scholarly journals Gossypiboma: a ghastly find

2018 ◽  
pp. bcr-2017-221537
Author(s):  
Aitor de Gea Rico ◽  
Priya Krishna ◽  
Hannah Louise Devlin ◽  
Ashish Rohatgi
Keyword(s):  
Traffic Accident ◽  
Road Traffic ◽  
Epigastric Pain ◽  
Abdominal Ultrasound ◽  
Cystic Mass ◽  
Emergency Laparotomy ◽  
Complete Excision ◽  
Left Hypochondrium ◽  
Surgical History

A gossypiboma is a mass within a patient’s body comprising a cotton matrix surrounded by a foreign body granuloma. We describe an unusual presentation of a gossypiboma presenting in a 32-year-old man with acute epigastric pain and haematemesis. His surgical history revealed an emergency laparotomy following a road traffic accident 16 years ago. Initial gastroscopy showed extrinsic stomach compression. An abdominal ultrasound scan followed by a CT scan evidenced a large, well-defined, predominantly cystic mass with some solid areas occupying the left hypochondrium. Conservative management with insertion of a percutaneous drain proved to be inefficient. A laparotomy was performed; intraoperatively, the cyst was found to be ruptured and within it, a large surgical gauze was found. This was removed but required a distal pancreatectomy and gastrectomy for complete excision. He was discharged on day 74 of admission with outpatient follow-up.

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

An Uncommon Cause of Massive Intraperitoneal Bleeding: Leiomyoblastoma of the Stomach

1988 ◽  
Vol 74 (3) ◽  
pp. 365-367
Author(s):  
Alessandro Zerbi ◽  
Marco Braga ◽  
Alessandro Sironi ◽  
Agostino Faravelli ◽  
Valerio Di Carlo
Keyword(s):  
Abdominal Mass ◽  
Abdominal Ultrasound ◽  
Cystic Mass ◽  
Emergency Laparotomy ◽  
Intraperitoneal Rupture ◽  
Abdominal Masses ◽  
Liver And Pancreas ◽  
Intraperitoneal Bleeding ◽  
Upper Abdominal ◽  
Diagnostic Investigations

A large exogastric leiomyoblastoma in a 48-year-old male revealed by asymptomatic upper abdominal mass is reported. Abdominal ultrasound, computerized tomography scan and magnetic resonance showed a 20 cm cystic lesion apart from liver and pancreas of undetermined origin. During hospitalization, massive intraperitoneal bleeding due to rupture of the mass was observed. An emergency laparotomy was carried out, and excision of a large, ruptured, cystic mass involving the greater gastric curvature was performed. Microscopy revealed a gastric leiomyoblastoma. Even if infrequent, massive intraperitoneal bleeding is a very serious complication of gastric leiomyoblastoma. Considering the difficulty of an accurate preoperative diagnosis and the risk of intraperitoneal rupture, the authors suggest that similar abdominal masses should be managed by quick diagnostic investigations and early surgical procedures.

An Innovative Modified Orbital Implant in Enucleated Eyes for Postoperative Functionality and Cosmesis

2017 ◽  
Vol 2 (1) ◽  
pp. 47-50
Author(s):  
A Dokania ◽  
Y Rizvi ◽  
Surabhi Sinha
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Surgical Mesh ◽  
Road Traffic ◽  
Muscle Attachment ◽  
Artificial Eye ◽  
Polyglactin 910 ◽  
Orbital Implant ◽  
Ocular Discomfort

