scholarly journals LAPAROSCOPIC SIMULTANEOUS PARTIAL PERICYSTECTOMY AND TOTAL CYSTECTOMY FOR HYDATID LIVER CYSTS – CASE REPORT

2015 ◽  
Vol 88 (3) ◽  
pp. 415-419
Author(s):  
Bogdan Stancu ◽  
Octavian Andercou ◽  
Daniela Pintea ◽  
Aurel Mironiuc ◽  
Dan Alin Pop
Keyword(s):  
Postoperative Morbidity ◽  
Liver Cyst ◽  
Biliary Fistula ◽  
Fistula Formation ◽  
Limited Area ◽  
Saline Irrigation ◽  
Abdominal Ct Scan ◽  
Laparoscopic Cystectomy ◽  
The Right ◽  
Surgical Manipulation

Surgery remains the gold standard for the treatment of patients with echinococcosis, despite significant economic costs, advances in medical treatment and interventional radiology; in the past decades there has been a tendency toward laparoscopic surgery.We present a 66-year-old patient, from a rural area, who was admitted to our service complaining of spontaneous and palpatory pains in the right hypocondrium, headaches and dizziness. Abdominal  CT scan highlighted 2 round calcified tumors, one of 7.2 cm diameter (VIIIth segment) with liquid densities, and the other one localized higher, with a diameter of 2.3 cm (IVth segment).Under general anesthesia, after the neutralization of the content of the cyst with hypertonic saline irrigation, we performed laparoscopic partial pericystectomy of the VIIIth segment liver cyst and total laparoscopic cystectomy of the IVth segment liver cyst. Postoperative evolution was favorable without biliary fistula formation, postoperative infections or cystic cavities abscesses.Laparoscopic surgery seems to be effective and safe for uncomplicated cysts in accessible segments of the liver, combined with adjuvant albendazole therapy to reduce complications and postoperative morbidity, but the procedure has its own disadvantages such as a limited area of surgical manipulation.

scholarly journals Biliary Surgery Via Minilaparotomy — A Limited Procedure for Biliary Lithiasis

HPB Surgery ◽  
1993 ◽  
Vol 6 (4) ◽  
pp. 245-254 ◽  
Author(s):  
Takukazu Nagakawa
Keyword(s):  
Operation Time ◽  
Skin Incision ◽  
Postoperative Recovery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Limited Area ◽  
Biliary Surgery ◽  
The Right ◽  
Upper Abdomen ◽  
Surgical Manipulation

Cholelithiasis until now has been treated using solvents, lithotripsy via a biliary endoscope, laser or shock wave lithotripsy, and laparoscopic cholecystectomy. have developed a new surgical treatment for cholelithiasis in which a cholecystectomy is performed through a minilaparotomy. This paper presents this new technique and discusses the principles of surgery for cholelithiasis using this technique. This procedure is performed by a 2 to 3 cm subcostal skin incision in the right hypochondrium. More than 400 patients were treated by this technique. This procedure is not different in terms of blood loss .or operation time from conventional methods, and no significant complications have occurred. Intraoperative X-ray examination is performed routinely because of easy insertion of a tube from the cystic duct into the bile duct. Reduction of the length of the incision greatly facilitates postoperative recovery, shortening the hospital length-of-stay to within 3 days. The surgical manipulation of only a limited area of the upper abdomen is unlikely to induce postoperative syndromes, such as adhesions or ileus. Following this experience, a biliary drainage procedure based on cholangionmanomery and primary closure of the choledochotomy was introduced. This approach allowed even patients with choledocholithiasis to undergo a minilaparotomy and be discharged within one week.

scholarly journals Lung autotransplantation for bronchial necrosis after radiotherapy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Nobori ◽  
Masaaki Sato ◽  
Mizuki Morota ◽  
Yoshikazu Shinohara ◽  
Daisuke Yoshida ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Pulmonary Function ◽  
Treatment Success ◽  
Locally Advanced ◽  
Fistula Formation ◽  
Bronchial Anastomosis ◽  
Silicone Stent ◽  
Feasible Option ◽  
Malignant Germ Cell Tumor ◽  
The Right

