The role of diagnostic laparoscopy in abdominal masses

Background: Diagnostic laparoscopy is an added tool that has become widely available for the assessment of abdominal masses in addition to conventional imaging. It is the best real time imaging technique due to the magnification and intense illumination provided. The aim of this work is the assessment of the impact of performing diagnostic laparoscopy at the start of operations intended for resection of an abdominal mass.Methods: This prospective study included 40 patients admitted for surgical resection of an abdominal mass. All Patients were subjected to thorough conventional investigations followed by diagnostic laparoscopy performed prior to the start of the definitive operation. We assessed the extra time needed, complications encountered, effect on decision making and the overall benefit of laparoscopy in this context.Results: Overall 21 patients (52.5%) did benefit from diagnostic laparoscopy somehow between upgrading the staging, affecting the laparotomy incision site and confirming feasibility of laparoscopic resection. Of the patients who proceeded to a laparotomy (n=30), diagnostic laparoscopy missed local invasion in 7 patients, which precluded the resection of the tumor in 5 of them. Only 1 complication related to diagnostic laparoscopy was encountered in the form of a port-site hematoma (2.5%).Conclusions: While diagnostic laparoscopy doesn't carry significant added morbidity, it might save the patient an unnecessary laparotomy by altering the preoperative staging and improving the accuracy of anatomical and pathological diagnoses. Laparoscopy has its limitations mainly in the assessment of the retroperitoneal space as well as direct tumor invasion to adjacent organs and vessels.

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Retroperitoneal Abscess Simulating Abdominal Mass in a Child

APSP Journal of Case Reports ◽

10.21699/ajcr.v8i5.619 ◽

2017 ◽

Vol 8 (5) ◽

pp. 32

Author(s):

Rahul Gupta

Keyword(s):

Abdominal Pain ◽

Peritoneal Cavity ◽

Diagnostic Laparoscopy ◽

Iliac Fossa ◽

Abdominal Mass ◽

Hepatic Flexure ◽

Retroperitoneal Abscess ◽

Ascending Colon ◽

Retroperitoneal Mass ◽

Abdominal Masses

Retroperitoneal abscess may simulate other abdominal masses. A 2-year-old girl presented with abdominal pain and lump in right iliac fossa for the last one week. Investigations revealed a mass extending from pelvis up to right sub-hepatic region. Diagnostic laparoscopy revealed an unremarkable peritoneal cavity, except that ascending colon up to hepatic flexure was elevated suggestive of retroperitoneal mass. A small flank incision was then made and abscess was drained.

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Current role of imaging in the management of children with Wilms tumor according to the new umbrella protocol

Journal of Advanced Health Care ◽

10.36017/jahc2001-012 ◽

2020 ◽

pp. 51-63

Author(s):

Varchetta Giovanni ◽

Tanzillo Paolina ◽

Mei Sara

Keyword(s):

Wilms Tumor ◽

Abdominal Mass ◽

Epidemiological Data ◽

Renal Tumors ◽

Postoperative Treatment ◽

Malignant Rhabdoid Tumor ◽

Presumptive Diagnosis ◽

Medical Checkup ◽

Abdominal Masses

Wilms tumor is the most common primary renal tumor in childhood. Children with Wilms tumor typically present with an asymptomatic abdominal mass, usually detected on a routine medical checkup or discovered coincidentally by parents. The initial differential diagnosis is with extrarenal abdominal masses; once a tumor of renal origin is established, distinguishing between Wilms tumor and other primary renal neoplasms such as congenital mesoblastic nephroma, clear cell sarcoma, malignant rhabdoid tumor and renal cell carcinoma may not be easy. However, in many cases imaging findings in conjunction with the patient's clinical and epidemiological data, allow the diagnosis of Wilms tumor. Wilms tumor care offers one of the most striking examples of success of pediatric oncology. Over the last decades the European SIOP studies have been the key to developing standardized diagnostic procedures, improved risk stratification, and adjusted treatment recommendations for children with Wilms tumor and this has resulted rate of overall survival is currently greater than 90%. As in previous SIOP trials and studies, the new protocol for the diagnosis and treatment of childhood renal tumors, the UMBRELLA SIOP–RTSG 2016, mandates preoperative chemotherapy without preceding mandatory histological assessment. Therefore, imaging studies are essential to obtain a presumptive diagnosis of WT, to provide disease staging information and to measure the tumor volume after neoadjuvant chemotherapy for the purposes of postoperative treatment stratification. This review describes role of imaging in the management of children with Wilms tumor, according to the current recommendations of the UMBRELLA protocol.

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Intergroup Threat and Outgroup Attitudes

Social Psychology ◽

10.1027/1864-9335/a000127 ◽

2013 ◽

Vol 44 (5) ◽

pp. 311-319 ◽

Cited By ~ 12

Author(s):

Marco Brambilla ◽

David A. Butz

Keyword(s):

Gay Men ◽

Social Group ◽

Welfare Recipients ◽

Intergroup Attitudes ◽

Social Policies ◽

Intergroup Threat ◽

Economic Threat ◽

The Impact ◽

General Climate

Two studies examined the impact of macrolevel symbolic threat on intergroup attitudes. In Study 1 (N = 71), participants exposed to a macrosymbolic threat (vs. nonsymbolic threat and neutral topic) reported less support toward social policies concerning gay men, an outgroup whose stereotypes implies a threat to values, but not toward welfare recipients, a social group whose stereotypes do not imply a threat to values. Study 2 (N = 78) showed that, whereas macrolevel symbolic threat led to less favorable attitudes toward gay men, macroeconomic threat led to less favorable attitudes toward Asians, an outgroup whose stereotypes imply an economic threat. These findings are discussed in terms of their implications for understanding the role of a general climate of threat in shaping intergroup attitudes.

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