ABSTRACT Orbital implants replace the volume lost by enucleated eye, impart motility to the prosthesis, and maintain cosmetic symmetry with the fellow eye. They include nonintegrated, synthetic semi-integrated, integrated, bio-integrated, and biogenic varieties. The much favored hydroxyapatite (bio-integrated) implant, due to its rough surface, needs to be wrapped in donor sclera or other wrapping materials (like polyglactin-910 mesh, polytetrafluoroethylene sheet, etc.) to which the muscles could be directly sutured. Cost factor of such wrappings is often prohibitive that add to the expense of such implants. Purpose To highlight monofilament polypropylene surgical mesh commonly used for herniorrhaphy as an alternative implant wrapping for achieving augmented implant volume and enabling easier extraocular muscle attachment in postenucleation reconstruction of artificial eye. Materials and methods Following enucleation of a nonfunctional eye in a patient who met with a road traffic accident, a 14 mm hydroxyapatite ball was used to replace the globe. The ball was wrapped with a monofilament polypropylene surgical mesh used in herniorrhaphy and sutured. The patient achieved a satisfactory cosmesis and movements of the implant for different gazes. No ocular discomfort or implant extrusion was reported following 6 months of follow-up. Conclusion Monofilament polypropylene mesh can be used safely as an orbital implant wrapping, economizing the implant cost. How to cite this article Sinha S, Rizvi Y, Dokania A. An Innovative Modified Orbital Implant in Enucleated Eyes for Postoperative Functionality and Cosmesis. Int J Adv Integ Med Sci 2017;2(1):47-50.

scholarly journals Outcome of traumatic Extradural Hematoma (EDH) using Glasgow Outcome Scale (GOS)

2018 ◽  
Vol 5 (10) ◽  
pp. 3327
Author(s):  
Dixit V. Prajapati ◽  
Nimish J. Shah
Keyword(s):  
Traffic Accident ◽  
Surgical Intervention ◽  
Road Traffic ◽  
Extradural Hematoma ◽  
Factors Affecting ◽  
Poor Outcome ◽  
Ct Head ◽  
Lost To Follow Up ◽  
Time Of Intervention

Background: Outcome in patient with EDH depends on various factors like GCS at presentation, Volume of hematoma, time of intervention, age, location of hematoma, etc. This study was carried out to find out correlation (if any) between outcome and various factors affecting it. Aim and objectives of this study were to study outcome of patients with traumatic EDH in terms of poor outcome (GOS score 1,2,3), Good outcome (GOS Score 4,5)Methods: This study was carried out in 91 patients having positive CT Head for EDH. Follow up was done every monthly up to 3 months. GOS was recorded at each follow up. Results: Road traffic accident was the most common mode of trauma. 16 patients were operated. Four patients died immediately after diagnosis of traumatic EDH, before doing any intervention. One patient died on 1st post-operative day. After one month, two patients were lost to follow up, 80 patients had GOS 5, four patients had GOS 4. At 2nd and 3rd month, 83 patients had GOS 5, one patient had GOS 4. 17 patients had GCS 3-8, among them, 11 patients had GOS 5, one patient had GOS 4 and five patients died (GOS 1). 15 patients had GCS 9-12, among them, 15 patients had GOS 5. 57 patients had GCS 13-15, among them, 54 patients had GOS 5. 69 patients had EDH volume <30 ml and all patients had GOS 5. 20 patients had EDH volume ≥30 ml, among them, 14 patients had GOS 5, one patient had GOS 4 and five patients died. Conclusions: GOS in EDH patient is affected by GCS and EDH volume at presentation. Lower GCS and larger EDH volume have poor outcome. Surgical intervention in larger EDH volume improves outcome.

Long-term follow-up of intrahepatic biliary cystadenoma and cystadenocarcinoma following hepatectomy

2020 ◽  
Author(s):  
Jiangming Chen ◽  
Wei Geng ◽  
Yijun Zhao ◽  
Kun Xie ◽  
Guobin Wang ◽  
...  
Keyword(s):  
Management Strategies ◽  
Elevated Serum ◽  
Liver Cyst ◽  
Cystic Mass ◽  
Radical Excision ◽  
Imaging Features ◽  
Older Woman ◽  
Complete Excision