Abstract Background Bronchial necrosis is a rare but fatal complication after radiation therapy. Because of the anatomical complexity and rarity of this condition, determining the most appropriate management for individual patients is extremely challenging. Lung autotransplantation is a surgical technique that has been applied to hilar neoplastic lesions to preserve pulmonary function and avoid pneumonectomy. We herein report a case of bronchial necrosis secondary to radiotherapy that was treated with lung autotransplantation. Case presentation A 46-year-old man developed broad necrosis and infection of the right bronchus secondary to previous stereotactic body-radiation therapy. This treatment was supplied close to a right hilar metastatic pulmonary tumor derived from a mediastinal malignant germ cell tumor that had been surgically resected with the left phrenic nerve. The bronchial necrosis accompanied by infection with Aspergillus fumigatus was progressive despite antibiotics and repetitive bronchoscopic debridement. Because of the patient’s critical condition and limited pulmonary function, right lung autotransplantation with preservation of the right basal segment was selected. An omental flap was placed around the bronchial anastomosis to prevent later complications. The postoperative course involved multiple complications including contralateral pneumonia and delayed wound healing at the bronchial anastomosis with resultant stenosis, the latter of which was overcome by placement of a silicone stent. The patient was discharged 5 months postoperatively. Three months after discharge, however, the patient developed hemoptysis and died of bronchopulmonary arterial fistula formation. Conclusions We experienced an extremely challenging case of bronchial necrosis secondary to radiotherapy. The condition was managed with lung autotransplantation and omental wrapping; however, the treatment success was temporary and the patient eventually died of bronchopulmonary arterial fistula formation. This technique seems to be a feasible option for locally advanced refractory bronchial necrosis, although later complications can still be fatal.

scholarly journals An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

2020 ◽  
Vol 8 ◽  
pp. 232470962098243
Author(s):  
Khalid Sawalha ◽  
Anthony Kunnumpurath ◽  
Ronald McCann
Keyword(s):  
Hepatic Artery ◽  
Open Cholecystectomy ◽  
Artery Aneurysm ◽  
Hemodynamic Instability ◽  
Central Line ◽  
Hepatic Artery Aneurysm ◽  
Artery Pseudoaneurysm ◽  
Right Hepatic Artery ◽  
Abdominal Ct Scan ◽  
The Right

An 80-year-old male patient presented with sepsis secondary to infected central line which was placed for native aortic valve endocarditis. He also had melena and abdominal pain prior to his presentation. Abdominal computed tomography (CT) was done, which showed cholelithiasis. Esophagogastroduodenoscopy was also done with no source of bleeding identified. Later, he developed hemodynamic instability requiring aggressive fluid resuscitation and multiple packed blood cell transfusions. In view of his hemodynamic instability, a repeat abdominal CT scan showed air droplets within the gallbladder pneumobilia, ascites, diverticulosis, and a bleeding infrahepatic hematoma measuring 6 × 10 cm, which was not on his prior scan 2 days prior. A mesenteric arteriogram was performed that identified an aneurysm of the right hepatic artery with no active bleeding; therefore, it was coiled. Due to his continued clinical decompensation, he underwent an urgent open cholecystectomy, in which serosanguineous fluid, cholecystocolic fistula, and old clot related to his previous bleed were encountered. However, control of bleeding was difficult, and the patient expired. We report this case of right hepatic artery aneurysm that we believe its etiology was related to eroding cholecystitis.

scholarly journals Is Nighttime Really Not the Right Time for a Laparoscopic Cholecystectomy?

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Anna C. M. Geraedts ◽  
Meindert N. Sosef ◽  
Jan Willem M. Greve ◽  
Mechteld C. de Jong
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Morbidity ◽  
Time Of Day ◽  
Outcome Data ◽  
Emergency Procedure ◽  
Out Of Hours ◽  
Increased Risk ◽  
The Right ◽  
The Impact ◽  
Univariate Analyses

