scholarly journals Management of villous adenoma - beyond endoscopic techniques

2019 ◽  
pp. 87-89
Author(s):  
B. . Sisir ◽  
S. . Sankar ◽  
Balu Jagan ◽  
Kumar G. Santhosh ◽  
M. N.V. Neelendra
Keyword(s):  
Clinical Picture ◽  
Villous Adenoma ◽  
Surgical Intervention ◽  
Benign Neoplasm ◽  
Complete Removal ◽  
Histological Diagnosis ◽  
Endoscopic Appearance ◽  
Epithelial Surface ◽  
Endoscopic Techniques ◽  
Descriptive Term

Polyp’ is a descriptive term for abnormal projection above an epithelial surface and is not a histological diagnosis. Adenoma is a benign neoplasm of glandular origin and is significant because they are cancers in making. Once a polyp is found, it must be removed in total. Attempts at estimating the polyp histology by endoscopic appearance are often incorrect. With recent advances in endoscopic techniques, most of the polyps are removable through endoscopy. However, there remain a few situations depending on location, size of the lesion and endoscopic expertise available, where complete removal of the polyp requires surgical intervention especially so for large sessile adenomas. We are presenting here four cases of villous adenoma requiring surgical intervention each managed differently depending on presentation and overall clinical picture.

scholarly journals Sphenochoanal Polyp - "The Forgotten Element?"

2021 ◽  
Vol 29 (2) ◽  
pp. 209-212
Author(s):  
Misbahul Haque ◽  
Subhrajit Das ◽  
Subrata Mukhopadhyay
Keyword(s):  
Case Report ◽  
Nasal Obstruction ◽  
Surgical Approach ◽  
Surgical Intervention ◽  
Complete Removal ◽  
Endoscopic Polypectomy ◽  
Complete Excision ◽  
Sphenochoanal Polyp

Introduction The occurrence of isolated spheno-choanal polyps are not very common and can be very well confused with antro-choanal polyps or adenoids in adolescents and children. Appropriate diagnosis and prompt surgical intervention are essential for its removal.   Case Report We report one such case of a 16 year old female who presented with complaints nasal obstruction and reduced hearing. Endoscopic polypectomy was done with complete removal of the polyp.   Discussion Sphenochoanal Polyp is often misdiagnosed and proper investigations are thus essential for its diagnosis. Surgical Approach is the mainstay form of treatment with complete excision of the polyp.

scholarly journals Early Diagnosis and Treatment of Patients with Mucopolysaccharidosis IV and VI

2016 ◽  
Vol 23 (3) ◽  
pp. 63-70
Author(s):  
L. K Mikhailova ◽  
T. V Sokolova ◽  
O. A Polyakova
Keyword(s):  
Early Childhood ◽  
Early Diagnosis ◽  
Enzyme Replacement Therapy ◽  
Clinical Picture ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Dna Testing ◽  
Enzyme Replacement ◽  
Skeletal Changes ◽  
Fatal Complications

Mucopolysaccharidosis (MPS) is an orphan pathology characterized by polymorphism of clinical manifestations and development of typical skeletal changes. However in early childhood the clinical picture is not clear that leads to misdiagnosis and results in inadequate management of patients including unjustified surgical intervention. Early clinical and roentgenologic changes specific to mucopolysaccharidosis IV and VI that enable to suspect the pathology development, to perform required examination with compulsory confirmation by DNA testing results and prescribe vital enzyme replacement therapy as soon as possible are presented. Early diagnosis and initiation of etiotropic treatment and timely correction of the occurring pathology ensure prevention of fatal complications.

Colonic Flat Neoplasia: Frequency and Concordance Between Endoscopic Appearance and Histological Diagnosis in a French Prospective Series

2004 ◽  
Vol 99 (9) ◽  
pp. 1795-1800 ◽  
Author(s):  
Marie-Danièle Diebold ◽  
Emmanuelle Samalin ◽  
Corinne Merle ◽  
Olivier Bouché ◽  
Thierry Higuero ◽  
...  
Keyword(s):  
Histological Diagnosis ◽  
Endoscopic Appearance

Volume of surgical interventions for benign colorectal tumors – an analysis of 3510 surgical and endoscopic resections in the single colorectal center in Poland

2021 ◽  
Vol 93 (6) ◽  
pp. 11-19
Author(s):  
Michał Spychalski ◽  
Marcin Włodarczyk ◽  
Katarzyna Winter ◽  
Jakub Włodarczyk ◽  
Igor Dąbrowski ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Histopathological Examination ◽  
Early Stage ◽  
Benign Lesion ◽  
Screening Colonoscopy ◽  
Colorectal Tumors ◽  
Surgical Interventions ◽  
Endoscopic Techniques ◽  
Abdominal Approach ◽  
Appropriate Treatment

