scholarly journals Mediastinal Pseudocyst and Cardiac Tamponade Due to Massive Pericardial Effusion in Pediatric Chronic Calcific Pancreatitis

2016 ◽  
Vol 06 (03) ◽  
pp. 194-198 ◽  
Author(s):  
Suprit Basu ◽  
Mala Bhatacharya ◽  
Bidyut Debnath ◽  
Sandip Sen ◽  
Anish Chatterjee ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Pancreatic Enzyme ◽  
Recurrent Abdominal Pain ◽  
Chronic Calcific Pancreatitis ◽  
Contrast Enhanced ◽  
History Of ◽  
Posterior Mediastinal ◽  
Enhanced Computed Tomography

AbstractA 7-year-old male patient with a history of recurrent abdominal pain over 1 year presented with cardiac tamponade due to massive pericardial effusion, which was percutaneously drained. Contrast-enhanced computed tomography revealed a large posterior mediastinal cyst and calcified, heterogeneous pancreatic parenchyma. Elevated amylase and lipase levels of the cyst fluid confirmed the diagnosis of pancreatic pseudocyst, which was treated with an octreotide infusion and Roux-en-Y cystojejunostomy. The child was discharged on pancreatic enzyme supplement and was asymptomatic on follow-up.

Rare cause of chronic abdominal pain: left paraduodenal hernia and its surgical management

2021 ◽  
Vol 14 (12) ◽  
pp. e245024
Author(s):  
Ajay Chikara ◽  
Sasidhar Reddy Karnati ◽  
Kailash Chand Kurdia ◽  
Yashwant Sakaray
Keyword(s):  
Abdominal Pain ◽  
Stable Condition ◽  
Paraduodenal Hernia ◽  
Inferior Mesenteric Vein ◽  
Anterior Border ◽  
Initial Reduction ◽  
Contrast Enhanced ◽  
History Of ◽  
Enhanced Computed Tomography

A 30-year-old man presented with colicky abdominal pain for 2 months, associated with occasional episodes of bilious vomiting. He had a history of similar complaints at the age of 16 and 26 years. Contrast-enhanced computed tomography abdomen was consistent with a diagnosis of left paraduodenal hernia. On laparoscopy a 3 × 3 cm hernial defect was identified in the left paraduodenal fossa (fossa of Landzert). Contents were jejunal, and proximal ileal loops which were dilated and edematous. Anterior border of the sac was formed by the inferior mesenteric vein and left branch of the left colic artery. Initial reduction of contents was easy. However, complete reduction proved to be difficult due to adhesions with the sac opening, the hernial sac instead laid open by dividing the Inferior Mesentric Vein (IMV) (anterior border of defect) using a vascular stapler. The patient was discharged on postoperative day 3 in a stable condition. On follow-up the patient is doing well.

scholarly journals A case report: delayed right ventricular pericardial fistula and aneurysm following penetrating traumatic injury—a controversial aetiology

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Martina Steinmaurer ◽  
Blanche Cupido ◽  
Matthew Hannington ◽  
Rodgers Manganyi
Keyword(s):  
Pericardial Effusion ◽  
Right Ventricular ◽  
Cardiac Tamponade ◽  
Traumatic Injury ◽  
Clinical Signs ◽  
The Body ◽  
Delayed Presentation ◽  
True Aneurysm ◽  
History Of

Abstract Background Right ventricular aneurysms (RVAs) are rare. We present a case with a combined RVA and right ventricular pericardial fistula resulting in a pericardial effusion and cardiac tamponade. The RVA was detected 47 days after the patient suffered a gunshot wound. This report adds to the body of scarce literature on RVA aetiology, diagnoses, and treatment. Case summary A 30-year-old male patient presented with worsening respiratory distress over a 7-day period with clinical signs of cardiac tamponade following a history of a gunshot (with associated liver laceration, pulmonary embolism, right nephrectomy, and sepsis) 47 days prior. Transthoracic echocardiography showed a large circumferential pericardial effusion and an RVA. The patient was emergently taken for surgical repair of the RVA. Discussion Our case presents a delayed presentation of a gunshot heart and an aetiology with indications of and against a true aneurysm. It brings attention to possible complications of penetrating precordial injuries, with the need for consideration and possible evaluation at follow-up. The literature on the operative excision of RVA is reviewed and various aetiological factors and consequences are discussed.

