scholarly journals Surgical Management of Encapsulating Peritoneal Sclerosis: A Case Report in Kidney Transplant Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
R. Shahbazov ◽  
M. Talanian ◽  
J. L. Alejo ◽  
F. Azari ◽  
A. Agarwal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Enteral Nutrition ◽  
Kidney Transplant ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Clinical Syndrome ◽  
Kidney Transplant Patient ◽  
Gastrocutaneous Fistula

Introduction. Encapsulating peritoneal sclerosis (EPS) is a clinical syndrome of progressive fibrotic change in response to prolonged, repetitive, and typically severe insult to the peritoneal mesothelium, often occurring in the setting of peritoneal dialysis (PD). Clear guidelines for successful management remain elusive. We describe the successful surgical management of EPS in a 28-year-old male s/p deceased donor kidney transplant for end-stage renal disease (ESRD) secondary to focal segmental glomerulosclerosis (FSGS). This patient received PD for 7 years but changed to hemodialysis (HD) in the year of transplant due to consistent signs and symptoms of underdialysis. EPS was visualized at the time of transplant. Despite successful renal transplantation, EPS progressed to cause small bowel obstruction (SBO) requiring PEG-J placement for enteral nutrition and gastric decompression. The patient subsequently developed a chronic gastrocutaneous fistula necessitating chronic TPN and multiple admissions for pain crises and bowel obstruction. He was elected to undergo surgical intervention due to deteriorating quality of life and failure to thrive. Surgical management included an exploratory laparotomy with extensive lysis of adhesions (LOA), repair of gastrocutaneous fistula, and end ileostomy with Hartmann’s pouch. Postoperative imaging confirmed resolution of the SBO, and the patient was transitioned to NGT feeds and eventually only PO intake. He is continuing with PO nutrition, gaining weight, and free from dialysis.Conclusion. Surgical intervention with LOA and release of small intestine can be successful for definitive management of EPS in the proper setting. In cases such as this, where management with enteral nutrition fails secondary to ongoing obstructive episodes, surgical intervention can be pursued in the interest of preserving quality of life.

scholarly journals Concentric mastopexy for pubertal gynaecomastia in an African child

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Afieharo I Michael ◽  
Olayinka A Olawoye ◽  
Odunayo M Oluwatosin
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Surgical Management ◽  
Watchful Waiting ◽  
Surgical Intervention ◽  
Male Breast ◽  
African Child

Abstract Gynaecomastia refers to the enlargement of the male breast. It can be psychologically disturbing for children and adolescents as well as adults. While in children watchful waiting is advised as the gynaecomastia could resolve, surgical intervention becomes necessary where there is significant psychosocial disturbance. We present a case of an African child whose quality of life improved after correcting the gynaecomastia. We highlight the concentric mastopexy method in the surgical management of gynaecomastia.

Surgical management of large glomus jugulare tumours: infra-and trans-temporal approach

1989 ◽  
Vol 103 (12) ◽  
pp. 1167-1180 ◽  
Author(s):  
D. A. Moffat ◽  
D. G. Hardy
Keyword(s):  
Quality Of Life ◽  
Surgical Management ◽  
Neurological Deficit ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Cranial Nerves ◽  
Surgical Results ◽  
Historical Aspects ◽  
Post Operative Period

AbstractSurgery may have to be considered in the management of large glomus tumours since other modalities of treatment are not curative. The judicious use of surgical intervention is imperative since a neurological deficit involving the last four cranial nerves may ensue and consideration of the quality of life of the patient in the post-operative period is of paramount importance. A brief description of the historical aspects and pathology of these tumours is followed by an analysis of the clinical presentation, investigation and assessment of a series of 10 patients. Six patients underwent surgery and their tumours were removed by the infra-and trans-temporal approach. This is described and illustrated in detail and the surgical results presented.