Abstract Backgroud: We present our experiences, particularly long term followup, of 20 patients who underwent operations for BCA or BCAC over the last 15 years in an effort to formulate more effective management strategies Methods: Clinical data on patients with pathologically confirmed BCA or BCAC between June 2002 and May 2017 were retrospectively analyzed. Results: Twenty patients were pathologically diagnosed with intrahepatic BCA (12) or BCAC (8); the mean ages for these 2 groups were 46.3 years and 62.0 years, respectively (P = 0.000). The main imaging feature for most BCA patients (83.3%) was cystic mass with septations. The main imaging features for BCAC were unilocular or unilocular cysts with papillary projections or solid portions. All BCAC patients received surgical treatment. No BCA patients developed recurrent cystadenoma after complete excision. Five (62.5 per cent) of the 8 BCAC patients died during a median follow-up time of 61.8 months. Three deaths were due to metastasis. The median follow-up of BCAC patients without a recurrence was 90.7months (range 31–152). Conclusions: Factors associated with a higher likelihood of BCA or BCAC include being a middle-aged or older woman, having elevated serum CA19-9 levels, showing high-risk features on imaging, and having recurrent liver cyst(s). Radical excision is recommended to obtain long-term tumor-free survival.

Urothorax Associated with Uroperitoneum in a Dog Without Diaphragmatic Disruption

2015 ◽  
Vol 51 (4) ◽  
pp. 256-259 ◽  
Author(s):  
Paraskevi P. Tsompanidou ◽  
Tilemahos L. Anagnostou ◽  
George M. Kazakos ◽  
Lysimachos G. Papazoglou ◽  
Eugenia S. Flouraki ◽  
...  
Keyword(s):  
Traffic Accident ◽  
Care Management ◽  
Biochemical Analysis ◽  
Road Traffic ◽  
Pathological Condition ◽  
Abdominal Cavity ◽  
Good Health ◽  
Fluid Accumulation ◽  
Mixed Breed

Accumulation of urine in the pleural space secondary to uroperitoneum with no disruption of the diaphragm appears to be a rare pathological condition. A 2 yr old male mixed-breed dog was referred with dyspnea and abdominal pain after a road traffic accident. Plain radiographs demonstrated pleural effusion and reduced serosal detail in the abdominal cavity that was compatible with fluid accumulation. Retrograde urethrography revealed a pelvic urethra rupture. Biochemical analysis of the pleural and abdominal fluid confirmed the diagnosis of urothorax and uroperitoneum. The dog underwent a prepubic urethrostomy and intensive care management. The dog was reported to be in good health after a follow up time of 10 mo. To the authors' knowledge, this is the first reported case of urothorax associated with uroperitoneum with no detectable defects of the diaphragm in a dog.

scholarly journals Extruded talus treated with reimplantation and primary tibiotalocalcaneal arthrodesis

2017 ◽  
Vol 99 (4) ◽  
pp. e125-e127 ◽  
Author(s):  
HR Mohammad ◽  
J A’Court ◽  
A Pillai
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Weight Bearing ◽  
Transverse Process ◽  
High Energy ◽  
Tibiotalocalcaneal Arthrodesis ◽  
Cortical Screw ◽  
Neck Fracture

Extruded talus is a rare serious result from a high-energy injury to a supinated and plantar flexed foot. Treatment remains controversial with a lack of congruent evidence for talar reimplantation. A 34-year-old woman was involved in a road traffic accident at 40 mph. Imaging revealed a left talus extruded anterolaterally with a talar neck fracture. Additional injuries included right acetabular fracture, transverse process fractures and rib fractures, which were treated conservatively. The talus was reimplanted and the talar neck fixed with a cortical screw. A hindfoot nail was used to fuse the calcaneus, talus and tibia. Follow-up at two years showed solid tibiotalocalcaneal fusion, with no evidence of avascular development, and the patient was fully weight bearing without pain. We believe this is the first published case of successful primary tibiotalocalcaneal fusion for extruded talus injuries.

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