Emergency resection of large, ulcerating phyllodes tumour with active bleeding

2021 ◽  
Author(s):  
Mark Yang ◽  
Rebecca Bei Jia Cui ◽  
Ruwan Perera



2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110199
Author(s):  
Young Hoon Sul ◽  
Yook Kim

Transcatheter arterial embolization (TAE) is the standard of care for haemodynamically-stable patients with blunt hepatic injury but it is sometimes impossible due to unfavourable vascular anatomies. This case report describes a 43-year-old male patient with abdominal pain following a motorcycle accident. Based on computed tomography (CT) findings, he was diagnosed with high-grade hepatic injury with coeliac axis stenosis (CAS) due to compression by the median arcuate ligament, and an aberrant right hepatic artery. Contrast-enhanced ultrasonography (CEUS) demonstrated multiple high echogenic tubular and ovoid structures suggestive of active bleeding within the injured liver area. Angiography revealed unique interlobar and intrahepatic collateral vessels between the right and left hepatic arteries. Liver haemorrhages were also identified. Catheterization of the feeding arteries through the collateral pathway was unsuccessful, so a decision was made to cannulate the stenotic portion of the coeliac trunk with a 5-Fr Yashiro catheter. After several attempts, the microcatheter was successfully advanced coaxially into the common hepatic artery. Embolization was performed with a 1:2 mixture of N-butyl cyanoacrylate and iodized oil. Successful haemostasis was confirmed following TAE. CEUS helped clinicians identify active bleeding following traumatic solid organ injury. TAE was a safe and effective treatment strategy. Before performing TAE, attention should be given to the presence of CAS associated with compression by the median arcuate ligament.



2015 ◽  
Vol 11 ◽  
pp. 91-94 ◽  
Author(s):  
Sanjay Warrier ◽  
Sang Y. Hwang ◽  
Keagan Gibbings ◽  
Hugh Carmalt ◽  
Sandra O’Toole


2016 ◽  
Vol 42 (5) ◽  
pp. S13
Author(s):  
Aimen Amer ◽  
Kirsty McColl ◽  
Helen Mathers


2021 ◽  
Vol 34 (02) ◽  
pp. 130-140
Author(s):  
Purnima Shukla ◽  
Purak Misra ◽  
Risabh Kumar Jain ◽  
Rajiv Kumar Misra

AbstractPhyllodes tumours (PTs) of the breast are rare biphasic fibroepithelial neoplasm. They have potentiality to recur and metastasise. Majority of them follow a benign clinical course. We have treated one patient suffering from PT at the out-patient department of Sri Ram Medical & Homoeopathic Research Centre, Gorakhpur, India. After detailed case taking and repertorisation, first Conium maculatum and later on Phytolacca decandra and Calcarea fluorica were prescribed on the basis of individualisation to treat the case. Outcomes were assessed clinically every month for subjective improvement and objectively by ultrasonography reports at every 6-month interval. Gradual improvement was noted over time. The case has been assessed with MONARCH Inventory, which shows ‘definite’ association between the medicine and the outcome.



Neurology ◽  
2014 ◽  
Vol 83 (10) ◽  
pp. 883-889 ◽  
Author(s):  
H. B. Brouwers ◽  
M. R. Raffeld ◽  
K. M. van Nieuwenhuizen ◽  
G. J. Falcone ◽  
A. M. Ayres ◽  
...  


2014 ◽  
Vol 8 (11-12) ◽  
pp. 888 ◽  
Author(s):  
Lan Qian Lancia Guo ◽  
Benny Chi-Bun So ◽  
Robin R. Gray

To the best of our knowledge, we report the first known case of a large intraprostatic hematoma with active bleeding following transrectal ultrasound-guided prostate biopsy.



2014 ◽  
Vol 8 (7-8) ◽  
pp. 561 ◽  
Author(s):  
Matteo Ferrari ◽  
Umberto Capitanio ◽  
Nathalie Rizzo ◽  
Massimo Freschi ◽  
Francesco Montorsi ◽  
...  

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery.



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