Computed tomographic and sonographic findings in a dog with duplex kidney, ureter duplex and ectopic ureterocele

2020 ◽  
Vol 48 (01) ◽  
pp. 44-48
Author(s):  
Katharina I. Kopp ◽  
Sebastian Schaub ◽  
Christine Peppler ◽  
Alexander Acker ◽  
Kerstin von Pueckler
Keyword(s):  
Abdominal Ultrasound ◽  
Duplex Kidney ◽  
Ectopic Ureterocele ◽  
Computed Tomographic ◽  
Contrast Enhanced ◽  
History Of ◽  
Enhanced Computed Tomography ◽  
French Bulldog ◽  
Contrast Enhanced Computed Tomography

AbstractA 5-month-old, male French bulldog was presented with a history of urinary incontinence. Abdominal ultrasound showed changes compatible with a ureterocele and a bilobed right kidney. Excretory computed tomographic urography was consistent with right-sided duplex kidney, ureter duplex and ectopic ureterocele. To the authors’ knowledge, this is the first description of a duplex kidney with an ectopic ureterocele diagnosed with ultrasound and contrast enhanced computed tomography in a dog. After the imaging diagnosis, a neoureterocystostomy was performed. In the follow-up examination the dog presented with mild incontinence which was treated medically using phenylpropanolamine.

scholarly journals Chronic massive pericardial effusion: a case report and literature review

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097309
Author(s):  
Ying-shuo Huang ◽  
Jian-xiong Zhang ◽  
Ying Sun
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Severe Heart Failure ◽  
Final Diagnosis ◽  
High Dose ◽  
Indwelling Catheter ◽  
Large Pericardial Effusion ◽  
History Of ◽  
Lymph Node Tuberculosis

Chronic massive pericardial effusion without cardiac tamponade is relatively rare. Nearly half of all patients with chronic large pericardial effusion are asymptomatic. We report a case of a 77-year-old man who presented with an asymptomatic chronic massive pericardial effusion, with no evidence of cardiac tamponade or pericardial constriction during a 10-year follow-up. The patient had a complex history of lymph node tuberculosis, hypertension, hypothyroidism, and polycythemia vera, as well as high-dose 31P radiation exposure 45 years ago. There was no evidence of tuberculosis infection, hypothyroidism, malignant tumor, severe heart failure, uremia, trauma, severe bacterial or fungal infection, chronic myeloid leukemia, or bone marrow fibrosis after admission. The patient underwent pericardiocentesis twice. The pericardial effusion comprised exudate fluid with a high proportion of monocytes. The patient refused indwelling catheter drainage or pericardiectomy. The likely final diagnosis was recurrent chronic large idiopathic pericardial effusion.

Intraductal Papillary Mucinous Neoplasm of the Pancreas

2021 ◽  
Vol 8 (28) ◽  
pp. 2562-2566
Author(s):  
Jayalatha Nethagani ◽  
Priyanka Govula ◽  
Revathi Chandu ◽  
Pravin Raj T
Keyword(s):  
Epigastric Pain ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Uncinate Process ◽  
Cystic Lesions ◽  
Chronic Alcoholic ◽  
Contrast Enhanced ◽  
History Of ◽  
Head Of The Pancreas ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 36-year-old non-smoker, chronic alcoholic female presented with recurrent episodes of epigastric pain and vomiting in the last 10 days. H/o similar episodes of pain 3 times, with last episode was noted 2 months back. She also had history of vomiting (3 episodes). Jaundice/melena/steatorrheas was not observed. Subsequently, contrast-enhanced computed tomography (CECT) of the patient was done and it showed well defined multiple cystic lesions with peripheral wall enhancement involving head and body of pancreas, largest measuring 24 X 22 X 22 mm in the head of the pancreas, the lesion was seen abutting antro-pyloric region anteriorly. Main pancreatic is mildly dilated measuring 4 mm in diameter. A well-defined heterogeneously hypodense (necrotic) para duodenal lesion, was noted inferior to uncinate process, m/s 22 X 20 X 20 mm, which is indicative of lymph nodal deposit. On magnetic resonance cholangiopancreatography (MRCP): few cystic lesions were seen scattered in the pancreatic parenchyma, with one of the cysts showing communication with main pancreatic duct (MPD) ab.

scholarly journals Myxoid liposarcoma of small bowel presenting with intussusception and obstruction: A case report

2022 ◽  
pp. 519-521
Author(s):  
Mohd Monis ◽  
Divyashree Koppal ◽  
Aiman Ibbrahim ◽  
Zeeshan Nahid
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Leading Edge ◽  
Surgical Excision ◽  
Myxoid Liposarcoma ◽  
Histopathological Analysis ◽  
Contrast Enhanced ◽  
Well Differentiated ◽  
Enhanced Computed Tomography

