scholarly journals A mega gallbladder removed by laparoscopic cholecystectomy: a case report

2020 ◽  
Vol 7 (11) ◽  
pp. 3795
Author(s):  
Alexandra Bastidas ◽  
Liliana Cuevas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laboratory Tests ◽  
Surgical Planning ◽  
Laparoscopic Approach ◽  
Chronic Cholecystitis ◽  
Pathological Examination ◽  
Preoperative Period ◽  
Elevated Alkaline Phosphatase ◽  
The Right ◽  
Distended Gallbladder

Report the case of a giant gallbladder secondary to chronic cholecystitis treated with laparoscopic cholecystectomy with no complications. The patient was a 79-year-old woman who attended the emergency department because of a long-standing abdominal pain in the right hypochondrium exacerbated in the last 2 months. Physical exam revealed fever and a sensible mass in the right flank, laboratory tests shown leucocytosis, a mild indirect hyperbilirubinemia and elevated alkaline phosphatase. Images revealed an importantly distended gallbladder with sludge, stones and hydrops associated. Antibiotic therapy was started. She ultimately underwent laparoscopic cholecystectomy. A pathological examination evidenced cholelithiasis, acute and chronic cholecystitis. Only a few cases of surgical treatment of mega gallbladders are found in the literature. It is important to recognize them in the preoperative period for an adequate surgical planning. A laparoscopic approach was successful in our case.

DIAGNOSIS TIROID

2016 ◽  
Vol 21 (3) ◽  
pp. 304
Author(s):  
Liong Boy Kurniawan ◽  
Mansyur Arif
Keyword(s):  
Thyroid Hormone ◽  
Laboratory Tests ◽  
Thyroid Disorder ◽  
Functional Tests ◽  
Hormone Binding ◽  
Functional Diagnosis ◽  
Underlying Condition ◽  
Unusual Combination ◽  
The Right ◽  
Underlying Diseases

Thyroid disease often causes unspecific or mild symptoms, so laboratory tests are needed to confirm the functional diagnosis of the thyroid disorder. The laboratory tests which are important to establish the diagnosis of thyroid disorder include: total and free thyroidhormones, its related (thyroid) hormone binding proteins and auto antibodies. The thyroid hormone tests are mostly measured with competitive or sandwich immunoassays and each method can be interfered by several factors. Some drugs may increase or decrease thethyroid functional tests and several factors such as: underlying diseases, age, pregnancy, occurrence of heterophil antibody and auto antibodies may also interfere the thyroid tests results. The interpretation of an unusual combination from thyroid stimulating hormonesuch as free thyroxin and tri-iodothyronine results needs confirmation of underlying condition for establishing the right diagnosis. This review is aimed to evaluate several factors which may influence the thyroid tests and interpretation.

SINGLE PORT LAPAROSCOPIC CHOLECYSTECTOMY IN HUE CENTRAL HOSPITAL

2012 ◽  
pp. 25-30
Author(s):  
Xuan Dong Pham ◽  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Hai Thanh Nguyen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Port ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Central Hospital ◽  
Gallbladder Polyp ◽  
Gallbladder Polyps ◽  
Hospital Patients ◽  
Wound Pain ◽  
Initial Results

Purpose: Evaluating the initial results in applying single port laparoscopic cholecystectomy at Hue Central Hospital. Patients and methods: 29 gallbladder polyps, gallstones with symptoms of acute or chronic cholecystitis and surgeried by single port laparoscopic cholecystectomy at Hue Central Hospital from March 2011 to December 2011. Results: Male/female was 0.45/1. Age: 49.24 ± 16.43 (21-81), 40 to 60 years 54.6%. Cholecystitis: 75.9%, 17.3% gallbladder polyp, gallbladder adenomyomatosis 3.4%. Added 1 trocart because difficult dissection surgery 10.2%, bleeding 6.8% difficult to handle, added 2 trocart 3.4%. Bleeding intraoperative 10.3%. Operating time: 76.2 ± 33.5 minutes, hospital stay: 4 - 6 days 51.7%. Wound pain after 2 weeks of hospital discharge 6.9%, with no wound seromas and no wound infection. Conclusions: Single port laparoscopic cholecystestomy is safe, has fewer complications, can be done with experienced surgeons laparoscopic surgery. Keywords: Single port laparoscopic cholecystectomy, gallbladder ston Key words: Single port laparoscopic cholecystectomy, gallbladder stone

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

scholarly journals Laparoscopic Resection of Renal Capsular Endometriosis in a Woman with Menstrual-Related Flank Pain: Case Report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abbas Basiri ◽  
Iman Ghanaat ◽  
Hamidreza Akbari Gilani
Keyword(s):  
Flank Pain ◽  
Pathological Examination ◽  
Histologic Evaluation ◽  
Normal Renal Parenchyma ◽  
Perinephric Space ◽  
Superior Portion ◽  
The Right ◽  
First Time ◽  
Laparoscopic Removal