Mucopolysaccharidoses Causing Valvular Heart Disease: Report and Review of Surgical Management

2017 ◽  
Vol 11 (4) ◽  
pp. NP22-NP24 ◽  
Author(s):  
Carlos O. Encarnacion ◽  
Dustin Hang ◽  
Michael Earing ◽  
Michael E. Mitchell
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Surgical Management ◽  
Valvular Heart Disease ◽  
Surgical Intervention ◽  
Genetic Disorder ◽  
Type I ◽  
Mucopolysaccharidosis Type I ◽  
Scheie Syndrome

Mucopolysaccharidosis type I is a genetic disorder with impaired glycosaminoglycan degradation. Cardiac pathologic involvement in this subset of patients is predominantly valvular heart disease. Valvular heart disease seen in these patients will most likely require surgical intervention in their lifetime. Only a limited amount of reports are dedicated to the cardiac surgical management of mucopolysaccharidoses. We present the case of a 32-year-old female with Hurler-Scheie syndrome who required multiple valve replacements due to progression of valvular dysfunction and decline in the quality of life. Multidisciplinary evaluation and discussion early are crucial for quality of life optimization in this cohort of patients.

Exercise-Induced Scalenus Syndrome

2008 ◽  
Vol 36 (2) ◽  
pp. 369-374 ◽  
Author(s):  
Panagiotis Baltopoulos ◽  
Charalampos Tsintzos ◽  
George Prionas ◽  
Maria Tsironi
Keyword(s):  
Quality Of Life ◽  
Thoracic Outlet Syndrome ◽  
Surgical Intervention ◽  
Case Series ◽  
Signs And Symptoms ◽  
Underlying Mechanism ◽  
Level Of Evidence ◽  
Full Activity ◽  
Exercise Induced

Background Thoracic outlet syndrome is described as a group of distinct disorders producing signs and symptoms attributed to compression of nerves and blood vessels in the thoracic outlet region. Purpose To describe the exercise-induced scalenus anticus syndrome attributed to the anterior scalenus hypertrophy as a thoracic outlet syndrome underlying mechanism and to give recommendations for a safe and effective surgical treatment. Study Design Case series; Level of evidence, 4. Methods Twelve young professional athletes admitted for thoracic outlet syndrome (8 cases of neurologic thoracic outlet syndrome, 4 cases of mixed neurologic and vascular thoracic outlet syndrome) who reported numbness, tingling, early fatigue, muscle weakness, and pain were enrolled in the study. Scalenus hypertrophy was suspected to be the causative factor. Scalenectomy was performed in all cases. Results All patients had moderate to severe hypertrophy of the anterior scalenus muscle. Scalenectomy was performed, and there were no intraoperative or postoperative complications. Full activity was quickly achieved, and no recurrence of symptoms was documented. Conclusion Surgical intervention for scalenus anticus syndrome can allow an athlete to return to full activity and improve quality of life. Surgical intervention seems to be the treatment of choice in terms of restoring quality of life and physical activity.

Surgical management of hypothalamic hamartomas in patients with gelastic epilepsy

2008 ◽  
Vol 25 (3) ◽  
pp. E8 ◽  
Author(s):  
Bassam Addas ◽  
Elisabeth M. S. Sherman ◽  
Walter J. Hader
Keyword(s):  
Quality Of Life ◽  
Epileptic Encephalopathy ◽  
Clinical Syndrome ◽  
Seizure Freedom ◽  
Interstitial Radiotherapy ◽  
Hypothalamic Hamartomas ◽  
Surgical Options ◽  
Gelastic Epilepsy ◽  
Refractory Seizures

Gelastic epilepsy (GE) associated with hypothalamic hamartomas (HHs) is now a well-characterized clinical syndrome consisting of gelastic seizures starting in infancy, medically refractory seizures with or without the development of multiple seizure types, and behavioral and cognitive decline. It has been postulated that the development of the HH-GE syndrome is a result of a progressive epileptic encephalopathy or secondary epileptogenesis, which is potentially reversible with treatment of the HH. A variety of surgical options for the treatment of HHs exist, including open and endoscopic procedures, radiosurgery, interstitial radiotherapy, and stereotactic radiofrequency thermocoagulation. Surgical treatment can result in seizure freedom in up to 50% of patients and can be accompanied by significant improvements in behavior, cognition, and quality of life. Partial treatment of HHs may be sufficient to reduce seizure frequency and improve behavior and quality of life with less risk. A component of reversible cognitive dysfunction may be present in some patients with an HH-GE syndrome.

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