Two cases of non-parasitic splenic cysts and spleen-preserving therapy

2021 ◽  
Author(s):  
SB Kumar ◽  
J Richards ◽  
K Butcher ◽  
R Welbourn
Keyword(s):  
Management Strategy ◽  
Acute Onset ◽  
Optimal Management ◽  
Infection Rates ◽  
Spleen Preserving ◽  
First Case ◽  
Splenic Cysts ◽  
Laparoscopic Fenestration ◽  
Post Traumatic

We review two different presentations of non-parasitic splenic cysts, both of which are post-traumatic in aetiology. The first case was of slower onset and was managed electively. The second case was of acute onset and was managed as an emergency. Non-parasitic splenic cysts are uncommon and the optimal management strategy for them is not well defined. Historically, treatment has been with open splenectomy; however, infection rates following this surgery have been high, making it an unattractive management option. Both cases were managed successfully with laparoscopic fenestration with no recurrence at subsequent follow-up.

scholarly journals Huge Non-parasitic Mesothelial Splenic Cyst in a Child: A Case Report and Literature Review

2021 ◽  
Vol 15 ◽  
pp. 117955652110215
Author(s):  
Imed Krichen ◽  
Kais Maazoun ◽  
Murad Kitar ◽  
Naglaa M Kamal ◽  
Ubaidullah Khan ◽  
...  
Keyword(s):  
Pediatric Surgery ◽  
Management Strategy ◽  
Secondary Infection ◽  
Splenic Cyst ◽  
Partial Splenectomy ◽  
Abdominal Ultrasonography ◽  
Case Presentation ◽  
Best Management ◽  
Splenic Cysts

Background: Splenic cysts are one of the relatively rare conditions in pediatric surgery practice. Primary non-parasitic splenic cysts are even more scarce. Case presentation: A 13-years-old female patient presented with chronic left hypochondrial pain of 2 months duration. Abdominal ultrasonography and computed tomography revealed huge 18 cm × 14 cm × 10 cm splenic cyst. Deroofing of the cyst was done which was complicated by secondary infection. Subsequently, the patient was re-operated on and partial splenectomy done with good outcome at 6 months follow up. Conclusion: Partial splenectomy is the best management strategy for huge non-parasitic splenic cysts in children. There is also less recurrence rate of splenic cysts with preservation of splenic functions.

scholarly journals Laparoscopic fenestration surgery of a large primary splenic cyst

2020 ◽  
Vol 7 (11) ◽  
pp. 3815
Author(s):  
Harsh Bhomaj ◽  
Aditya Prasad Padhy ◽  
Pran Singh Pujari
Keyword(s):  
Preoperative Evaluation ◽  
Cystic Mass ◽  
Splenic Cyst ◽  
Spleen Preserving ◽  
Splenic Cysts ◽  
Left Hypochondrium ◽  
Contrast Enhanced ◽  
Laparoscopic Fenestration ◽  
Fenestration Surgery ◽  
Enhanced Computed Tomography

Splenomegaly is a major and perhaps the only concern pertaining to spleen for surgeons. Splenic cysts are rare presentations as splenomegaly, with about 800 cases reported so far. Presenting a case report of a 19 years old boy presented with a mass in the abdomen below the rib cage on the left side since 1 year. No other associated complaints. On clinical evaluation a soft cystic mass of size 10×10 cm approximately, was felt extending upto and just above the umbilicus, occupying the left hypochondrium, epigastrium, left lumbar and part of umbilical region. On contrast enhanced computed tomography (CECT) abdomen and pelvis, a well-defined, rounded cystic swelling arising from the spleen and abutting the surrounding structures was noted. Clinically diagnosing it as a primary splenic cyst and after thorough preoperative evaluation the patient was planned for laparoscopic fenestration surgery of the cyst. Surgery involved aspirating, deroofing of the cyst with omental packing of the cyst cavity. This surgery is a novel minimally invasive spleen preserving approach to such types of splenic cysts. This approach carries the least morbidity and recurrence rate among its other options.