Abstract Background Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety. Case presentation A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence. Conclusion Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.

scholarly journals RONC-26. A CASE OF RADIATION NECROSIS OF THE CEREBELLUM 16 YEARS AFTER CHEMORADIOTHERAPY FOR MEDULLOBLASTOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii460-iii460
Author(s):  
Mayuko Miyata ◽  
Masahiro Nonaka ◽  
Akio Asai
Keyword(s):  
Radiation Necrosis ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Secondary Cancer ◽  
Brain Necrosis ◽  
Cerebellar Medulloblastoma ◽  
Cerebellar Peduncle ◽  
The Right ◽  
The Brain

Abstract BACKGROUND If new lesions are observed during follow-up of the malignant tumor after treatment, it is difficult to distinguish whether the tumor is a recurrent lesion, secondary cancer, or radiation necrosis of the brain. We have encountered a patient with symptomatic radiation necrosis of the cerebellum 16 years after treatment of medulloblastoma. CASE PRESENTATION: A 24-year-old man who had received a tumor resection and chemoradiotherapy for cerebellar medulloblastoma at the age of 8 presented with dizziness. For the past 16 years, there was no recurrence of the tumor. He subsequently underwent MRI scan, and T1-Gd image showed enhanced lesion in the right cerebellar peduncle. Cerebrospinal fluid cytology analysis was negative for tumor. We suspected tumor reccurence or secondary cancer, and performed lesion biopsy. The result of the pathological examination was radiation necrosis of the cerebellum. DISCUSSION: The interval of radiation necrosis of the brain and radiotherapy can vary from months to more than 10 years. So, whenever a new lesion is identified, radiation brain necrosis must be envisioned. According to guidelines in Japan, there is no absolute examination for discriminating tumor recurrence from radiation brain necrosis and diagnosis by biopsy may be required. CONCLUSION We experienced a case of symptomatic radiation necrosis of the cerebellum 16 years after treatment. In patients showing new lesion after long periods of time, the possibility of radiation necrosis to be considered.

Ovarian abscessation and oophoritis in a first lactation dairy cow: a case report

Livestock ◽  
2021 ◽  
Vol 26 (5) ◽  
pp. 228-232
Author(s):  
David Charles ◽  
Victoria Wyse ◽  
Katie Waine ◽  
Mark Wessels
Keyword(s):  
Case Report ◽  
Dairy Cow ◽  
Transrectal Ultrasound ◽  
Rare Condition ◽  
Pathological Examination ◽  
The Right

A 28-month-old first lactation dairy cow presented as ‘oestrus not observed’ and transrectal ultrasound showed a hyperechoic mass on the right ovary. The mass continued to grow despite treatment, and 8 weeks later a right-sided ovariectomy was performed. A single, large, cavitated mass was found on gross pathological examination with histopathology confirming ovarian abscessation and oophoritis, a rare condition in cattle.

IS THERE STILL A DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY? — AN EXPLORATIVE AND DESCRIPTIVE STUDY TO IDENTIFY RISK FACTORS AND TO ESTABLISH A SCORING SYSTEM FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY.

2021 ◽  
pp. 52-54
Author(s):  
Suhas Umakanth ◽  
Srinath Subbarayappa ◽  
Jayanth Bannur Nagaraja
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Gallstone Disease ◽  
Descriptive Study ◽  
Gastrointestinal Illness ◽  
Prospective Analysis ◽  
Open Conversion ◽  
Patient Demographics ◽  
Low Threshold ◽  
Distended Gallbladder

Background: Gallstone disease is among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is now the preferred approach to its treatment. When performing laparoscopic cholecystectomy, the surgeon should have the low threshold for open conversion in case of difculty. The aim of the study was Pre-operative prediction of difcult laparoscopic cholecystectomy using clinical, ultrasonographic and intraoperative parameters. Methods:This study was done on 200 patients presenting with symptomatic cholelithiasis who underwent laparoscopic cholecystectomy. A prospective analysis of parameters including the patient demographics, laboratory values, radiologic data and intraoperative parameters was performed. Results: The factors which were considered a difculty parameter were males, age>60years, preoperative ERCP, rised amylase, sonographic features of contracted or distended gallbladder and pericholecystic collection. Intraoperative parameters were adhesions around gallbladder, contracted or distended gallbladder inamed gallbladder. Conclusions: The above mentioned factors must be adequately studied and the surgeon and the patient should be prepared for difcult laparoscopic cholecystectomy.

scholarly journals Pure laparoscopic unilateral nephrectomy for a patient with a polycystic horseshoe kidney