Introduction: Colorectal cancer is the most frequent neoplasm of the whole gastrointestinal track. Due to screening colonoscopy program, colorectal lesions are often diagnosed at early stage. The vast majority of them are possible to remove endoscopically. However, a substantial percentage of benign lesion in Western centers are still operated. The aim of this article was to determine the percentage of surgical resections due to benign adenomas in the reference center of endoscopic submucosal dissection (ESD) and colorectal surgery in Poland. Materials and Methods: Retrospective analysis of 3 510 patients operated from 2015 to 2019 in Center of Bowel Treatment in Brzeziny. Results: We have analyzed 3 510 endoscopic and surgical procedures performed in the colon: 601 ESDs; 1 002 endoscopic mucosal resections (EMRs); and 1,907 surgical resections. Out of 601 ESDs, 57 invaded the submucosa, of which 29 (4.8%) were non-therapeutic ESDs. In 5 patients, due to occurrence of post-ESD perforation, an additional surgical intervention was necessary. Out of the 1,002 EMRs, 22 cases (2.2%) were diagnosed with deeply infiltrating cancers, which required a surgery. The overall percentage of the need for surgery in the endoscopically treated patients (ESD + mucosectomy) was 3.5% (56/1 603). Among resection surgeries, 15 of them (0.8%) ended with the diagnosis of a benign lesion in the postoperative histopathological examination. Conclusions: Inclusion advanced endoscopic techniques such as ESD to routine clinical practice in colorectal centers gives clear benefits for the patients. Well defined and standardized process of qualifying for appropriate treatment allows to significantly reduce the percentage of abdominal approach surgery due to benign colorectal lesions.  

A case of combined injury of the heart, lung and diaphragm

1930 ◽  
Vol 26 (7) ◽  
pp. 111-112
Author(s):  
B. V. Ognev
Keyword(s):  
Clinical Picture ◽  
Surgical Intervention ◽  
Correct Diagnosis ◽  
Modern Literature ◽  
Combined Injury ◽  
Internal Bleeding ◽  
Superficial Wound ◽  
Heart Injury ◽  
The Way

The issue of heart injury in combination with other organs has received sufficient attention in the modern literature. It was noted that in some cases, with a superficial wound of the heart or even one pericardium, death occurred from internal bleeding from other organs wounded along the way: lung, esophagus, spleen, stomach, liver, etc. Of the 33 cases of pericardial injuries indicated in the literature and on the basis of the works of Chugaev, Podobedova, Irgerai Chernyak, in 15 cases, death followed from internal bleeding from other organs. That is why a simultaneous superficial injury to the heart, or injury to only one pericardium along the way with other organs can give a very confusing clinical picture, as a result of which it is very difficult to make a correct diagnosis and have sufficient grounds for surgical intervention on the heart.

Endoscopic Management of Enterocutaneous Fistulae

2021 ◽  
Author(s):  
Katelin A. Mirkin ◽  
Eric M. Pauli
Keyword(s):  
Foreign Bodies ◽  
Surgical Intervention ◽  
Endoscopic Therapy ◽  
Wound Care ◽  
Management Strategies ◽  
Therapeutic Endoscopy ◽  
Endoscopic Management ◽  
Unique Challenge ◽  
Endoscopic Techniques ◽  
Definitive Management

AbstractEnterocutaneous fistulae (ECFs), abnormal epithelialized connections between the small bowel and skin, are associated with significant morbidity, and pose a unique challenge to patients and clinicians. Management of ECF requires sepsis control, effluent management, nutritional support, and local wound care. Traditionally, surgical intervention was required for ECF that failed to close with conservative management. With the rise of therapeutic endoscopy, new management strategies have emerged. Fluoroscopy-guided endoscopy is now used to delineate anatomy and determine potential therapy options. Definitive endoscopic management may involve through-the-scope and over-the-scope clips, or endoscopic suturing devices. Adjuncts to definitive management include removing foreign bodies, alleviating distal obstructions, and de-epithelializing fistula tracts. Even if an ECF is not amenable to definitive endoscopic therapy, endoscopy may help temporize and optimize a patient preoperatively. Endoscopy allows for the placement and repositioning of drains, stent placement to allow for diversion or improved wound care, and the placement of enteric feeding access. As endoscopic techniques expand and more tools become available, the ability to manage complex problems, such as ECF, endoscopically will grow.

