Fetal abdominal cysts: antenatal course and postnatal outcomes

2019 ◽  
Vol 47 (4) ◽  
pp. 418-421
Author(s):  
Elisabetta Sanna ◽  
Stavros Loukogeorgakis ◽  
Thomas Prior ◽  
Iris Derwig ◽  
Gowrishankar Paramasivam ◽  
...  
Keyword(s):  
Gestational Age ◽  
Surgical Intervention ◽  
Antenatal Diagnosis ◽  
Age At Diagnosis ◽  
Single Centre ◽  
Intestinal Origin ◽  
Abdominal Cyst

Abstract Background There is little information on which to base the prognostic counselling as to whether an antenatally diagnosed fetal abdominal cyst will grow or shrink, or need surgery. This study aims to provide contemporary data on prenatally diagnosed fetal abdominal cysts in relation to their course and postnatal outcomes. Methods Fetal abdominal cysts diagnosed over 11 years in a single centre were identified. The gestational age at diagnosis and cyst characteristics at each examination were recorded (size, location, echogenity, septation and vascularity) and follow-up data from postnatal visits were collected. Results Eighty abdominal cysts were identified antenatally at 28+4 weeks (range 11+0–38+3). Most (87%) were isolated and the majority were pelvic (52%), simple (87.5%) and avascular (100%). Antenatally, 29% resolved spontaneously; 29% reduced in size; 9% were stable and 33% increased in size. Forty-one percent of cysts under 20 mm diameter increased in size, while only 20% of cysts with a diameter of over 40 mm increased in size. The majority of cysts were ovarian in origin (n=45, 56%), followed by intestinal (n=15, 18%), choledochal (n=3, 4%), liver (n=2, 3%) and renal/adrenal origins (n=2, 3%), respectively. In 16% (n=13), the antenatal diagnosis was not obvious. Seventy-five percent of the cysts that persisted postnatally required surgical intervention. Conclusion Most antenatally diagnosed fetal abdominal cysts were ovarian in origin. Though most disappeared antenatally, nearly three quarters required surgical intervention when present after birth. Cysts of intestinal origin are more difficult to diagnose antenatally and often require surgery.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

TP1-1 Endovascular versus surgical management of pericallosal artery aneurysms, single centre experience

2019 ◽  
Vol 90 (3) ◽  
pp. e10.2-e10
Author(s):  
MS Draz ◽  
AK Toma ◽  
S Bezouich ◽  
P Grover
Keyword(s):  
Surgical Intervention ◽  
Case Series ◽  
Artery Aneurysm ◽  
Endovascular Management ◽  
Single Centre ◽  
Retrospective Case ◽  
Surgical Clipping ◽  
Pericallosal Artery ◽  
Single Centre Experience

ObjectivesComparing surgical versus endovascular management of pericallosal artery aneurysm.DesignRetrospective case series.SubjectsPatients managed in our unit for pericallosal artery aneurysms.MethodsPatients medical and radiological records were reviewed collecting data about presentation, management, complications. Clinical outcome was assessed by mRS at 3,6 and 12 months. Imaging were reviewed to report aneurysm size and treatment outcome.ResultsAverage follow up period 3.3 years SD ±3.5. 38 patients had SAH and 19 were incidentally discovered. Initial CT showed SAH in 21 patients, IVH in 3,ICH in 3 IVH and ICH in 9. 33 patients treated using endovascularly, 13 patients conservatively and 2 by surgical clipping. 33% of endovascular group had stroke caused by approach related complications. 41.3% of the patients had mRS (0–2) at 3 months period. Increased to 46.5% at 12 months. Average imaging follow up was 1.5 years (SD ±1.6). 36.3% of endovascular group showed aneurysm remnant filling or recurrence.ConclusionsPericallosal artery aneurysms are complex in nature and both management modalities are challenging. Complications were high in endovascular group. Surgical intervention should be considered in selected patients where complex intervention is required.

