scholarly journals Surgery for Ampullary Cancer in a Patient with Pancreatic Lipomatosis Caused by Cystic Fibrosis

2020 ◽  
Vol 14 (3) ◽  
pp. 695-701
Author(s):  
Nienke E. Vuurberg ◽  
Ilsalien Bakker ◽  
Anne Loes van den Boom ◽  
Robbert J. de Haas ◽  
Evelien W. Duiker ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Ct Scan ◽  
Pancreatic Duct ◽  
Total Pancreatectomy ◽  
Pancreatic Insufficiency ◽  
Ampullary Cancer ◽  
Gastrointestinal Malignancies ◽  
Preoperative Ct ◽  
Pancreaticojejunal Anastomosis

A patient with cystic fibrosis (CF) with pancreatic insufficiency presented with jaundice due to an ampullary tumour. CF is known for a higher incidence of gastrointestinal malignancies. The patient suffered from pancreatic insufficiency. At computed tomography (CT), pancreatic lipomatosis with absence of the pancreatic duct was seen. This is uncommon, also in patients with CF. During surgery, a total pancreatectomy was performed, because there was no possibility to construct a duct to mucosa anastomosis due to the absence of the pancreatic duct and more importantly the pancreas was already afunctional. The presence of lipomatosis increases the risk of leakage at the pancreaticojejunal anastomosis. Therefore, it is important to take this phenomenon, in this case already visible on the preoperative CT scan, into account during the workup for surgery.

The prognostic significance of supradiaphragmatic lymphadenopathy identified on preoperative computed tomography scan in patients undergoing primary cytoreduction for advanced stage epithelial ovarian cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16512-e16512
Author(s):  
V. Kolev ◽  
S. Mironov ◽  
O. Mironov ◽  
C. Moskowitz ◽  
N. M. Ishill ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Ct Scan ◽  
Epithelial Ovarian Cancer ◽  
Median Survival ◽  
Residual Disease ◽  
Prognostic Significance ◽  
Prognostic Impact ◽  
Preoperative Ct

e16512 Background: It has been hypothesized and shown in animal studies that the supradiaphragmatic lymph nodes serve as the principal nodes for lymphatic drainage of the entire peritoneal cavity. The purpose of this study was to determine the prognostic significance of enlarged supra-diaphragmatic nodes noted on preoperative computed tomography (CT) scan in patients with advanced epithelial ovarian cancer (EOC). Methods: We performed a retrospective chart review of all patients (pts) with FIGO stage III and IV EOC who had preoperative CT scans of the supradiaphragmatic region and primary cytoreductive surgery at our institution between 1997 and 2004. All scans were retrospectively reviewed by one board-certified radiologist (SM). To evaluate survival, Kaplan-Meier methods were used, with log rank Pvalues for comparisons. Results: A total of 212 eligible pts who underwent attempted primary cytoreduction followed by platinum-based systemic chemotherapy were identified for evaluation. With a median follow-up time of 52 mos, there were 135 deaths and a median overall survival of 48 mos (95% CI: 44–53). Of the 212 pts, 44 (21%) had supradiaphragmatic adenopathy with nodes >1 cm, while 168 (79%) did not have adenopathy in this distribution. None of the 44 pts with adenopathy had the enlarged nodes removed at primary cytoreduction. The median survival was 49 mos for pts with and 48 mos for patients without adenopathy (p = 0.46). In total, 155 (73%) patients underwent optimal cytoreduction (residual disease ≤ 1 cm). In the optimally cytoreduced pts, the median survival for the 125 pts without supradiaphragmatic adenopathy was 52 mos (95%CI: 45–59) compared to 51mos (95%CI: 41–58) for the 30 pts with supradiaphragmatic adenopathy (p = 0.33). Conclusions: Although a previous study has shown that supradiaphragmatic adenopathy was associated with poorer overall survival in EOC patients, our study did not confirm these findings. In our study, enlarged supradiaphragmatic nodes noted on preoperative CT scan did not have significant prognostic impact and therefore their clinical significance remains uncertain. No significant financial relationships to disclose.

