless, some cases of torsion of the omentum require surgical repair. Accordingly, a laparoscopic approach is minimally invasive and efficient in performing omentectomy.

HCFMUSP. 2. Pós-graduando do Departamento de Cardio-Pneumologia da FMUSP e Aluno do Curso de Especialização em Transplante Cardíaco-InCor-HCFMUSP. 3. Coordenador da Liga de Transplante Cardíaco da FMUSP e aluno do Curso de Especialização em Transplante Cardíaco-InCor-HCFMUSP. 4. Acadêmico da FMUSP e Membro da Liga de Transplante da FMUSP.

ObjectiveTo describe and demonstrate the viability of a method for evaluating knee kinematics, by means of a continuous passive motion (CPM) machine, before and after anterior cruciate ligament (ACL) injury.MethodsThis study was conducted on a knee from a cadaver, in a mechanical pivot-shift simulator, with evaluations using optical tracking, and also using computed tomography.ResultsThis study demonstrated the viability of a protocol for measuring the rotation and translation of the knee, using reproducible and objective tools (error < 0.2 mm). The mechanized provocation system of the pivot-shift test was independent of the examiner and always allowed the same angular velocity and traction of 20 N throughout the movement.ConclusionThe clinical relevance of this method lies in making inferences about the in vivo behavior of a knee with an ACL injury and providing greater methodological quality in future studies for measuring surgical techniques with grafts in relatively close positions.

An obese 22-year-old man with a history of recurrent respiratory infections presented to the emergency room with left pleuritic chest pain, productive cough with mucupurulent sputum and an axillary temperature of 37.7°C. Blood work showed elevated inflammatory parameters and chest X-ray was relevant for heterogeneous infiltration in the left base and opacity of the left costophrenic angle. An angio-CT scan revealed areas of bilateral consolidation with presence of an arterial branch originating from the aorta to the collected area of the left lower lobe, consistent with a respiratory infection grafted on a intralobar pulmonary sequestration of the left lung base. The infectious process was treated and the patient was planned for a lower left lobectomy.