scholarly journals 948 Visceral Artery Aneurysms- A Single Centre Experience Over 6 Years

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Zaki ◽  
M Ashrafi ◽  
A Balakrishnan
Keyword(s):  
Medical Records ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Visceral Artery ◽  
National Guidelines ◽  
Single Centre ◽  
Endovascular Interventions ◽  
Single Centre Experience ◽  
Visceral Artery Aneurysms

Abstract Introduction The incidence of visceral artery aneurysms (VAA) varies from 0.01-0.1%. They are significant with a mortality risk of up to 75% if ruptured. Given there are no national guidelines we decided to conduct this study to assess the management of VAA in our trust and recommend local guidelines. Method We retrospectively identified patients who had a detected VAA between April 2014 and April 2020. Medical records and relevant imaging were reviewed in detail. MDT outcomes and subsequent mortalities noted. Results We identified 62 VAA in 59 patients (23 male), median age 65 years, and mean diameter 18.1 mm. 95 % were detected on CT, the indication was mostly malignancy. MDT outcomes were to continue surveillance for 43 patients with yearly scans, 5 patients had primary surgical repair, 7 patients had endovascular interventions, 1 patient had primary endovascular intervention that failed and required surgical intervention. 7 patients were discharged from follow up due to age and size (12 mm) or VAA completely thrombosed. Conclusions In our unit decisions to intervene were based on size > 20mm, rapid increase in size on surveillance, the presence of portal hypertension or possibly the patients’ young age. There were no mortalities linked to VAA.

scholarly journals Lymphoma Occurring during Pregnancy: Obstetric Outcome and Overall Survival in a Series of 19 Patients

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5289-5289
Author(s):  
Anna Vanazzi ◽  
Fedro Peccatori ◽  
Barbara Buonomo ◽  
Di Loreto Eugenia ◽  
Giovanna Scarfone ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Gestational Age ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Obstetric Complications ◽  
Age At Diagnosis ◽  
Additional Patient ◽  
Maternal Outcomes

INTRODUCTION AND BACKGROUND: Lymphoma during pregnancy is a rare and highly challenging condition. Recent evidences show that chemotherapy can be safely administered during pregnancy, however the effects on obstetric and neonatal outcomes are still largely unknown. Aim of this study is to illustrate the oncologic management and to investigate the obstetric, neonatal and maternal outcomes in a series of cases diagnosed with lymphomas during pregnancy. PATIENTS AND METHODS: A retrospective analysis has been conducted in a cohort of pregnant patients diagnosed with Hodgkin lymphoma (HL) and non-Hodgkin Lymphoma (NHL) between 2006 and 2019. Data were collected from the clinical databases and medical records at Istituto Europeo di Oncologia and IRCCS Policlinico di Milano (Milano, Italy). Data on maternal disease, treatments, obstetric complications, fetal and maternal outcomes were analyzed. RESULTS: We identified 19 pregnant patients diagnosed with HL and NHL. Their median age at diagnosis was 29 years (range 23-39). Nodular sclerosis HL was the most common histological subtype (9 patients); primary Mediastinal B-cell lymphoma (PMBCL) was diagnosed in 4 patients, Diffuse Large B Cell NHL in 2 patients, whereas Burkitt lymphoma, Anaplastic Large Cell Lymphoma (ALCL), Follicular NHL and primary cutaneous ALCL were diagnosed in one patient for each of these subtypes. Seven women were diagnosed with advanced disease, with bulky presentation in 5 of them and B symptoms in 3 patients. The median gestational age at diagnosis was 22 weeks (range 7-30). Three patients were diagnosed in the first trimester of pregnancy. Two of them opted for a termination of pregnancy in order to initiate immediate treatment. The remaining 17 pregnancies ended in a live birth. Overall, 8 pregnant women received antenatal chemotherapy, started at a median gestational age of 23 weeks (range 23-33). Treatment included ABVD in 4 patients, CEOP in 3 patients, CHOP in 1 patient (rituximab delayed after delivery in 4 patients). One additional patient received radiotherapy on cutaneous lesion delivered at 33 weeks (primary cutaneous ALCL). Seven out of 9 patients treated during pregnancy obtained a complete response (CR). In eight patients treatment was postponed (due to indolent histology or asymptomatic and non-bulky disease). Obstetric complications occurred during chemotherapy at week 33 in 1 patient with intrauterine growth restriction (IUGR) and oligohydramnios. After a median follow up of 32 months, 13/19 patients are alive and free of disease, 1 patient relapsed 6 y after diagnosis of HL and she is presently undergoing salvage treatment, 1 patient non yet evaluable, 4 patients lost at follow-up. CONCLUSIONS: Treating lymphomas during pregnancy is feasible, however the management of a pregnant patient with lymphoma requires multidisciplinary approach. In case of low risk disease and/or disease occurring in late gestational phase, therapy can be deferred to post-partum. If required, standard chemotherapeutic regimens can be administered during the 2nd and 3rd trimester, with minimal maternal or fetal complications. Starting treatment during pregnancy does not imply an adverse long-term outcome. Disclosures No relevant conflicts of interest to declare.

