scholarly journals Minilaparotomy a Good Option in Specific Cases: A Case Report of Bilateral Ovarian Germ Cell Tumor

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
D. Bolla ◽  
N. Deseö ◽  
A. Sturm ◽  
A. Schöning ◽  
C. Leimgruber
Keyword(s):  
Acute Abdominal Pain ◽  
Adnexal Mass ◽  
Past History ◽  
Ovarian Tissue ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Expectant Management ◽  
Small Incision ◽  
Risk Of Rupture ◽  
The Right

Mature cystic teratomas (MCTs) of the ovary represent 44% of ovarian neoplasmas. The surgical approach is important in young women especially for the cosmetic results. Nowadays most of the ovarian surgeries can be performed laparoscopically. An alternative between laparoscopy and laparotomy is the minilaparotomy (ML) which can be an interesting option, thanks to the small incision. We report a 39-year-old woman who was referred to our hospital with acute abdominal pain. In her past history the patient had an uncomplicated delivery. During pregnancy a 6 cm bilateral MCT was diagnosed and expectant management was followed. A left-sided ovarial torsion was postulated, and laparoscopic detorsion was performed. To avoid a rupture of the left MCT, the operation was interrupted. To remove the cyst, a ML was done two weeks later. A left-sided salpingo-oophorectomy was performed due to a large cyst including the entire ovary. On the other side, the right dermoid cyst was entirely removed. The advantage of a ML is not only shorter operating time with less learning curve compared to laparoscopy but also the possibility to extract the adnexal mass from the abdominal cavity with lower risk of rupture and in addition the possibility to preserve more ovarian tissue.

Laparoscopic Treatment of Hydrocele of the Canal of Nuck in Pediatric Patients

2017 ◽  
Vol 28 (04) ◽  
pp. 378-382 ◽  
Author(s):  
Sung Lee
Keyword(s):  
Pediatric Patients ◽  
Inguinal Canal ◽  
Abdominal Cavity ◽  
Operating Time ◽  
High Ligation ◽  
Canal Of Nuck ◽  
The Mean ◽  
The Right ◽  
Short Operating Time

Introduction Hydrocele of the canal of Nuck (HCN) causes an inguinal swelling in pediatric females similar to that observed in case of inguinal hernia. HCN should be considered in the differential diagnosis of hernia in such children. Although laparoscopic operations have been reported in several cases for the treatment of HCN in adults, they have not been reported for the treatment in pediatrics. This study aimed to evaluate the outcomes of laparoscopic intracorporeal hydrocelectomy with high ligation as a treatment for HCN in pediatrics. Materials and Methods I retrospectively reviewed the charts of 26 pediatric females aged ≤10 years who underwent laparoscopic hydrocelectomy with high ligation at Damsoyu Hospital, Seoul, Republic of Korea from September 2012 to December 2016. Results The mean age was 3.31 (1–10) years. HCN was on the right in 11 patients and on the left in 15. The presenting symptom in all cases was inguinal swelling. HCN was of the hourglass type inside the inguinal canal in 17 patients and in the abdominal cavity outside the inguinal canal in 9. All patients were treated with laparoscopic hydrocelectomy with high ligation. The mean operating time was 17.8 minute (15–30). The wounds were scarcely visible immediately after surgery. There were no postoperative complications and no recurrences on follow-up. Conclusion Laparoscopic intracorporeal hydrocelectomy with high ligation is effective for HCN in pediatrics owing to its short operating time, excellent cosmesis, and no recurrence.

scholarly journals Acute Presentation of Large Size Clear Cell Ovarian Carcinoma as Double Torsed Ovarian Tumor

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 89
Author(s):  
Diana Bužinskienė ◽  
Vilius Rudaitis ◽  
Karolina Misevičiūtė
Keyword(s):  
Acute Abdominal Pain ◽  
Clear Cell ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Abdominal Ct ◽  
Large Size ◽  
Abdominal Ct Scan ◽  
Clear Cell Ovarian Carcinoma ◽  
The Right ◽  
Dark Blue

We report a 46-year-old patient who presented to the emergency department with complaints of acute abdominal pain, nausea, and vomiting. An abdominal CT scan revealed a large (207 × 155 × 182 mm) thin-walled inhomogeneous tumor connected to the uterus and right ovary. Emergency surgery laparotomy was performed. Inside the abdominal cavity, a 30 × 30 cm heterogenous, dark blue tumor in the right adnexa area, torsed two times, weighing 3700 g was found. Histological examination revealed right ovary clear cell carcinoma. We emphasize the rare nature of the histology and presentation of this case report. Ovarian clear cell carcinomas are relatively rare malignancies, presenting in 5 to 10% of ovarian malignant tumors in the west.