Characterization of two distinct chloride channels in cultured dog pancreatic duct epithelial cells

1997 ◽  
Vol 272 (1) ◽  
pp. G172-G180 ◽  
Author(s):  
T. D. Nguyen ◽  
D. S. Koh ◽  
M. W. Moody ◽  
N. R. Fox ◽  
C. E. Savard ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Epithelial Cells ◽  
Pancreatic Duct ◽  
Chloride Channels ◽  
Pancreatic Insufficiency ◽  
Disulfonic Acid ◽  
Cl Channels ◽  
Vitro Model

Cl- secretion by pancreatic duct epithelial cells (PDEC) regulates cellular HCO3- secretion, an important component of the exocrine pancreas. In cystic fibrosis, for example, impaired function of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl- channel results in decreased pancreatic secretion and secondary pancreatic insufficiency. Studies of ion transport by PDEC have been hindered by the lack of a practical in vitro model. We have successfully cultured nontransformed dog PDEC on Vitrogen-coated permeable membranes overlying a feeder layer of myofibroblasts and report the characterization of Cl- channels in these cells. Cl- conductance, assessed through efflux of 125I from PDEC, was stimulated by agents acting via adenosine 3',5'-cyclic monophosphate (cAMP) or cytosolic Ca2+. The Cl- conductances activated by cAMP and Ca2+ were distinct, since they were differentially inhibited by 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid and, to a lesser extent, by 5-nitro-2-(3-phenylpropylamino)benzoic acid and diphenylamine-2 carboxylate. Patch-clamp studies confirmed the presence of Cl- channels activated by cAMP and Ca2+, with differential inhibition by 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid. The presence of CFTR Cl- channels in PDEC was confirmed by immunoblotting. These cultured PDEC are an optimal model for studies of pancreatic duct secretion.

The Role of Carcinoembryonic Antigen as a Predictor of the Need for Preoperative Computed Tomography in Colon Cancer Patients

2006 ◽  
Vol 72 (10) ◽  
pp. 897-901
Author(s):  
Alicia D. Holt ◽  
Justin T. Kim ◽  
Zuri Murrell ◽  
Richard Huynh ◽  
Michael J. Stamos ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Ct Scan ◽  
Carcinoembryonic Antigen ◽  
Cancer Patients ◽  
Clinical Utility ◽  
Stage Iv ◽  
Stage Iv Disease ◽  
Preoperative Ct

A retrospective study of 117 patients with the diagnosis of colon cancer was performed to evaluate the clinical utility of the preoperative computed tomography (CT) scan and to assess the role of carcinoembryonic antigen (CEA) as a predictor of the need for CT scan in colon cancer patients. Forty-nine patients had a CT scan that altered their treatment. One hundred per cent of stage IV patients versus only 26.5 per cent of stage I, II, and III patients had their operative and/or treatment planning altered by the preoperative CT. The sensitivity of CT scan in predicting metastatic disease was 90.3 per cent. All patients with stage IV disease had an abnormal CEA (>3 ng/mL). There was 89.7 per cent of stage IV patients who had a CEA twice that of normal or above. By using a CEA level of 3.1 ng/mL or above as a prerequisite for preoperative tomography, 34 nonmetastatic patients would not have had preoperative CT scans. Using a prerequisite of 6.1 ng/mL or above, 49 nonmetastatic patients would not have had a preoperative CT scan, and 90 per cent of the stage IV patients would have been imaged. We recommend obtaining a preoperative CT scan on those patients with a CEA value twice that of normal or greater.

scholarly journals Utility of the CT Scan in Diagnosing Midgut Volvulus in Patients with Chronic Abdominal Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Shahverdi ◽  
Mehdi Morshedi ◽  
Maryam Allahverdi Khani ◽  
Mohammad Baradaran Jamili ◽  
Fatemeh Shafizadeh Barmi
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Mesenteric Artery ◽  
Chronic Abdominal Pain ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Common Complication ◽  
Preoperative Ct

Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient. The preoperative CT findings were pathognomonic.

Combined Image Guidance and Intraoperative Computed Tomography in Facilitating Endoscopic Orientation within and around the Paranasal Sinuses

2008 ◽  
Vol 22 (6) ◽  
pp. 635-641 ◽  
Author(s):  
Sarah K. Wise ◽  
Richard J. Harvey ◽  
John C. Goddard ◽  
Patrick O. Sheahan ◽  
Rodney J. Schlosser
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Paranasal Sinus ◽  
Image Guidance ◽  
Sinus Surgery ◽  
Intraoperative Ct ◽  
Intraoperative Computed Tomography ◽  
Significant Difference ◽  
Preoperative Ct ◽  
Anatomic Region