scholarly journals FOETAL INTRA ABDOMINAL CYST: ANTENATAL DIAGNOSIS AND FOLLOW-UP

2000 ◽  
Vol 56 (3) ◽  
pp. 237-239
Author(s):  
CHANDRA MAUDAR ◽  
SS NAWARE ◽  
AMARJIT SINGH ◽  
B PURI
Keyword(s):  
Antenatal Diagnosis ◽  
Abdominal Cyst

Pregnancy and early post-natal outcomes of fetuses with functionally univentricular heart in a low-and-middle-income country

2020 ◽  
Vol 30 (12) ◽  
pp. 1844-1850
Author(s):  
Balu Vaidyanathan ◽  
Aparna Vijayaraghavan ◽  
Stephy Thomas ◽  
Abish Sudhakar
Keyword(s):  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Middle Income Country ◽  
Age At Diagnosis ◽  
Middle Income ◽  
Comfort Care ◽  
Live Births ◽  
Survival Status ◽  
Intention To Treat

AbstractBackground:Care of children with functionally univentricular hearts is resource-intensive.Objectives:To analyse pregnancy and early post-natal outcomes of fetuses with functionally univentricular hearts in the setting of a low–middle-income country.Methods:A retrospective study was conducted during the period of January 2008–October 2019. Study variables analysed included gestational age at diagnosis, maternal and fetal comorbidities and cardiac diagnosis including morphologic type of single ventricle. Outcomes analysed included pregnancy outcomes, type of post-natal care and survival status on the last follow-up.Results:A total of 504 fetuses were included. Mean maternal age was 27.5 ± 4.8 years and mean gestational age at diagnosis was 25.6 ± 5.7 weeks. Pregnancy outcomes included non-continued pregnancies (54%), live births (42.7%) and loss to follow-up (3.3%). Gestational age at diagnosis was the only factor that impacted pregnancy outcomes (non-continued pregnancies 22.5 ± 3.5 vs. live births 29.7 ± 5.7 weeks; p < 0.001). Of the 215 live births, intention-to-treat was reported in 119 (55.3%) cases; of these 103 (86.6%) underwent cardiac procedures. Seventy-nine patients (36.7%) opted for comfort care. On follow-up (median 10 (1–120) months), 106 patients (21%) were alive. Parental choice of intention-to-.treat or comfort care was the only factor that impacted survival on follow-up.Conclusions:Prenatal diagnosis of functionally univentricular hearts was associated with overall low survival status on follow-up due to parental decisions on not to continue pregnancy or non-intention-to-treat after birth. Early detection of these complex defects by improved prenatal screening can enhance parental options and reduce resource impact in low-and-middle-income countries.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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