scholarly journals Post traumatic antral stenosis in a cat

2019 ◽  
Vol 69 (1) ◽  
pp. 131-136
Author(s):  
Angelo Pelloni ◽  
Francesca Del Signore ◽  
Giovanni Aste ◽  
Silvia Zordan ◽  
Angela De Magistris ◽  
...  
Keyword(s):  
Body Weight Gain ◽  
Endoscopic Examination ◽  
The Body ◽  
Gastric Distension ◽  
Wall Thickening ◽  
First Case ◽  
Loss Of Weight ◽  
Gastric Stenosis ◽  
Post Traumatic

Abstract The goal of this study was to report the first case of antral stenosis in a cat. We have described a clinical case of a 9 months old domestic shorthaired cat referred for persistent and refractory vomiting, anorexia and loss of weight. Ultrasound (US) examination detected a mild gastric distension, mild wall thickening (5mm), severe serosal irregularities and a constriction between the fundus and body. Computed tomography (CT) was then performed: a severe gastric stenosis between the body and antrum with minimum contrast transit was detected and confirmed by flexible endoscopic examination. The antral localization of the stenosis was revealed after a cranial celiotomy and Y-U plastic was necessary to correct the defect. The patient completely recovered after surgery with significant body weight gain and remained in remission throughout a 2-years follow-up. While in human medicine there is evidence of acquired antral stenosis, no information is available about the same lesion in the feline species. To the best of our knowledge, this is the first case of antral stenosis in cats.

When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS)

2021 ◽  
Vol 14 (1) ◽  
pp. e238006
Author(s):  
Mitchell Cox ◽  
Sophie Paviour ◽  
Sophie Gregory ◽  
Rusheng Chew
Keyword(s):  
Drug Reaction ◽  
Cytomegalovirus Reactivation ◽  
First Case ◽  
Metropolitan Hospital ◽  
Orthopaedic Ward ◽  
Systemic Hypersensitivity ◽  
Systemic Symptoms ◽  
Inflammatory Syndrome ◽  
Intravenous Glucocorticoids

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.

Complete resolution of acute pancreatitis-induced chylous ascites following transhepatic portal vein stenting

2020 ◽  
Vol 13 (12) ◽  
pp. e235986
Author(s):  
Alexander Tindale ◽  
James Jackson ◽  
Darina Kohoutova ◽  
Panagiotis Vlavianos
Keyword(s):  
Portal Vein ◽  
Complete Resolution ◽  
Chylous Ascites ◽  
Biliary Pancreatitis ◽  
Acute Biliary Pancreatitis ◽  
Portal Vein Stenosis ◽  
First Case ◽  
Vein Stenosis ◽  
Inflammatory Changes

We introduce a case of a 73-year-old man who developed intractable chylous ascites due to portal vein compression as a result of peripancreatic inflammatory changes after acute biliary pancreatitis. After stenting the portal vein stenosis, the chylous ascites improved from requiring weekly paracentesis to requiring no drainage within 4 months of the procedure and at the 15-month follow-up. To our knowledge, it is the first case reported in the literature where portal vein stenting has successfully been used to treat pancreatitis-induced chylous ascites.

Extremely Elevated Cerebrospinal Fluid Protein and Glucose Level in a Neonate with Hypernatremic Dehydration

2020 ◽  
Author(s):  
Arti Maria ◽  
Tapas Bandyopadhyay
Keyword(s):  
Cerebrospinal Fluid ◽  
Neurodevelopmental Outcome ◽  
Neurological Sequelae ◽  
Glucose Levels ◽  
Csf Analysis ◽  
First Case ◽  
Time Of Admission ◽  
Cerebrospinal Fluid Protein ◽  
Hypernatremic Dehydration

AbstractWe describe the case of a term newborn who presented with hypernatremic dehydration on day 19 of life. The baby was otherwise hemodynamically stable with no evidence of focal or asymmetric neurological signs. The laboratory tests at the time of admission were negative except for hypernatremia and the extremely elevated levels of cerebrospinal fluid (CSF) protein (717 mg/dL) and glucose levels (97 mg/dL). The hypernatremic dehydration was corrected as per the unit protocol over 48 hours. Repeat CSF analysis done after 5 days showed normalization of the protein and glucose levels. Serial follow-up and neuroimaging showed no evidence of neurological sequelae. Unique feature of our case is this is the first case reporting such an extreme elevation of CSF protein and glucose levels that have had no bearing on neurodevelopmental outcome at 1 month and 3 months of follow-up.