scholarly journals Primary Gastrointestinal Stromal Tumor of the Liver with Cystic Changes

2019 ◽  
Vol 13 (1) ◽  
pp. 58-65
Author(s):  
Takashi Tashiro ◽  
Fumihiro Uwamori ◽  
Yukiomi Nakade ◽  
Tadahisa Inoue ◽  
Yuji Kobayashi ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Past History ◽  
Brain Infarction ◽  
Arterial Phase ◽  
First Case ◽  
Positron Emission ◽  
Cystic Changes ◽  
Multiple Bone Metastases ◽  
The Right ◽  
Cells Of Cajal

Gastrointestinal stromal tumors (GISTs) are known to originate specifically from the intestinal cells of Cajal located in the gastrointestinal mesenchyme. GISTs developing outside of the digestive tract have barely been reported. We encountered a first case of large primary GISTs in the liver with cystic changes. A 63-year-old man with a past history of brain infarction visited our hospital. The computed tomography (CT) revealed a 6-cm and a 10-cm mass in the right and the caudal lobe of the liver, respectively. These tumors have marginal enhancement in the arterial phase; however, they presented as hypodense in the internal tumor sites. Both liver tumors had cystic changes. Gastrointestinal examinations using endoscopy revealed no other gastrointestinal tumors, and [18F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed multiple bone metastases in addition to the liver tumors. The liver tumor specimens were composed of spindle cells, and the immunohistochemical staining for c-Kit and for DOG1, as discovered on GIST, was positive. The patient was diagnosed with primary hepatic GIST with cystic changes.

scholarly journals Late presentation of extrauterine adenomyomas after laparoscopic morcellation at hysterectomy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammed Nagdi Zaki ◽  
Aafia Mohammed Farooq Gheewale ◽  
Nada Ibrahim ◽  
Ibrahim Abd Elrahman
Keyword(s):  
Case Report ◽  
Transvaginal Ultrasound ◽  
Iliac Fossa ◽  
Abdominal Cavity ◽  
Laparoscopic Hysterectomy ◽  
Pathology Report ◽  
Presacral Space ◽  
Gnrh Analogue ◽  
Power Morcellation ◽  
The Right

Abstract Background An adenomyoma is a well circumscribed form of adenomyosis and can be located within the myometrium, in the endometrium as a polyp, or extrauterine with the last being the rarest presentation amongst the three. With the ongoing advancement in gynecological surgery, the use of electromechanical morcellators have made the removal of large and dense specimens possible with minimally invasive techniques. However, it has also caused an increase in complications which were previously rare. Whilst the tissue is being grinded within the abdominal cavity, residual tissue can spread and remain inside, allowing for implantation to occur and thereby giving rise to recurrence of uterine tissue as a new late postoperative complication. Case presentation A 45-year-old woman presented with worsening constipation and right iliac fossa pain. Her past surgical history consists of laparoscopic supra-cervical hysterectomy that was indicated due to uterine fibroids. Computerized tomography and magnetic resonance imaging were done, which showed an irregular lobulated heterogeneous mass seen in the presacral space to the right, located on the right lateral aspect of the recto-sigmoid, measuring 4.5 × 4.3 × 4.3 cm in size. A transvaginal ultrasound revealed a cyst in the left ovary. The patient had a treatment course over several months that included Dienogest (progestin) and Goserelin (GnRH analogue) with add-back therapy. In line with the declining response to medications, the patient was advised for a laparoscopic ovarian cystectomy. During the surgery, an additional lesion was found as a suspected fibroid and the left ovarian cyst was identified as pockets of peritoneal fluid which was sent for cytology. The surgical pathology report confirmed adenomyosis in both specimens, namely the right mass and the initially suspected fibroid. Conclusion In this case report, we showcase a rare occurrence of an extrauterine adenomyoma presenting two years post laparoscopic morcellation at hysterectomy. This poses questions regarding the benefits versus risks of power morcellation in laparoscopic hysterectomy.

scholarly journals Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Naoki Enomoto ◽  
Kazuhiko Yamada ◽  
Daiki Kato ◽  
Shusuke Yagi ◽  
Hitomi Wake ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Abdominal Cavity ◽  
Three Dimensional ◽  
Simulation Software ◽  
3D Simulation ◽  
Diaphragmatic Defect ◽  
Intestinal Malrotation ◽  
Intestinal Loop ◽  
Bochdalek Hernia ◽  
The Right

Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.