2014 ◽  
Vol 8 (11-12) ◽  
pp. 881 ◽  
Author(s):  
Shawn Dason ◽  
Christopher B Allard ◽  
Bobby Shayegan ◽  
Kevin Piercey
Keyword(s):  
Renal Transplantation ◽  
Autosomal Dominant ◽  
Iliac Fossa ◽  
Laparoscopic Approach ◽  
Horseshoe Kidney ◽  
Laparoscopic Nephrectomy ◽  
Polycystic Kidney ◽  
Large Size ◽  
Autosomal Dominant Polycystic Kidney ◽  
The Right

A 45-year-old female patient with autosomal dominant polycystic kidney disease (ADPKD) and a horseshoe kidney underwent right laparoscopic nephrectomy. The indication for nephrectomy was to create space within the right iliac fossa for renal transplantation. The operation proceeded as routine for laparoscopic nephrectomy for ADPKD, but was uniquely challenging due to the large size and extensive vasculature of the polycystic horseshoe kidney. In addition to documenting the feasibility of the pure laparoscopic approach for nephrectomy in patients with ADPKD and horseshoe kidney, this case highlights the abnormal location and vasculature encountered when operating on horseshoe kidneys.

scholarly journals Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits

2005 ◽  
Vol 20 (5) ◽  
pp. 347-352 ◽  
Author(s):  
Alberto Goldenberg ◽  
Jacques Matone ◽  
Wagner Marcondes ◽  
Fernando Augusto Mardiros Herbella ◽  
José Francisco de Mattos Farah
Keyword(s):  
Inflammatory Response ◽  
Abdominal Wall ◽  
Peritoneal Cavity ◽  
Abdominal Cavity ◽  
Mesh Fixation ◽  
Rabbit Model ◽  
Laparoscopic Approach ◽  
Preperitoneal Space ◽  
Similar Amount ◽  
The Right

PURPOSE: Compare, in a rabbit model, the inflammatory response and adhesions formation following surgical fixation of polypropilene and Vypro mesh in the inguinal preperitoneal space. METHODS: Fourteen male New Zealand rabbits, weighing between 2.000 to 2.500 g were used. A midline incision was made and the peritoneal cavity was exposed. The 2,0X1,0 cm polypropylene mesh was fixed in the left flank and secured to the margins with 3-0 prolene in a separate pattern. In the right flank, a 2,0X1,0 cm Vypro II mesh was sewn in the same way. After the post surgical period, the animals were again anesthetized and underwent laparoscopic approach, in order to identify and evaluate adhesions degree. Both fixed prosthesis were excised bilaterally with the abdominal wall segment, including peritoneum, aponeurosis and muscle and sent to a pathologist RESULTS: Operative time ranged from 15 to 25 minutes and no difficulties in applying the mesh were found. From the 14 polypropylene meshes fixed to the intact peritoneum, 11 had adhesions to the abdominal cavity (78,6%). Concerning Vypro mesh, 12 animals developed adhesions from the 14 with mesh fixation (85,7%). Histological examination of tissues harvested revealed fibroblasts, collagen, macrophages and lymphocytes between the threads of the mesh. CONCLUSION: Polypropylene and Vypro mesh, when implanted in the peritoneal cavity of rabbits provoke similar amount of adhesions. Vypro mesh tissues had higher fibrosis resulting in better mesh incorporation to the abdominal wall.

scholarly journals Atypical Growth Pattern of an Intraparenchymal Meningioma

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Zhen Zeng ◽  
Tijiang Zhang ◽  
Yihua Zhou ◽  
Xiaoxi Chen
Keyword(s):  
Growth Pattern ◽  
Pineal Region ◽  
Pathological Examination ◽  
Intracranial Meningioma ◽  
Temporal Region ◽  
Right Cerebral Hemisphere ◽  
Dural Attachment ◽  
The Right ◽  
Chinese Male ◽  
Irregular Mass

Meningiomas are the most common primary nonneuroglial extra-axial neoplasms, which commonly present as spherical or oval masses with a dural attachment. Meningiomas without dural attachment are rare and, according to their locations, are classified into 5 varieties, including intraventricular, deep Sylvain fissure, pineal region, intraparenchymal, or subcortical meningiomas. To the best of our knowledge, intraparenchymal meningioma with cerebriform pattern has never been reported. In this paper, we report a 34-year-old Chinese male patient who presented with paroxysmal headaches and progressive loss of vision for 10 months and blindness for 2 weeks. A thorough physical examination revealed loss of bilateral direct and indirect light reflex. No other relevant medical history and neurologic deficits were noted. Computed tomography and magnetic resonance imaging scans showed an irregular mass with a unique cerebriform pattern and extensive peritumoral edema in the parietal-occipital-temporal region of the right cerebral hemisphere. The initial diagnosis was lymphoma. Intraoperatively, the tumor was completely buried in a sulcus in the parietal-occipital-temporal region without connecting to the dura. The histological diagnosis was intracranial meningioma based on pathological examination. Therefore, when an unusual cerebriform growth pattern of a tumor is encountered, an intraparenchymal meningioma should be considered as a differential diagnosis.

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