Purpose. The impact of an out-of-hours laparoscopic cholecystectomy on outcome is controversial. We sought to determine the association between an out-of-hours procedure and postoperative complications within 90 days. Methods. Between 2014 and 2016, 1553 laparoscopic cholecystectomies were performed. Therapeutic, operative, and outcome data were prospectively collected and analyzed. We defined out of hours as during weekends, national holidays, and daily between 5PM and 8AM. Results. Most patients operated on were female (n=988; 63.6%) and the majority of procedures were electives (n=1341; 86.3%). Although all procedures were performed with a laparoscopic intent, 42 (2.7%) were converted to open procedure. In total, 145 (9.3%) procedures were out of hours, all nonelective, and in most cases for acute cholecystitis (n=111; 7.1%). Overall, there were 212 complications in 191 patients (12.3%), most (n=153; 9.9%) classified as minor. The conversion rate in the out-of-hours group was significantly higher (9.7% vs 2.0%; p<0.001). While univariate analyses revealed out-of-hours procedure (OR=1.83; p=0.008) to be associated with an increased risk of complications, when controlling for confounding factors by multivariate analysis, this association was not found. However, operation by surgical staff (OR=1.71) and conversion to laparotomy (OR=3.74) were found to be independently associated with an increased risk of complications (both p<0.05), while an emergency procedure tended to be associated with postoperative morbidity (OR=1.82; p=0.069). Conclusion. An out-of-hours laparoscopic cholecystectomy was not found to be an independent risk factor for developing postoperative morbidity and time of day should therefore only be a relative contraindication.

scholarly journals Obstructed descending colon mass pretended with Bockdalek hernia: a case report

2021 ◽  
Author(s):  
mohammad eslamian ◽  
Mohsen kolahdouzan
Keyword(s):  
Diaphragmatic Hernia ◽  
Abdominal Pressure ◽  
Right Colon ◽  
Abdominal Ct ◽  
Midline Laparotomy ◽  
Abdominal Ct Scan ◽  
Descending Colon ◽  
The Right ◽  
Thoracic And Abdominal ◽  
Diaphragmatic Hernias

Abstract Introduction: Adult Bochdalek hernia is one of the right-sided diaphragmatic hernias that less than 30 cases reported until now.Case: I herein report a 64-year-old female patient who had dyspnea, abdominal pain, and nausea. Primary imaging (thoracic and abdominal CT scan) showed a right-sided diaphragmatic hernia that was contained the liver and right colon. The patient underwent right posterior thoracotomy at first, so the 5*5 cm diaphragmatic defect was repaired. Due to peritonitis that happened after two days, a midline laparotomy was performed. Finally, it was cleared that the main problem was the obstructed and perforated descending colon mass that was presented with Bockdalek hernia. Unfortunately, she died.Conclusion It is important to determine the reason for the presentation of the symptomatic diaphragmatic hernia in adult patients. It should be considered that an increase of intra-abdominal pressure like the presence of obstructed colon mass can cause it.

Downscaling of a seasonal ensemble forecast at the convection-permitting resolution over the Horn of Africa using the WRF model

2021 ◽  
Author(s):  
Paolo Mori ◽  
Thomas Schwitalla ◽  
Markos Ware ◽  
Kirsten Warrach-Sagi ◽  
Volker Wulfmeyer
Keyword(s):  
Boundary Conditions ◽  
Wrf Model ◽  
Added Value ◽  
Limited Area ◽  
Horn Of Africa ◽  
Ensemble Spread ◽  
Rain Belt ◽  
Physics Ensemble ◽  
June July ◽  
The Right

&lt;p&gt;Studies have shown the benefits of convection-permitting downscaling at the seasonal scale using limited-area models. To evaluate the performance with real forecasts as boundary conditions, four members of the SEAS5 global ensemble were dynamically downscaled over Ethiopia during June, July, and August 2018 at a 3-km resolution. We used a multi&amp;#8208;physics ensemble based on the WRF model to compare the effects of boundary conditions and physics &lt;span&gt;&lt;span&gt;parametrization&lt;/span&gt;&lt;/span&gt; producing 16 ensemble members. With ECMWF analyses as a reference, SEAS5 averaged to a +0.17&amp;#176;C bias over Ethiopia whereas WRF resulted in +1.14&amp;#176;C. With respect to precipitation, the WRF model simulated 264 mm compared to 248 mm for SEAS5 and 236 mm for GPM-IMERG. The maximum northward extension of the tropical rain belt decreased by about 2&amp;#176; in both models. Downscaling enhanced the ensemble spread in precipitation by 60% on average, correcting the SEAS5 underdispersion. The WRF ensemble spread over Ethiopia was mostly generated by the perturbed boundary conditions, as their effect is often 50% larger than the physics&amp;#8208;induced variability. The results indicate that boundary condition perturbations are necessary, although not always sufficient, to generate the right amount of ensemble spread in a limited-area model with complex topography. The next step is to use specific methods to calculate the added value provided by the downscaling.&lt;/p&gt;