scholarly journals Physeal bar resection using a patient-specific guide with intramedullary endoscopic assistance for partial physeal arrest of the distal radius

2018 ◽  
Vol 138 (8) ◽  
pp. 1179-1188 ◽  
Author(s):  
Satoshi Miyamura ◽  
Hiroyuki Tanaka ◽  
Kunihiro Oka ◽  
Atsuo Shigi ◽  
Shingo Abe ◽  
...  
Keyword(s):  
Distal Radius ◽  
Surgical Intervention ◽  
Complete Removal ◽  
Patient Specific ◽  
Illustrative Case ◽  
Physeal Bar ◽  
Endoscopic Assistance ◽  
Novel Method ◽  
Physeal Bar Resection ◽  
Functional Problems

AbstractThe partial physeal arrest of the distal radius could result in progressive deformities and functional problems of the wrist. Despite being the most preferred surgical intervention, physeal bar resection (Langenskiöld procedure) is technically demanding. This manuscript aims to illustrate the technical tricks and present an illustrative case of premature physeal arrest of the distal radius managed with a novel method for the Langenskiöld procedure, involving complete removal of the bar using a patient-specific guide in combination with an intramedullary endoscopy technique that facilitated direct observation.

Sudden deafness and cerebellar tumour

1994 ◽  
Vol 108 (7) ◽  
pp. 584-586 ◽  
Author(s):  
E. Merino Gálvez ◽  
D. Hellín Meseguer ◽  
F. García Ortega ◽  
J. Manuel Mondejar
Keyword(s):  
Female Patient ◽  
Clinical Picture ◽  
Cranial Nerve ◽  
Cerebellopontine Angle ◽  
Surgical Intervention ◽  
Signs And Symptoms ◽  
Sudden Deafness ◽  
Direct Compression ◽  
Cerebellar Tumour ◽  
Cerebellar Involvement

AbstractWe report the case of a female patient who presented with sudden deafness as the first symptom of a cerebellar tumour which was not localized strictly in the cerebellopontine angle and did not show direct compression on the extrabulbar portion of the Vlllth cranial nerve. The clinical picture contained a number of signs and symptoms typical of cerebellar involvement.Surgical intervention restored the hearing and caused the symptoms to disappear.We also review the association between tumours and sudden deafness in the literature.

scholarly journals Minimally invasive endoscopic approach to perform complete coccygectomy in patients with chronic refractory coccydynia: illustrative case

2022 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Surgical Intervention ◽  
Single Case ◽  
Treatment Strategies ◽  
Complete Removal ◽  
Endoscopic Approach ◽  
Illustrative Case ◽  
Infection Rates ◽  
Single Case Report

BACKGROUND Coccydynia refers to debilitating pain in the coccygeal region of the spine. Treatment strategies range from conservative measures (e.g., ergonomic adaptations, physical therapy, nerve block injections) to partial or complete removal of the coccyx (coccygectomy). Because the surgical intervention is situated in a high-pressure location close to the anus, a possible complication is the formation of sacral pressure ulcers and infection at the incision site. OBSERVATIONS In this case report, the authors presented a minimally invasive, fully endoscopic approach to safely perform complete coccygectomy for treatment of refractory posttraumatic coccydynia. LESSONS Although this is a single case report, the authors hope that this novel endoscopic approach may achieve improved wound healing, reduced infection rates, and lower risk of penetration injury to retroperitoneal organs in patients requiring coccygectomy.

scholarly journals Mechanisms and Management of Acute Pancreatitis

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ari Garber ◽  
Catherine Frakes ◽  
Zubin Arora ◽  
Prabhleen Chahal
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Outlet Obstruction ◽  
Gallstone Pancreatitis ◽  
Drainage Procedure ◽  
Endoscopic Techniques ◽  
Persistent Abdominal Pain ◽  
Fluid Collections ◽  
Walled Off Necrosis

Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually. Complications arising from acute pancreatitis follow a progression from pancreatic/peripancreatic fluid collections to pseudocysts and from pancreatic/peripancreatic necrosis to walled-off necrosis that typically occur over the course of a 4-week interval. Treatment relies heavily on fluid resuscitation and nutrition with advanced endoscopic techniques and cholecystectomy utilized in the setting of gallstone pancreatitis. When necessity dictates a drainage procedure (persistent abdominal pain, gastric or duodenal outlet obstruction, biliary obstruction, and infection), an endoscopic ultrasound with advanced endoscopic techniques and technology rather than surgical intervention is increasingly being utilized to manage symptomatic pseudocysts and walled-off pancreatic necrosis by performing a cystogastrostomy.

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