Hematopoietic elements: The foreign invaders of the adrenal gland – Case series and review of literature

Introduction: Acquired adrenal insufficiency is a known risk of unilateral adrenalectomy. However, the rates of early and prolonged adrenal insufficiency following unilateral adrenalectomy are not well defined in the literature. Patients and Methods: We reviewed a case series of 184 consecutive patients to determine the likelihood of steroid supplementation at 30 days and 1 year following adrenalectomy. 109 lesions were non-functional and 75 (41%) demonstrated functionality, including 33 pheochromocytomas, 20 cortisol-producing adenomas, 19 aldosteronomas, and 3 cases of cortisol-secreting hyperplasia. No patients with a nonfunctional lesion, pheochromocytoma, or aldosteronoma required steroid supplementation following surgery. Eleven of 23 patients (48%) with primary adrenal Cushing syndrome required cortisol supplementation at 30 days, and only 1 patient (4%) necessitated supplementation one year following surgery. Discussion: Approximately 50% of patients with cortisol-producing lesions in the adrenal gland will require supplementation 30-days following surgery. Only 4% will require persistent exogenous steroids at 1-year. Conversely, less than 1% of patients with different types of functional or non-functional tumors required supplementation after surgery. Conclusion: The incidence of adrenal insufficiency following unilateral adrenalectomy is low. A large majority of patients requiring steroid supplementation 30 days following surgery are able to wean off this requirement by 1 year. With this information, we can better counsel our patients and set clearer expectations for the potential need of cortisol supplementation following adrenalectomy

Download Full-text

INCIDENTAL PRESENTATION OF ADRENAL GANGLIONEUROMA: CASE SERIES AND REVIEW OF LITERATURE

10.36106/ijsr/5402614 ◽

2020 ◽

pp. 69-71

Author(s):

Farhana Zakaria ◽

Altaf Khan ◽

Rahul Bhargava

Keyword(s):

Surgical Treatment ◽

Adrenal Gland ◽

Neural Crest ◽

Adrenal Mass ◽

Histopathological Examination ◽

Case Series ◽

Neural Crest Cells ◽

Posterior Mediastinum ◽

Review Of Literature ◽

Adrenal Ganglioneuroma

Adrenal Ganglioneuromas are uncommon tumours arising from neural crest cells in posterior mediastinum and retroperitoneum. Rarely do they arise from adrenal gland and most of them are incidentally detected and hormonally inactive. Radiologically, they appear as any other adrenal mass, hence histopathological examination and immunohistochemistry plays a major role. With the advent of laparoscopy and robot, outcome of surgical treatment has improved a lot.

Download Full-text

Ventral Foramen Magnum Neurenteric Cysts: Case Series and Review of Literature

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0034-1383918 ◽

2014 ◽

Vol 75 (S 02) ◽

Author(s):

G. Prasad ◽

A. Suri ◽

B. Sharma

Keyword(s):

Case Series ◽

Foramen Magnum ◽

Review Of Literature

Download Full-text

PRESENTATION AND MANAGEMENT OF BILATERAL TIBIAL SHAFT FRACTURE: A PROSPECTIVE CASE SERIES OF RARE ENTITY AND REVIEW OF LITERATURE

Medico Research Chronicles ◽

10.26838/medrech.2018.5.3.426 ◽

2018 ◽

Vol 5 (4) ◽

pp. 314

Author(s):

Sharma Bhanu ◽

R. S. Parmar

Keyword(s):

Case Series ◽

Shaft Fracture ◽

Tibial Shaft Fracture ◽

Rare Entity ◽

Tibial Shaft ◽

Review Of Literature ◽

Prospective Case Series

Download Full-text

Reversal of DIRECT-ACTING Oral Anticoagulants in Urgent Surgery of the Proximal Aorta: case Series and Review of the literature

Current Pharmaceutical Design ◽

10.2174/1381612825666181226150006 ◽

2019 ◽

Vol 24 (38) ◽

pp. 4534-4539 ◽

Cited By ~ 1

Author(s):

Eric Zimmermann ◽

Fawzi Ameer ◽

Berhane Worku ◽

Dimitrios Avgerinos

Keyword(s):

Oral Anticoagulants ◽

Aortic Surgery ◽

Management Strategies ◽

Case Series ◽

Published Data ◽

Review Of Literature ◽

Clotting Factors ◽

Urgent Surgery ◽

Direct Acting ◽

Direct Acting Oral Anticoagulants

Introduction: Proximal aorta interventions impose significant bleeding risk. Patients on concomitant anticoagulation regimens compound the risk of bleeding in any surgery, but especially cardiothoracic interventions. The employment of direct-acting oral anticoagulants (DOAC), namely those that target clotting factors II or X, has expanded at a precipitous rate over the last decade. The emergence of their reversal agents has followed slowly, leaving clinicians with management dilemmas in urgent surgery. We discuss current reversal strategies based on the available published data and our experience with proximal aortic surgery in patients taking DOACs. Literature Search: We performed a review of literature and present three cases from our experience to offer insight into management strategies that have been historically successful. A review of literature was conducted via PubMed with the following search string: (NOAC or DOAC or TSOAC) and (aorta or aortic or (Stanford and type and a)). Case Presentation: We present three case presentations that illustrate the importance of DOAC identification and offer management strategies in mitigating associated bleeding risks in urgent or emergent surgeries. Conclusion: Treatment teams should be aware of the technical limitations of identifying and reversing DOACs. In view of the tendency toward publishing positive outcomes, more scientific rigor is required in the area of emergency DOAC reversal strategies.

Download Full-text