A Rare Case of an Aneurysm of the External Iliac and the Common Femoral Vein

1996 ◽  
Vol 11 (1) ◽  
pp. 34-38 ◽  
Author(s):  
N. Labropoulos ◽  
S. K. Volteas ◽  
A. Al Kutoubi ◽  
A. N. Nicolaides ◽  
A. O. Mansfield
Keyword(s):  
Iliac Fossa ◽  
Femoral Vein ◽  
Oral Anticoagulants ◽  
Fistula Formation ◽  
Compression Stockings ◽  
Vein Wall ◽  
Av Fistula ◽  
Common Femoral Vein ◽  
Acute Thrombosis ◽  
The Right

Objective: To report a case of an external iliac – common femoral vein aneurysm and review the literature on the subject. Design: Case report. Setting: Academic Vascular Surgery and Radiology Units, St Mary's Hospital, London, UK. Patients, Interventions and Results: The aneurysm occurred in a 34-year-old woman and was diagnosed with venography, duplex scanning and magnetic resonance venography. It underwent acute thrombosis and, as the thrombus was well organized and extensive, thrombectomy was not possible. The patient was treated with standard heparin followed by oral anticoagulants for 5 months. Thirty months after the operation the right calf remains swollen but soft and non-tender and the patient is currently treated with grade II full-length compression stockings. Since there were no findings of vein compression or malignancy it seems that the formation of the aneurysm resulted from a congenital weakness of the venous wall. Conclusions: The most common presentation of these aneurysms is of a mass of the abdomen or the iliac fossa, while thromboembolism is not uncommon. The main causes are arteriovenous (AV) fistula formation and congenital weakness of the vein wall. For the first the preferred treatment is AV fistula ligation while for the rest ligation with or without vein reconstruction has been successfully used.

scholarly journals Radiofrequency Energy in Hepatic Bed during Partial Cystectomy for Hydatid Liver Disease: Standing Out from the Usual Conservative Surgical Management

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Eleftherios Mantonakis ◽  
Alexandros Papalampros ◽  
Demetrios Moris ◽  
Nikolaos Dimitrokallis ◽  
Panagiotis Sakarellos ◽  
...  
Keyword(s):  
Liver Disease ◽  
Postoperative Morbidity ◽  
Effective Means ◽  
Partial Cystectomy ◽  
Radiofrequency Energy ◽  
Recurrence Rates ◽  
Right Lobe ◽  
The Mean ◽  
The Right

Background. Surgical treatment of hydatid liver disease (HLD) is divided into conservative and radical procedures. While conservative techniques are easier and faster to perform, there is an emerging need to reduce their morbidity and recurrence rates. Our aim was to present and evaluate the efficiency and safety of the application of radiofrequency energy (TissueLink® and Aquamantys® systems) in hepatic bed during partial cystectomy.Materials and Methods. Eighteen consecutive patients with hydatid liver cysts were referred to our department between April 2006 and June 2014. Data about demographics, mortality, morbidity, and recurrence rate were obtained and analyzed retrospectively.Results. The mean follow-up was 38 months (range: 4–84 months). The postoperative course of most patients was uneventful. One case of recurrence was found in our series in a patient with 4 cysts in the right lobe, 3 years after initial treatment. He was reoperated on with the same method.Conclusions. Saline-linked RF energy seems to be an effective means to be employed in conservative surgical procedures of HLD, with satisfactory postoperative morbidity. Recurrence rates appear to be low, but further follow-up is needed in order to draw safer conclusions.

scholarly journals Biliobronchial fistula due to hydatidosis of the liver and choledocholithiasis

2009 ◽  
Vol 62 (5-6) ◽  
pp. 281-284 ◽  
Author(s):  
Dragoljub Bilanovic ◽  
Darko Zdravkovic ◽  
Borisav Toskovic
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Liver Cyst ◽  
Bronchial Tree ◽  
Liver Lobe ◽  
X Ray ◽  
Abdominal Approach ◽  
Chest X Ray ◽  
The Right ◽  
And Control

