scholarly journals Surgical management of post-surgical intercostal thoracic-abdominal nerve neuroma

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Soubrata Raikar ◽  
Arun Angelo Patil ◽  
Amelia Simmons ◽  
Thomas Nilles-Melchert
Keyword(s):  
Laparoscopic Surgery ◽  
Nerve Block ◽  
Severe Pain ◽  
Left Kidney ◽  
Scar Tissue ◽  
Intercostal Nerve ◽  
Diagnostic Study ◽  
Case Presentation ◽  
Proximal Stump

Abstract Background Formation of post-operative neuroma formation after laparoscopic surgery is not common. Its diagnosis is often missed because pain often mimics intra-abdominal pathology. In this paper, the authors report a case in which the severe pain resulting from the abovementioned neuroma was successfully treated by excision of neuroma and implant of the proximal stump into the adjacent muscle. Case presentation The patient is a 20-year-old female who had laparoscopic surgery on her left kidney. Immediately after surgery, she started experiencing severe pain at the operative site that continued for 5 years. A recent nerve block of the thoracic-abdominal intercostal nerve deep in the abdominal wall immediately beneath the incision gave her temporary relief for a couple of weeks. The patient was operated on. The neuroma was identified in the scar tissue of the transversalis muscle. The neuroma was excised, and the proximal stump was buried in the adjacent muscle. After the operation, she was free of pain and continues to be free of pain at 6 months follow-up. Conclusion Formation of neuroma with severe chronic abdominal pain can occur after laparoscopic surgery. Nerve block is a diagnostic study for this condition. Neuroma resection with burying the covering of the stump can result in the cure of the pain.

scholarly journals Laparoscopic Surgery Management of Hydronephrosis Secondary to Left Paraduodenal Hernia in Cryptorchid: Case Report and a Literature Review

2020 ◽  
Author(s):  
Xin Wang ◽  
Yong Guan ◽  
Yong Wu ◽  
QingYa Meng
Keyword(s):  
Laparoscopic Surgery ◽  
Paraduodenal Hernia ◽  
Medical Work ◽  
Secondary Surgery ◽  
Case Presentation ◽  
Left Ureter ◽  
Long Term Follow Up ◽  
Surgery Management

Abstract Background: Left paraduodenal hernia (PDH) is a mesenterico-parietal hernia with retroperitoneal retrocolic herniation of the small bowel into a sac formed by a peritoneal fold located near the fourth portion of the duodenum. It’s a rare cause of hydronephrosis by compressed the upper left ureter. Traditionally, PDH are treated by laparotomy.Case presentation: An 8-year-old boy’s primary purpose was the treatment of cryptorchidism. But hydronephrosis was detected and it was induced by left paraduodenal hernia. Diagnostic laparoscopic exploration confirmed the diagnosis left paraduodenal hernia secondary hydronephrosis. Cryptorchidism was the primary purpose of treatment. The patient was treated with laparoscopic surgery, fixed left paraduodenal hernia, released the ureteropelvic junction obstruction (UPJO) and treated hydronephrosis.Conclusion: Secondary surgery for treating cryptorchidism would be performed and the long-term follow up was necessary.This case suggests us a rare cause of hydronephrosis in children. Every why has a wherefore. We must pay much attention to any unusual details in our medical work even though these details aren’t related to our primary objects.

Müllerianosis of the urinary bladder with unilateral complete renal agenesis: a rare coincidental finding causing delayed presentation

2020 ◽  
Vol 13 (7) ◽  
pp. e235217
Author(s):  
Shanmugasundaram Rajaian ◽  
Lakshman Murugasen ◽  
Deepti Jain ◽  
Srinivas Chakravarthy Narasimhachar
Keyword(s):  
Urinary Bladder ◽  
Benign Lesion ◽  
Left Kidney ◽  
Scar Tissue ◽  
Delayed Presentation ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Ureteric Orifice

Müllerianosis is a rare benign lesion of the urinary bladder, which is constituted by two or more of the Müllerian-duct-derived tissues. We report a 45-year-old perimenopausal multiparous woman presenting with occasional episodes of dysuria and lower abdominal discomfort of recent duration. Ultrasound examination revealed a well-defined lesion in urinary bladder and the absence of left kidney. Contrast-enhanced CT of the abdomen confirmed the findings. During diagnostic cystoscopy, haemorrhagic polypoidal lesions were noted in the left side of the posterolateral wall and dome of urinary bladder along with the absence of left ureteric orifice. Transurethral resection of the bladder lesions was done and histology examination confirmed the diagnosis of Müllerianosis. She was administered Luteinizing hormone-releasing hormone (LHRH) agonist monthly. At 1 year of follow-up, cystoscopy showed only scar tissue. The case was reported for the rarity of Müllerianosis noted in a patient with unilateral agenesis of kidney, a possible cause of delayed presentation.

scholarly journals Glubran 2®: A New Acrylic Glue for Neuroradiological Endovascular Use

2003 ◽  
Vol 9 (3) ◽  
pp. 249-254 ◽  
Author(s):  
M. Leonardi ◽  
P. Cenni ◽  
L. Simonetti ◽  
A. Bozzao ◽  
A. Romano ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Left Kidney ◽  
Arterial Occlusion ◽  
Microscopic Analysis ◽  
Scar Tissue ◽  
Left Renal Artery ◽  
Large White ◽  
Glubran 2 ◽  
Embolization Procedure