scholarly journals Severe Hypertriglyceridemia-Induced Acute Pancreatitis

2021 ◽  
pp. 218-224
Author(s):  
Gyula Molnár ◽  
V. Anna Gyarmathy ◽  
Noémi Zádori ◽  
Péter Hegyi ◽  
Péter Kanizsai
Keyword(s):  
Acute Pancreatitis ◽  
Acute Abdominal Pain ◽  
Blood Cholesterol ◽  
Individual Factors ◽  
Lipid Levels ◽  
Human Monoclonal Antibodies ◽  
Pcsk9 Inhibitors ◽  
Severe Hypertriglyceridemia ◽  
The Right

The prevalence of familial hypercholesterolemia (FH) is about 1 in 200–500 in the general population, but approximately less than 1% of those affected are actually diagnosed. One of the most promising approaches to treat FH is utilizing human monoclonal antibodies. This is a case study describing a 47-year-old male patient who presented to the Emergency Department with acute abdominal pain caused by severe hypertriglyceridemia (HTG)-induced acute pancreatitis (AP). We report the steps necessary for establishing the right diagnosis and the management of HTG-induced AP, which are inevitable for the reduction of severity and mortality. This case study shows that hypercholesterolemia is an underdiagnosed and potentially lethal disease. Once diagnosed, all measures should be considered to control blood cholesterol and lipid levels. The decision to administer PCSK9 inhibitors should not be solely based on economical calculation, but rather individual factors should also be considered to weigh the risk/benefit ratio.

scholarly journals Intestinal obstruction caused by pericecal internal herniation

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Acute Abdominal Pain ◽  
Treatment Preference ◽  
Treatment Modalities ◽  
Internal Herniation ◽  
Lower Quadrant ◽  
Surgical History ◽  
The Right ◽  
Right Lower Quadrant

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.

scholarly journals Acute abdomen due appendicitis with atypical presentation leading to shock in an obese patient and with chronic liver disease

2014 ◽  
Vol 24 (1) ◽  
pp. 85
Author(s):  
Alexandra Damasio Todescatto ◽  
Felipe Ferreira Laranjeira ◽  
Júlia De Gasperi ◽  
Davyd Emaanuel Fin de Lehmann ◽  
Bruna Schmitt de Lacerda ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Acute Abdomen ◽  
Collateral Circulation ◽  
Acute Abdominal Pain ◽  
Clinical Status ◽  
Chronic Liver ◽  
Difficult Diagnosis ◽  
Atypical Presentations ◽  
The Right

AIMS: To expose a case of acute abdomen due to appendicitis whose diagnosis was difficult and complicated because of the patient's profile and his comorbidities. CASE DESCRIPTION: Male patient, 52 years old, superobese, smoker and with chronic liver disease, complaining of acute abdominal pain in the right hypochondrium, vomiting and low diuresis. Initially with no signs of peritoneal irritation, the patient was medically managed, but presented worsening of clinical status, progressing to shock and cardiac arrest. The investigation by laparotomy found acute appendicitis, collateral circulation and liver cirrhosis. CONCLUSIONS: Acute abdomen has great impact on emergency care and, since it comprises several clinical situations, knowing and suspecting its main causes and its atypical presentations becomes essential, mainly in cases of difficult diagnosis.

Republished: Successful treatment of ruptured multiple fusiform middle cerebral artery aneurysms with silk vista baby flow diverter in a 10-months-old infant

2021 ◽  
pp. neurintsurg-2021-017554.rep
Author(s):  
Giovanni Barchetti ◽  
Loris Di Clemente ◽  
Mauro Mazzetto ◽  
Mariano Zanusso ◽  
Paola Ferrarese ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Successful Treatment ◽  
Expectant Management ◽  
Flow Diverter ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Microsurgical Clipping ◽  
Parent Artery Occlusion ◽  
The Right

We report the successful treatment of multiple ruptured fusiform middle cerebral artery (MCA) aneurysms in a 10-month-old girl. This previously healthy infant presented with subarachnoid haemorrhage and was found to have multiple irregular dilatations of the superior division branch of the right MCA. Cerebral angiography was performed and confirmed the presence of multiple fusiform aneurysms of the MCA. After multidisciplinary team discussion, it was decided to treat the aneurysms with endovascular approach, using a flow-diverter. Microsurgical clipping was deemed risky because of the high likelihood of parent artery occlusion and expectant management was also considered inappropriate because of the risk of re-bleeding. Dual antiplatelet therapy was started, and a flow-diverter was successfully delivered in the superior division branch of the right MCA. The post-operative course was uneventful, MRI at 12 months did not show any sign of recurrence and at 3 years of age the patient had a normal neurological examination.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

Sign in / Sign up

Export Citation Format

Share Document