scholarly journals Hepatic Cyst Infection Following Aspiration Sclerotherapy: a Case Series

2014 ◽  
Vol 23 (4) ◽  
pp. 441-444 ◽  
Author(s):  
Titus F.M. Wijnands ◽  
Marten A. Lantinga ◽  
Joost P.H. Drenth
Keyword(s):  
Abdominal Pain ◽  
Case Series ◽  
Hepatic Cyst ◽  
Minimal Invasive ◽  
Safe Procedure ◽  
Hepatic Cysts ◽  
Cyst Infection ◽  
Tentative Diagnosis ◽  
Invasive Intervention

Mass-related symptoms caused by hepatic cysts are effectively treated by aspiration sclerotherapy (AS). This minimal-invasive intervention is regarded as a safe procedure. Hence, occurrence of complications is low. Transient fever is commonly reported as a side effect. However, documentation on a post-procedural hepatic cyst infection as a complication of AS is limited. We present five cases in which a tentative diagnosis of postprocedural hepatic cyst infection was made. Patients typically presented with abdominal pain and fever, had to be admitted to our hospital, and were treated with long term antibiotics. Ultimately, the cyst infection successfully resolved with ciprofloxacin in all cases.

scholarly journals Efficacy and safety of selective decontamination of the digestive tract (SDD) to prevent recurrent hepatic cyst infections in polycystic liver disease: a retrospective case series

2020 ◽  
Vol 75 (9) ◽  
pp. 2666-2669
Author(s):  
Lucas H P Bernts ◽  
Shosha E I Dekker ◽  
Darius Soonawala ◽  
Roger J M Brüggemann ◽  
Heiman F L Wertheim ◽  
...  
Keyword(s):  
Liver Disease ◽  
Adverse Events ◽  
Digestive Tract ◽  
Case Series ◽  
Hepatic Cyst ◽  
Selective Decontamination ◽  
Polycystic Liver Disease ◽  
Polycystic Liver ◽  
Cyst Infection ◽  
Polymyxin E

Abstract Background Hepatic cyst infection is a complication of polycystic liver disease (PLD) that causes substantial morbidity. Repetitive infection is frequent and is increasingly difficult to treat. As translocated gut bacteria are considered the cause, we hypothesize that selective decontamination of the digestive tract (SDD) reduces recurrence of hepatic cyst infection. Methods We performed a retrospective, observational study in two referral centres. All patients with PLD treated with SDD for hepatic cyst infection were included. Efficacy was determined by calculating the infection incidence (hepatic cyst infections per month) before and during SDD therapy. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE). Results We identified eight patients who received SDD (88% female, 88% polycystic kidney disease). The median age was 65 years (IQR: 51–74 years). SDD lowered the median incidence from 0.09 episodes per month (IQR: 0.06–0.25 episodes per month) to 0.01 episodes per month (IQR: 0.00–0.05 episodes per month) (P = 0.12). Discontinuation of SDD led to rapid recurrence of cyst infection (71% within 6 weeks). SDD consisted of polymyxins with/without aminoglycosides. The median SDD treatment duration was 20 months (range: 3–89 months). Six patients (75%) developed adverse events [CTCAE Grade 1 (gastrointestinal: n = 3) or Grade 3 (ototoxicity: n = 1; fungal infection: n = 1)], mostly attributable to aminoglycosides; one patient developed polymyxin E resistance. Conclusions SDD prophylaxis provides a novel strategy for limiting recurrent hepatic cyst infection in PLD patients. However, adverse events are frequent and curtail its use. As most were attributable to aminoglycosides, polymyxin E is considered the preferred therapy.

scholarly journals Percutaneous Vertebroplasty for Symptomatic Schmorl’s Nodes: 11 Cases with Long-term Follow-up and a Literature Review

2017 ◽  
Vol 2 (20;2) ◽  
pp. 69-75
Author(s):  
Gao-Jun Teng
Keyword(s):  
Physical Therapy ◽  
Percutaneous Vertebroplasty ◽  
Case Series ◽  
Small Sample ◽  
Vertebral Compression Fractures ◽  
Safe Procedure ◽  
Long Term Follow Up ◽  
Schmorl’S Nodes