Gastrointestinal liposarcomas are extremely rare with the most common reported morphological subtype being dedifferentiated liposarcoma and well-differentiated liposarcoma. These tumors are rarely diagnosed preoperatively and diagnosis is only confirmed on histopathological analysis. Treatment of gastrointestinal liposarcomas consists of surgical excision with widely negative margins followed by post-operative irradiation and close follow-up. We report an exceedingly rare case of myxoid liposarcoma of the small bowel (ileum) presenting with an unusual presentation with intussusception and intestinal obstruction. A 42-year-old male presented to the emergency department with features of intestinal obstruction. Contrast-enhanced computed tomography abdomen revealed ileo-ileal intussusception with an endoluminal soft-tissue lesion at the leading edge. The patient was taken for surgical intervention and the involved segment of the bowel along with the lesion was resected and re-anastomosis done. Histological sections of the mass along with immunohistochemistry suggested the pathological diagnosis of myxoid liposarcoma.

scholarly journals Alteplase for Massive Pulmonary Embolism after Complicated Pericardiocentesis

2019 ◽  
Author(s):  
Ricardo Cleto Marinho ◽  
José Luis Martins ◽  
Susana Costa ◽  
Rui Baptista ◽  
Lino Gonçalves ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Pericardial Effusion ◽  
Thrombolytic Therapy ◽  
Cardiac Tamponade ◽  
Massive Pulmonary Embolism ◽  
Extensive Study ◽  
Life Saving ◽  
Obstructive Shock

Background: The occurrence of a high-risk pulmonary embolism (PE) within 48 hours of a complicated pericardiocentesis to remove a haemorrhagic pericardial effusion, is an uncommon clinical challenge. Case summary: The authors report the case of a 75-year-old woman who presented with signs of imminent cardiac tamponade due to recurring idiopathic pericardial effusion. The patient underwent pericardiocentesis that was complicated by the loss of 1.5 litres of blood. Within 48 hours, the patient had collapsed with clear signs of obstructive shock. This was a life-threating situation so alteplase was administered after cardiac tamponade and hypertensive pneumothorax had been excluded. CT chest angiography later confirmed bilateral PE. The patient achieved haemodynamic stability less than an hour after receiving the alteplase. However, due to the high risk of bleeding, the medical team suspended the thrombolysis protocol and switched to unfractionated heparin within the hour. The cause of the PE was not identified despite extensive study, but after 1 year of follow-up the patient remained asymptomatic. Discussion: Despite the presence of a contraindication, the use of thrombolytic therapy in obstructive shock after exclusion of hypertensive pneumothorax can be life-saving, and low-dose thrombolytic therapy may be a valid option in such cases.

Clip-assisted endoscopic cyanoacrylate injection for gastric varices with a gastrorenal shunt: a multicenter study

Endoscopy ◽  
2019 ◽  
Vol 51 (10) ◽  
pp. 936-940 ◽  
Author(s):  
Mingyan Zhang ◽  
Ping Li ◽  
Haijun Mou ◽  
Yongjun Shi ◽  
Biguang Tuo ◽  
...  
Keyword(s):  
Gastric Varices ◽  
Safe Procedure ◽  
Technical Success ◽  
Technical Success Rate ◽  
Gastrorenal Shunt ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Lost To Follow Up ◽  
Contrast Enhanced Computed Tomography

Abstract Background The aim of this study was to evaluate the safety and efficacy of clip-assisted endoscopic cyanoacrylate injection for gastric varices with a gastrorenal shunt. Methods Records were reviewed of patients with gastric varices and concomitant gastrorenal shunts who underwent clip-assisted endoscopic cyanoacrylate injection at three tertiary centers between April 2016 and October 2018. The assessed outcomes were technical success rate, eradication of gastric varices, cyanoacrylate embolization, and all-cause rebleeding. Results A total of 61 patients were analyzed. The procedure was successful in all patients (100 %). Gastric varices were eradicated in 30 of 33 patients (90.9 %) according to contrast-enhanced computed tomography re-examination within 1 month after the procedure. No symptoms or signs of cyanoacrylate embolization related to the procedure were observed. Four patients (6.6 %) were lost to follow-up. All-cause rebleeding occurred in 13/57 patients (22.8 %) during a median follow-up period of 225 days (interquartile range 114 – 507 days). Conclusions Clip-assisted endoscopic cyanoacrylate injection appeared to be a safe procedure that was convenient and efficacious in the treatment of gastric varices with concomitant gastrorenal shunt.