Background The utility of image guidance (image-guided surgery [IGS]) and intraoperative computed tomography (CT) scanning as a tool for less experienced endoscopic surgeons to aid in localization of paranasal sinus and skull base anatomic structures was evaluated. Methods Partial endoscopic dissection was performed on cadaver specimens by three fellowship trained rhinologists. Anatomic sites within and around the sinuses were tagged with radio-opaque markers. Otolaryngology residents identified tagged anatomic sites using four successive levels of technology: endoscopy alone (simulating outpatient clinic), endoscopy plus preoperative CT (simulating endoscopic sinus surgery [ESS] without IGS), endoscopy plus IGS registered to preoperative CT (simulating current ESS with IGS), and endoscopy plus IGS registered to real-time intraoperative CT. Responses were graded as follows: consensus rhinologist answer (4 points), close answer without clinically significant difference (3 points), within anatomic region but definite clinical difference (2 points), outside of anatomic region (1 point), no answer (0 points). Results Eleven residents participated. Of 20 specific anatomic sites, IGS-intraoperative CT provided the most accurate anatomic identification at 16 sites. For 8 sites, IGS-intraoperative CT had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.29-0.67). For 6 sites, IGS-preoperative CT scan had a significantly higher score than endoscopy alone (p < 0.05; eta2 = 0.30-0.67). All participants found that IGS-intraoperative CT scan made them most comfortable in identifying anatomy. Conclusion Combined IGS and intraoperative CT scan technology may be an instructional adjunct for less experienced paranasal sinus surgeons for dissection and evaluation of unfamiliar or distorted anatomy.

Computed Tomography (CT) Scan Findings of the Paranasal Sinuses in Cystic Fibrosis

1995 ◽  
Vol 9 (5) ◽  
pp. 277-280 ◽  
Author(s):  
Max M. April ◽  
David E. Tunkel ◽  
Joan DeCelie-Germana ◽  
Pamela L. Zeitlin ◽  
S. James Zinreich
Keyword(s):  
Computed Tomography ◽  
Cystic Fibrosis ◽  
Ct Scan ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Uncinate Process ◽  
Lateral Nasal Wall ◽  
Middle Meatus ◽  
Nasal Symptoms ◽  
Paranasal Sinus Computed Tomography

Nearly all patients with cystic fibrosis (CF) have abnormal findings on plain paranasal sinus radiographs. To establish this relationship more accurately, 58 CF patients with nasal symptoms were evaluated with paranasal sinus computed tomography (CT). Bilateral medial displacement of the lateral nasal wall in the middle meatus and uncinate process demineralization were seen in 43 patients (74%). Three patients (5%) had unilateral displacement and uncinate demineralization. Ten patients had maxillary sinus opacification, two patients (3.5%) had unremarkable paranasal sinuses on CT, and another patient (2%) had normal findings on one side. Although the vast majority of CF patients do have paranasal sinus abnormalities, we found on CT scan a progression of abnormalities that range from normal sinuses to pansinus disease, and in 74%, bilateral medial displacement of the lateral nasal wall and uncinate process demineralization.

scholarly journals Chronic Calcific Pancreatitis in a 9-Year-Old Boy

2012 ◽  
Vol 2 (1) ◽  
pp. 43-45
Author(s):  
Debasish Das ◽  
Dev Prosad Paul ◽  
Kazi Sohel Iqbal
Keyword(s):  
Cystic Fibrosis ◽  
Chronic Pancreatitis ◽  
Ct Scan ◽  
Inflammatory Disease ◽  
Morphological Changes ◽  
Pancreatic Insufficiency ◽  
X Ray ◽  
Chronic Calcific Pancreatitis ◽  
Lateral Pancreaticojejunostomy ◽  
Calcific Pancreatitis

Chronic pancreatitis is defined as continuing inflammatory disease of pancreas, characterised  by irreversible morphological changes leading to pancreatic insufficiency. Chronic pancreatic  insufficiency without pancreatitis is also seen in children suffering from cystic fibrosis which is  a disease with congenital enzyme deficiency. Mean age of chronic pancreatitis is about 40  years. We present a case of a 9-year-old boy who was diagnosed as a case of chronic calcific  pancreatitis. He was admitted with the complaints of paraumbilical pain and vomiting and  was found diabetic. Diagnosis was established by X-ray, USG and CT scan of abdomen and  ERCP. He was treated surgically in the form of lateral pancreaticojejunostomy (Puestow’s  procedure). DOI: http://dx.doi.org/10.3329/jemc.v2i1.11929 J Enam Med Col 2012; 2(1): 43-45

scholarly journals Sinonasal Inverted Papilloma: Evaluating the Effectiveness of Prediction of the Site of Attachment based on Computed Tomography Scans

2016 ◽  
Vol 9 (2) ◽  
pp. 84-86
Author(s):  
Anna Salwa
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Paranasal Sinuses ◽  
Inverted Papilloma ◽  
Pathophysiological Mechanism ◽  
Sinonasal Inverted Papilloma ◽  
Computed Tomography Scans ◽  
Preoperative Ct ◽  
Primary Location ◽  
The Relationship