Two Landrace Large White swine underwent angiography by the femoral route. In both cases, the superior left renal artery was embolized by injection of 2 ml of Glubran 2®, diluted with Lipiodol 1:1 thereby excluding the superior left kidney poles from blood flow. During the follow-up period, neither pig presented any clinical symptom correlated to the embolization procedure. Case 1 was sacrificed after 30 days and case 2 after 60 days. Macroscopic and microscopic analysis was performed in both animals. Long-term follow-up of the two cases after endovascular injection of Glubran 2® showed that the embolization procedure was well-tolerated by the swine in terms of clinical symptoms and histological findings. Arterial occlusion was stable and a reasonable quantity of scar tissue appeared between 30 and 60 days, surrounding the ischaemic tissue. This follow-up experimental study offers further evidence that Glubran 2® is a safe embolizing material for human use as far as its chemical activity is concerned.

scholarly journals Pathophysiological clinical features of an infant with hypertension secondary to multicystic dysplastic kidney: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Keisuke Sugimoto ◽  
Takuji Enya ◽  
Kensuke Joh ◽  
Kohei Miyazaki ◽  
Tomoki Miyazawa ◽  
...  
Keyword(s):  
Left Kidney ◽  
Multicystic Dysplastic Kidney ◽  
Wall Thickening ◽  
Tubular Atrophy ◽  
Renal Masses ◽  
Renal Hypoplasia ◽  
Case Presentation ◽  
Post Surgery ◽  
Dysplastic Kidney

Abstract Background The association of hypertension with congenital renal hypoplasia has been established. We report a case of an infant who underwent nephrectomy for hypertension. Case presentation Magnetic resonance imaging for the mother revealed fetal renal masses, and fetal multicystic dysplastic kidney was suspected. Following birth, the baby developed hypertension. Numerous investigations revealed that the left kidney was non-functional, and she was initiated on benazepril hydrochloride. However, because the drug response was poor, the left kidney was removed at the age of 7 months. Examination of the renal specimen revealed abrupt transition from normal to atrophic cortex with lobar atrophy and cysts. Tubular atrophy, marked abnormal blood vessels with wall thickening, gathered immature glomeruli, and parenchymal destruction were observed. Renin was partially localized in the proximal tubules and the parietal epithelium of the Bowman’s capsule in the immature glomeruli. We speculated that an abnormal vascular structure and irregular renin localizations may be the cause of hypertension. Serum renin and aldosterone levels gradually reduced post-surgery, reaching normal levels on the 90th postoperative day. A long follow-up is needed due to the possibility of the child developing hypertension in the future. Conclusion This is a case of an infant with MCDK, which discusses the clinicopathological features based on the pathophysiological analysis, including renin evaluation.

scholarly journals Laparoscopic resection of a primary diaphragmatic schwannoma: a case report and literature review

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ayako Kamiya ◽  
Yukinori Yamagata ◽  
Hiroshi Yoshida ◽  
Kenichi Ishizu ◽  
Takeyuki Wada ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Submucosal Tumor ◽  
Gastric Wall ◽  
Pathological Examination ◽  
Initial Examination ◽  
Case Presentation ◽  
Nerve Sheath Tumors ◽  
Benign Schwannoma ◽  
Left Diaphragm

Abstract Background Schwannomas are nerve sheath tumors that commonly originate from the stomach and small intestine. A primary schwannoma of the diaphragm is rare and does not show any symptoms until it grows to a certain size. Hence, it is extremely rare that it was found at a size that allowed resection under videoscopic surgery. Case presentation A 77-year-old woman was referred to our department for surgical treatment of a tumor located near the gastric fornix. She underwent a routine esophagogastroduodenoscopy 2 years and 7 months prior to the referral. It was suspected that she had a submucosal tumor measuring 10 mm, located in the fornix, and was then referred to her previous physician. During her follow-up, endoscopic ultrasonography (EUS) revealed that the cystic structure had continued to grow toward the gastric wall, and she was then referred to the endoscopy division of our hospital. She continued to be followed-up, and it was noted that the tumor was gradually increasing in size. Therefore, she requested surgical resection, and was finally referred to our division. Since the tumor was rather small, we planned a laparoscopic surgery. An initial examination during the operation revealed that the tumor was located on the left diaphragm. Since the tumor was relatively small and visibility was good, we decided to continue with the laparoscopic surgery. Partial diaphragmectomy with complete inclusion of the tumor was performed, and the defect of the diaphragm was directly closed by a running suture. Pathological examination revealed a benign schwannoma that had originated from the diaphragm. To support our findings, we also reviewed the scientific literature on diaphragmatic schwannoma cases reported up to April 2020. Conclusions In this extremely rare case, we successfully resected the diaphragmatic schwannoma using laparoscopic surgery.

scholarly journals A case of sigmoid volvulus in an unexpected demographic

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mohammad Saba ◽  
Joshua Rosenberg ◽  
Gregory Wu ◽  
Gudata Hinika
Keyword(s):  
Abdominal Pain ◽  
Severe Pain ◽  
Rare Case ◽  
Young Female ◽  
Sigmoid Volvulus ◽  
Case Presentation ◽  
Operative Complications ◽  
History Of ◽  
Male Sex ◽  
Emergent Laparotomy

Abstract Background A sigmoid volvulus occurs when a segment of the colon twists upon its mesentery. This infliction is associated with old age, multiple co-morbidities, and the male sex. We present a rare case of sigmoid volvulus that occurred in a healthy young female. Case presentation A 28-year-old female presented with a one week history of constipation and abdominal pain. Her symptoms suddenly worsened and became associated with vomiting and severe pain. A focused history taking and physical examination showed peritoneal signs that led to timely diagnostic imaging to be implemented. Computed tomography (CT) of the abdomen was consistent with sigmoid volvulus. Our patient underwent emergent laparotomy with a sigmoidectomy and recovered with no post-operative complications. Conclusion This case report emphasizes the importance of clinicians maintaining a sigmoid volvulus as a rare, yet important differential when approaching abdominal pain in young healthy patients.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

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