Background: Percutaneous vertebroplasty (PVP) is commonly used to treat symptomatic vertebral compression fractures. However, its long-term effectiveness and safety for use in the treatment of symptomatic Schmorl’s nodes (SNs) refractory to conservative treatment is uncertain. Objectives: To present a case series with PVP for symptomatic SNs not responding to conservative therapy and assess the effectiveness and safety for such treatment with long-term follow-up. To present a review of the literature regarding SNs and treatment options. Study Design: Single center retrospective observational study. Setting: This study consists of patients from a large academic center in China. Methods: Between January 2008 and December 2013, 11 patients suffering from symptomatic SNs that were refractory to medical or physical therapy, underwent PVP procedures in our department. All patients had a definitive diagnosis of SNs by magnetic resonance imaging (MRI) and computed tomography (CT). The visual analog scale (VAS) was assessed preoperatively at 4 hours, at one month, and every 6 months postoperatively during the long-term (mean: 58.0 months) follow-up period. Results: Each of the 11 patients reported an immediate and distinct relief of their back pain. No one reported a worsening of symptoms. The VAS decreased from an average preprocedural score of 7.9 to a postprocedural score of 2.1 at 4 hours. The VAS averaged 1.8 during the mean followup period of 58.0 (range 24.1 to 98.9) months. There were no postoperative complications during the follow-up period. At the end of the follow-up period, all 11 patients were unrestricted in their activities. Limitations: This study is a retrospective study with a small sample size. Conclusions: PVP is an effective and safe procedure for the treatment of symptomatic SNs, which are refractory to medical or physical therapy. Key words: Percutaneous vertebroplasty, symptomatic Schmorl’s nodes, vertebral endplate fracture, endplate osteonecrosis, Modic changes

scholarly journals Unusual Causes of Abdominal Pain after Colonoscopy: A Case Series

2019 ◽  
Vol 10 (03) ◽  
pp. 180-182
Author(s):  
Dorsa Samsami ◽  
Peter Sargon ◽  
Baseer Qazi ◽  
Alan Shapiro
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Complication Rate ◽  
Umbilical Hernia ◽  
Acute Diverticulitis ◽  
Case Series ◽  
Colonic Perforation ◽  
Severe Abdominal Pain ◽  
Safe Procedure ◽  
Common Causes

AbstractColonoscopy is a relatively safe procedure with an overall complication rate between 0.2 and 0.35%. Complications do occur, however, including preparation related complications, colonic perforation, postpolypectomy hemorrhage, postpolypectomy coagulation syndrome, and other less-common miscellaneous complications. Abdominal pain is one of the more common complaints that symptomatic patients will present with after a colonoscopy, occurring up to 5% of the time. Although the cause is usually minor and does not require further workup, gastroenterologists are most concerned about perforation and postpolypectomy coagulation syndrome in the setting of severe abdominal pain. However, as gastroenterologists, we must also be cognizant that there may be other less-common causes of the abdominal pain. The four cases presented here illustrate rare presentations of abdominal pain after colonoscopy, consisting of acute diverticulitis, incarcerated umbilical hernia, acute gangrenous cholecystitis, and rupture of the ovarian cyst.

scholarly journals Hepatic Cyst: An Unusual Suspect of Syncope

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Mohammad K. Choudhry ◽  
Bei Xiong ◽  
Antony Anandaraj ◽  
John Trillo
Keyword(s):  
Abdominal Pain ◽  
Total Bilirubin ◽  
Hepatic Cyst ◽  
Gamma Glutamyl Transferase ◽  
Serous Fluid ◽  
Lower Quadrant ◽  
Hepatic Cysts ◽  
History Of ◽  
Glutamyl Transferase ◽  
Right Lower Quadrant

The patient is a 75-year-old man with history of diabetes and hypertension who presented with syncope after experiencing sharp, 10/10 right flank and abdominal pain worsening over three weeks associated with decreased appetite. Physical examination revealed hepatomegaly and right lower quadrant (RUQ) tenderness, negative for peritoneal signs. Bloodwork showed leukocytosis (13 K/mcl), alkaline phosphatase (141 U/L), total bilirubin (2.0 mg/dL), and gamma-glutamyl transferase (172 U/L). Computed Tomography (CT) revealed multiple hepatic cysts with the largest measuring 17 × 14 × 18 cm (Figure 1). Parenteral opiates provided minimal relief. Cardiac and neurologic etiologies of syncope were ruled out. The patient’s course was complicated by opioid-induced delirium as his abdominal pain progressively worsened despite escalating doses of parenteral and oral analgesics. Gastroenterology and interventional radiology consulted to evaluate for Glisson’s capsular stretch. Therapeutic aspiration yielded 2.5 L of serous fluid, which alleviated the patient’s pain. Cytology was negative for malignancy. Opiates were titrated down. Repeat CT (Figure 2) showed cysts that were significantly reduced in size. The patient showed complete resolution of symptoms and was subsequently discharged. We present a rare case of a large hepatic cyst causing syncope. In the appropriate clinical setting, syncope with RUQ tenderness and hepatomegaly should raise the index of suspicion for hepatic cysts.