scholarly journals Inflammatory myofibroblastic tumor of the bladder: case report and review of the literature

2013 ◽  
Vol 7 (3-4) ◽  
pp. e237-40 ◽  
Author(s):  
Li Wei ◽  
Liang Jianbo ◽  
Wei Qiang ◽  
Yu Hai ◽  
Lan Zhixiang
Keyword(s):  
Inflammatory Myofibroblastic Tumor ◽  
Bladder Tumor ◽  
Malignant Potential ◽  
Rare Tumor ◽  
Review Of The Literature ◽  
Gross Hematuria ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Inflammatory myofibroblastic tumor (IMT) is a rare tumor with malignant potential, and it has been described in many major organs. However, bladder location is very uncommon. We report the case of a 23-year-old women presented with painless gross hematuria last for 2 weeks. Contrast-enhanced computed tomography (CT) revealed a bladder tumor. The patient underwent a open partial cystectomy and the final pathologic diagnosis was inflammatory myofibroblastic tumor of bladder. Typical IMTs can be locally aggressive, thus close follow-up is necessary.

scholarly journals 502 Secondary cardiac lymphoma complicated with tamponade

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
P H Lee
Keyword(s):  
Pericardial Effusion ◽  
Malignant Lymphoma ◽  
Cardiac Tamponade ◽  
Complete Resolution ◽  
Sinus Tachycardia ◽  
Left Ventricular ◽  
Pulmonary Congestion ◽  
Shortness Of Breath ◽  
Pericardial Mass

Abstract Introduction A 72-year-old lady presented with one-week history of palpitation and shortness of breath. She had pyrexia of unknown origin for 4 weeks associated with weight loss. Initial clinical examination revealed sinus tachycardia of 110 beats/min and saturations of 96% on 2L/min oxygen. Neck exam revealed a 2 x 3 cm firm mass at left supraclavicular fossa. Electrocardiogram showed sinus tachycardia at 106 beats/min. There was fixed T wave inversions over anterolateral chest leads and inferior limb leads. Chest radiograph showed enlarged cardiac silhouette and evidence of pulmonary congestion Procedure Transthoracic echocardiogram revealed a moderate pericardial effusion with an 8 x 4 cm pericardial mass compressing at the right atrioventricular groove (Figure B & C). Respiratory variation of Doppler mitral and tricuspid inflow velocities suggested cardiac tamponade (Figure A). Inferior vena cava was engorged with impaired inspiratory collapse. Left ventricular size and function were otherwise normal. Urgent pericardiocentesis was performed which yielded 1 litre of light blood stained fluid. Her had subjective improvement of symptoms. There was also resolution of sinus tachycardia and pulmonary congestion. PET/CT scan showed multiple enlarged hypermetabolic lymph nodes in multiple regions above and below the diaphragm, worrisome for malignant lymphoma. Cytological assessment of pericardial fluid showed scattered large lymphoid cells which are immunoreactive to B cell marker CD 20 (Figure E & F). Bone marrow exam showed normal marrow. First cycle of R-CEOP and intrathecal methotrexate was given. Follow-up echocardiogram in one week after chemotherapy showed complete resolution of pericardial effusion. Prior pericardial mass also showed marked reduction in size (Figure D). No tamponade physiology was present. She tolerated the chemotherapy well with complete resolution of palpitation and shortness of breath. She was discharged from hospital with outpatient follow up and continuation of chemotherapy course. Discussion Cardiac tumors are rare and secondary tumors remain the most common etiology. Most of these metastatic tumors arise from solid organs such as lung, breast, kidney, melanoma as well as lymphoma. Echocardiography is a valuable tool both in diagnosis and assessment of hemodynamic significance of cardiac masses. It also aids in diagnosis of associated condition such as pericardial effusion. In this case, the cardiac tamponade is both contributed by mechanical compression of cardiac mass coupled with moderate pericardial effusion. Successful pericardiocentesis achieved temporary normalization of tamponade physiology and aided in early histological diagnosis of malignant lymphoma with pericardial metastasis. Timely initiation of intensive systemic chemotherapy was the key to rapid tumor size reduction, complete resolution of tamponade physiology and control of recurrent pericardial effusion. Abstract 502 Figure. Echo & histology

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