INTRODUCTION Biliobronchial fistula (BBF) is an abnormal communication between the biliary system and bronchial tree due to trauma, hemiheptectomy benign biliary stricture with cholangitis and necrotic hepatic infections such as hydatid disease. Intratoracic rupture of a hydatis cyst of the liver is a rare but severe complication with an incidence about 1% and mortality rate about 10%. CASE REPORT A 50-year-old male patient presented with cough, episodes of biliary expectoration and haemoptysis followed with fever, fatigue and dyspnea. The diagnosis was set by echosonography, Chest x-ray finding, CT scan, bronchoscope aspirates while bronchography did not show results. The surgery was done through right subcostal laparotomy. A hydatid cyst was found in the right liver lobe its diameter being 10 cm, fixed with diaphragm. Intraoperative cholangiography revealed choledocholithiasis (two calculi), dilatation of bile ducts and communication of right hepatic duct with the irregular liver cavity as well as with the bronchi of the right lower pulmonary lobe. Cholecystectomy, choledocholitotomy with drainage lavage of bile ducts pericystectomy and cyst evacuation was performed, followed by diaphragm necrosectomy. The postoperative period and control cholangiography through T drain were normal. DISCUSSION The surgical treatment has five goals: to treat the liver cyst, secure free biliary drainage, perform hepatodiaphragmatic disconection, solve intratoracic lesion and restore ti diaphragm. We believe these goals could be achieved through abdominal approach except for irreversible bronchiectasis, intratoracal collection and chronic pulmonary sepsis. CONCLUSION In any case, a surgery still remains the treatment of choice in cases of echinococcosis. Most cases can be solved by laparo-tomy.

scholarly journals The Spectral Reflectance Response of ‘Riviera’ Common Bermudagrass to Increasing Saline Irrigation Concentrations

2020 ◽  
pp. 1-6
Author(s):  
Lakshmy Gopinath ◽  
Matthew Barton ◽  
Justin Quetone Moss
Keyword(s):  
Salinity Stress ◽  
Spectral Reflectance ◽  
Linear Regression Analysis ◽  
Limited Area ◽  
Visual Response ◽  
Salinity Treatment ◽  
Visual Responses ◽  
Saline Irrigation ◽  
Measuring Device ◽  
Common Bermudagrass

The availability of freshwater is a growing concern throughout the world as it is an increasingly valuable and limited resource. Alternative water resources such as recycled water low in quality and high in salinity are now frequently used to irrigate turfgrass. However, irrigating with highly saline water can affect the growth, performance, appearance, and quality of turfgrass. Bermudagrass (Cynodon sp.) is the most commonly used turfgrass throughout the southern United States. In this study, the spectral reflectance and visual response of ‘Riviera’ common bermudagrass (Cynodon dactylon) were evaluated by consecutively irrigating with 12 salinity concentrations (4–48 dS·m−1) in increments of 4 dS·m−1 via manual overhead irrigation for 30 days. The experiment was replicated in time in a controlled environment with four replications for each salinity treatment and control. ‘Riviera’ maintained a leaf firing (LF) value above 5 (rated on a scale from 1 to 9) when irrigated with 28 dS·m−1 for 30 days. Also, the LF value did not fall below 2 when irrigated with a salinity concentration of 48 dS·m−1 for 30 days, suggesting high salinity tolerance of ‘Riviera’. However, in this study, the normalized difference vegetation index (NDVI) had a lower ability to detect the increase in salinity stress due to the limited area measured by the NDVI measuring device used. An increase in sodium ion concentration was observed in the shoot with increasing salinity concentrations. The NDVI was highly correlated (r = 0.93) to LF, indicating the usefulness of NDVI as a tool to measure the magnitude of salinity stress. The multiple linear regression analysis revealed that the data showed a linear response to salinity stress with LF (r2 = 0.86) and NDVI (r2 = 0.76) decreasing linearly as the salinity concentration and days of treatment increased. This study provides an accurate depiction of the spectral and visual responses of ‘Riviera’ when exposed to multiple salinity concentrations with narrow increments.

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