Long Term Outcomes of Nasoseptal Perforation Repair With an Anterior Ethmoidal Artery Flap

2021 ◽  
pp. 194589242110121
Author(s):  
Jacopo Zocchi ◽  
Federico Russo ◽  
Luca Volpi ◽  
Hassan Ahmed Elhassan ◽  
Giacomo Pietrobon ◽  
...  
Keyword(s):  
Demographic Data ◽  
Case Series ◽  
Standard Technique ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Closure Rate ◽  
Lower Success Rate ◽  
Ethmoidal Artery ◽  
Anterior Ethmoidal Artery

Background Nasoseptal perforation repair is a challenging condition with no standard technique for repair recognized. Methods A case series of consecutive patients who underwent nasoseptal perforation repair with an anterior ethmoidal artery flap was conducted. Demographic data, preoperative features of the perforation and postoperative outcomes were analyzed. Closure rate, complications and persistence of nasal symptoms were documented. Results Thirty-two patients were included in the study. The average perforation diameter was 1.48 cm (range: 0.4–3 cm). Iatrogenic trauma was the most common cause (56% of patients). Nine cases ended up being idiopathic. The overall closure rate was 81%, but 87.5% when perforation had a 2-cm diameter or less. Of the six failures, 2 were due to flap necrosis and 4 to a residual anterior perforation. Despite the persistence, 2 patients solved their symptoms. One patient underwent revision surgery. Conclusion The anterior ethmoidal artery flap is a reliable and minimal invasive technique for closure of symptomatic perforations. For defects larger than 2 cm, a lower success rate and additional reconstructive measures should be considered. Objective questionnaires are needed in order to evaluate functional outcomes.

Intestinal Spirochaetosis-A case series from the developing world

2021 ◽  
pp. 004947552110490
Author(s):  
Zain Majid ◽  
Ghazi Abrar ◽  
Hina Ismail ◽  
Muhammad Danish ◽  
Muhammad Mubarak ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Case Series ◽  
Rare Condition ◽  
Gram Negative ◽  
Short Course ◽  
Heterogenous Group ◽  
Intestinal Spirochetosis ◽  
Economic Background

Spirochaetes comprise a heterogenous group of gram negative, motile, spiral shaped bacteria. Some of these pathogens are known to cause numerous human diseases such as Lyme disease, relapsing fever, syphilis and leptospirosis. However, intestinal spirochetosis is a rare condition. Patients frequently present with long-term complaints of loose stools, abdominal pain and weight loss and rectal bleeding. Hence to establish a diagnosis an endoscopy with biopsy is required. In this article, we describe four such cases, having different ages and socio- economic background, successfully treated with a short course of metronidazole.

scholarly journals EP.TH.273Intestinal Malrotation in Adults: A case series and Literature Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ramprasad Rajebhosale ◽  
Rajesh Chidambaranath ◽  
Cindy Cleto ◽  
Dylan Parmar ◽  
Najam Husain ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
General Practitioners ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Recurrent Abdominal Pain ◽  
Minimal Invasive ◽  
Interesting Case ◽  
General Surgeon ◽  
Diagnostic Challenge ◽  
Atypical Presentations

Abstract Aim Midgut malrotation is a rare but a very well-known congenital anomaly. It is a result of non-rotation, incomplete rotation or reversed rotation and fixation of midgut. Delayed diagnosis due to non-specific symptoms in elective cases and conversion to laparotomy due lack of intra-operative anatomical understanding in emergency cases imposes increase in patient dis-satisfaction, delayed recovery and healthcare cost burden. Here we report an interesting case series which impose a significant diagnostic challenge due to atypical clinical and radiological signs. Management of such cases by minimal invasive surgery is possible if general surgeons are aware of unusual anatomy and general practitioners are aware of such known but rare cases. Cases Two patients who presented on background of on and off recurrent non-specific attacks of abdominal pain, one of them as an emergency as midgut volvulus, were diagnosed radiologically and treated laparoscopically. The other one presented as an acute appendicitis and was converted to laparotomy, in spite of good laparoscopic expertise due to lack intra-operative anatomical understanding. Conclusion In the era of laparoscopic surgery, a general surgeon should encounter such an unusual case once in a lifetime. It is of paramount importance to be well verse with such unusual cases. General Practitioners should be aware of such atypical presentations of rare conditions causing recurrent abdominal pain. They should consider appropriate further imaging investigations and referrals for best possible patient care.

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Limb Salvage ◽  
Iliac Artery ◽  
Graft Patency ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
Safe Procedure ◽  
Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases

2020 ◽  
Vol 33 (6) ◽  
pp. 727-733
Author(s):  
Jasmine A. T. DiCesare ◽  
Alexander M. Tucker ◽  
Irene Say ◽  
Kunal Patel ◽  
Todd H. Lanman ◽  
...  
Keyword(s):  
Cervical Spondylosis ◽  
Case Series ◽  
Dynamic Imaging ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Artificial Disc ◽  
Younger Patients ◽  
Cervical Disc Replacement ◽  
Short And Long Term

Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and all patients required reoperation. This is the first reported case series of symptomatic segmental kyphosis after CDR.

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