Young Male with Bilateral ICA Dissection: Beyond CADISS Trial

2021 ◽  
pp. 251660852098428
Author(s):  
Vikas Bhatia ◽  
Chirag Jain ◽  
Sucharita Ray ◽  
jay Kumar
Keyword(s):  
Management Strategies ◽  
Young Male ◽  
Acute Onset ◽  
The Body ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Stroke Study ◽  
History Of

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.

scholarly journals Percutaneous posteroanterior screw fixation for Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture: Operative technique and randomized clinical results

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199799
Author(s):  
Tianming Yu ◽  
Jichong Ying ◽  
Jianlei Liu ◽  
Dichao Huang ◽  
Hailin Yan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Malleolar Fracture ◽  
Malleolar Fractures ◽  
Posterior Malleolar Fracture ◽  
Post Traumatic ◽  
Group 2 ◽  
Traumatic Arthritis ◽  
Group 1

Purpose: The study described a novel surgical treatment of Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture and patient outcomes at intermediate period follow-up. Methods: All patients from January 2015 to December 2017 with tri-malleolar fracture of which posterior malleolar fractures were Haraguchi type 1, were surgically treated in this prospective study. Lateral and medial malleolar fractures were managed by open reduction and internal fixation through dual incision approaches. 36 cases of Haraguchi type 1 posterior malleolar fractures were randomly performed by percutaneous posteroanterior screw fixation with the aid of medial exposure (group 1). And 40 cases were performed by percutaneous anteroposterior screw fixation (group 2). Clinical outcomes, radiographic outcomes and patient-reported outcomes were recorded. Results: Seventy-six patients with mean follow-up of 30 months were included. There were no significant differences in the mean operation time (81.0 ± 11.3 vs. 77.2 ± 12.4), ankle function at different periods of follow-up, range of motions and visual analog scale (VAS) at 24 months between the two groups ( p > 0.05). However, the rate of severe post-traumatic arthritis (Grade 2 and 3) and the rate of step-off rather than gap in radiological evaluation were lower in group 1 than that in group 2 ( p < 0.05). Conclusion: Using our surgical technique, more patients had good outcome with a lower rate of severe post-traumatic arthritis, compared with the group of percutaneous anteroposterior screw fixation. Percutaneous posteroanterior screw fixation can be a convenient and reliable alternative in treating Haraguchi type 1 posterior malleolar fracture.

Penile Lymphoepithelioma-Like Carcinoma: A Rare Case With PD-L1 Expression

2021 ◽  
pp. 106689692098834
Author(s):  
Raquel Machado-Neves ◽  
Bernardo Teixeira ◽  
Elsa Fonseca ◽  
Pedro Valente ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Tumor Cells ◽  
Rare Case ◽  
Malignant Tumors ◽  
Squamous Cell Carcinomas ◽  
The Third ◽  
The Past ◽  
First Case ◽  
Lymphoplasmacytic Infiltrate

Most malignant tumors of the penis are squamous cell carcinomas (SCC), being divided in 2 groups, one human papillomavirus (HPV)-related and another non-HPV-related, with lymphoepithelioma-like carcinoma (LELC) being one of the rarest HPV-related SCC. In this article, we report a case of a 50-year-old man who presented testicular swelling and pain for the past 3 months. A penile mass was identified, and the patient was submitted to a total penectomy. The penectomy specimen showed an ulcerated lesion at the glans reaching the cavernous bodies. Microscopic examination showed undifferentiated epithelial cells with syncytial growth pattern mix with a dense lymphoplasmacytic infiltrate, consistent with LELC. The tumor cells expressed p16 and all 3 different clones of PDL1 (22C3, SP263, and SP142). The patient is alive and well with a follow-up of 3 months. To our knowledge, this is the third LELC of the penis reported in literature and the first case reported with PDL1 expression.

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