ABSTRACT Sinonasal inverted papilloma is a benign neoplasm of epithelial origin, which represents 0.5 to 4% of all sinonasal tumors. Despite the histological benign nature of this type of tumor, it has a high rate of recurrence after surgical resection and significant malignant potential. Sinonasal inverted papilloma is treated as a locally aggressive tumor. The aggressive surgical approaches, such as en bloc resection via external excision or extensive mucosal stripping of the ipsilateral sinuses are replaced by less invasive intranasal endoscopic approaches. This creates a need for a very accurate preoperative assessment of the location of the tumor on computed tomography (CT) scan and identifies the location of the primary changes. Determination of the primary location of inverted papilloma is especially important for a radical resection of the tumor, because the tumor recurs mostly in the same location as the primary lesion. The aim of this study was to determine the relationship between changes in the preoperative CT scan of the paranasal sinuses and the location of papilloma by histological examination of surgical material. In this study, we evaluated the changes in the preoperative CT scans in the form of focal hyperostosis and erosion of the walls of the paranasal sinuses. Examined groups consisted of 12 people diagnosed with inverted papilloma and 15 peoples diagnosed with preinverted papilloma. Focal hyperostosis occurred in 83% of cases of inverted papilloma. Their location corresponded to 90% of the primal attachment of the tumor. Among the preinverted papillomas, focal hyperostosis occurred in less than 7% of the cases and did not correspond to the location of papilloma inverted. The analysis of remodeling and erosion of bone walls of the sinuses showed their presence in 67% of cases of inverted papilloma and 40% of cases of preinverted papilloma. However, their overlap with the location of the tumor was 50% for the inverted papilloma and 33% for the preinverted papilloma. Erosion and sinus bone destruction do not coincide closely with the primary location of the papilloma, because it is more the result of bone compression by the growing mass than bone invasion. The sites of focal hyperostosis closely coincide with the place of origin of the inverted papilloma, but the pathophysiological mechanism of this phenomenon is not fully understood. The relationship between the sites of focal hyperostosis and the location of the primary tumor can be used when planning surgery for accurate resection. How to cite this article Salwa A. Sinonasal Inverted Papilloma: Evaluating the Effectiveness of Prediction of the Site of Attachment based on Computed Tomography Scans. Clin Rhinol An Int J 2016;9(2):84-86.

scholarly journals The Correlation Between Preoperative Findings of High-Resolution Computed Tomography (HRCT) and Intraoperative Findings of Chronic Otitis Media (COM)

2019 ◽  
Vol 12 ◽  
pp. 117955061987047 ◽  
Author(s):  
Mariam Aljehani ◽  
Rayan Alhussini
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Ct Scan ◽  
Otitis Media ◽  
Predictive Value ◽  
Chronic Otitis Media ◽  
Diagnostic Value ◽  
P Value ◽  
High Resolution Computed Tomography ◽  
Preoperative Ct

Objectives: The aim of this study was to investigate the correlation between the preoperative findings of high-resolution computed tomography (HRCT) of temporal bone in chronic otitis media (COM) and the intraoperative findings. Methods: This retrospective study was conducted in the ORL-HNS Unit at Ohud Hospital, Medina, Saudi Arabia, during the period from January to September 2018. We included all patients with COM, and an informed consent was obtained from all participants. The HRCT images were studied in comparison with the intraoperative findings. The parameters of comparison were tympanic membrane, middle ear structures, and the status of cholesteatoma. Results: A total of 39 patients were included in the analysis: 14 male and 25 female patients. The age range was 9 to 50 years. As a result of the comparison between HRCT findings and intraoperative observations, we found that incus erosion through computed tomography (CT) was the same as during surgical observation in 12 cases (30.8%). Malleus appeared eroded on CT in 1 case (2.6%); however, 5 cases were seen with that observation during operation (12.8%). Cholesteatoma was similarly seen in the CT scan and during surgery with a significant relation between intraoperative cholesteatoma extending and HRCT findings of the disease (95% confidence level, P-value = 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value were 100% for detecting sigmoid plate erosion, dura exposure, incus erosion, stapes erosion, and malleus-incus joint discontinuity through preoperative CT. Conclusions: Intraoperative findings and HRCT have shown better results with good correlation of diagnostic value regarding the comparisons between recorded observations, especially in detecting sigmoidal plate erosion, dural exposure, incus and stapes erosion, and malleus-incus joint discontinuity. Preoperative CT scan is beneficial and contributory in the decision of indicating surgery to patients.

Sign in / Sign up

Export Citation Format

Share Document