scholarly journals Diagnosis, Management, and Therapy of Fetal Ovarian Cysts Detected by Prenatal Ultrasonography: A Report of 36 Cases and Literature Review

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2224
Author(s):  
Takeya Hara ◽  
Kazuya Mimura ◽  
Masayuki Endo ◽  
Makoto Fujii ◽  
Tatsuya Matsuyama ◽  
...  
Keyword(s):  
Literature Review ◽  
Fetal Surgery ◽  
Expectant Management ◽  
Maximum Diameter ◽  
Ovarian Cysts ◽  
Prenatal Ultrasonography ◽  
Cyst Size ◽  
Ultrasound Findings ◽  
Perinatal Management

Background: Fetal ovarian cysts are the most frequently diagnosed intra-abdominal cysts; however, the evidence for perinatal management remains controversial. Methods: We retrospectively reviewed cases of fetal ovarian cysts diagnosed by prenatal ultrasonography at our institution between January 2010 and January 2020. The following were investigated: gestational age at diagnosis, cyst size, appearance, prenatal ultrasound findings, and postnatal outcomes. Prior to 2018, expectant management was applied in all cases; after 2018, in utero aspiration (IUA) of simple cysts ≥ 40 mm was performed. Results: We diagnosed 29 and seven simple and complex cysts, respectively. Fourteen patients had simple cysts with a maximum diameter < 40 mm, and two of them progressed to complex cysts during follow-up; however, when the diameter was limited to < 35 mm, no cases showed progression to complex cyst. Fifteen of the simple cysts were ≥ 40 mm; three progressed to complex cysts, and two of them were confirmed to be ovarian necrosis. In four patients who underwent IUA, the ovaries could be preserved. Conclusions: IUA is a promising therapy for preserving ovaries with simple cysts ≥ 40 mm in diameter; however, the indications for fetal surgery and the appropriate timing of intervention require further study.

scholarly journals Functional Ovarian cysts: Expectant management versus Oral contraceptives

2021 ◽  
Vol 12 (1) ◽  
pp. 03
Keyword(s):  
Oral Contraceptives ◽  
Ethinyl Estradiol ◽  
Expectant Management ◽  
Hormonal Treatment ◽  
Oral Contraception ◽  
Reproductive Age ◽  
Ovarian Cysts ◽  
P Value ◽  
Cyst Size ◽  
Chi Square

Background: Ovarian cyst is a common problem in females of reproductive age group. Objective: To compare the expectant management and use of oral contraceptives for the management of ovarian cysts. Methodology: This was a comparative study, conducted in the department of Obstetrics and Gynecology, Sheikh Zayed Medical College, Rahim Yar Khan, from January 2017 to December 2018. A total of 870 females were included through non-probability, purposive sampling. Informed verbal consent was obtained. Ultrasound was performed to measure the cyst size, site, and characteristics. The lottery method was used to divide the patients into two groups. Patients in group E received expectant treatment (placebo) and in group OC, patients were prescribed hormonal treatment with combined oral contraceptive (COCP) having ethinyl estradiol 0.03mg and levonorgestril 0.15mg. Then patients were counseled and followed up for one month. After one month, USG was performed again to measure success as cyst resolution. The collected data was analyzed into SPSS 16. Both groups were compared for success by using the chi-square test, taking p-value <0.05 as significant. Results: Mean age of females was 26.42±7.59 years. There were 488 (56%) married females while 382 (44%) were unmarried. Mean cyst size was 3.93±1.28cm. was achieved in 605 (69.5%) females, out of which 259 (59.5%) had expectant management while 346 (79.5%) had oral contraception. Success (Cyst resolution) was achieved in 605 (69.5%) females, out of which 259 (59.5%) had expectant management while 346 (79.5%) had oral contraception. (p=0.00). Conclusion: It was concluded that oral contraceptives are more effective and successful in the resolution of ovarian cysts as compared to expectant management.

scholarly journals Role of Laparoscopy in the Management of Neonatal Ovarian Cysts

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Vijay C Pujar ◽  
Shirin S Joshi ◽  
Yeshita V Pujar ◽  
Hema A Dhumale
Keyword(s):  
Monthly Interval ◽  
Ovarian Cysts ◽  
Cyst Size ◽  
Newborn Period ◽  
Laparoscopy Group ◽  
Laparoscopic Management ◽  
Future Fertility ◽  
Laparoscopic Deroofing

Aim: Ovarian cysts in the newborn period are simple cysts which resolve on their own. Complications like torsion leading to loss of ovarian units are well documented. Surgical treatment should always be performed in a way to protect the ovaries and to ensure future fertility. The aim of this study was to study the safety and efficacy of laparoscopic management of neonatal ovarian cysts.Materials and Methods: Neonates with ovarian cysts over last 6 years were retrospectively studied. Thirty seven ovarian cysts were detected antenatally and 32 of them persisted postnatally. All babies were asymptomatic. Nine babies with cyst size more than 5cms underwent laparoscopic deroofing, fenestration or cystectomy; the rest 23 babies were managed conservatively. Sonographic monitoring was done at monthly interval for change in contents, echogenicity of walls and features of torsion. Follow up was done with USG at 3 and 6 months and MRI after 1 year.Results: No procedure related complications were seen in the laparoscopy group and no loss of ovarian units were seen in 1 year follow-up. In the observation group, cysts resolved in 3- 12 months period. Three babies developed complications and 4(17%) ovarian units were lost.Conclusion: Ovarian cysts are the most frequent among intra-abdominal cysts in newborns. Neonatal ovarian cysts are known to resolve spontaneously. Laparoscopic management of these cysts is safe and efficacious even in neonatal age and should be the treatment of choice when indicated.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

Factors related to complete occlusion of arteriovenous malformations after gamma knife radiosurgery

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 96-101 ◽  
Author(s):  
Jong Hee Chang ◽  
Jin Woo Chang ◽  
Yong Gou Park ◽  
Sang Sup Chung
Keyword(s):  
Gamma Knife ◽  
Arteriovenous Malformations ◽  
Gamma Knife Radiosurgery ◽  
Maximum Diameter ◽  
Content Type ◽  
Complete Occlusion ◽  
Factors Associated ◽  
Martin Grade ◽  
Fine Print

Object. The authors sought to evaluate the effects of gamma knife radiosurgery (GKS) on cerebral arteriovenous malformations (AVMs) and the factors associated with complete occlusion. Methods. A total of 301 radiosurgical procedures for 277 cerebral AVMs were performed between December 1988 and December 1999. Two hundred seventy-eight lesions in 254 patients who were treated with GKS from May 1992 to December 1999 were analyzed. Several clinical and radiological parameters were evaluated. Conclusions. The total obliteration rate for the cases with an adequate radiological follow up of more than 2 years was 78.9%. In multivariate analysis, maximum diameter, angiographically delineated shape of the AVM nidus, and the number of draining veins significantly influenced the result of radiosurgery. In addition, margin radiation dose, Spetzler—Martin grade, and the flow pattern of the AVM nidus also had some influence on the outcome. In addition to the size, topography, and radiosurgical parameters of AVMs, it would seem to be necessary to consider the angioarchitectural and hemodynamic aspects to select proper candidates for radiosurgery.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

2021 ◽  
pp. 1-11
Author(s):  
Hamid Reza Niknejad ◽  
Melissa Frederickx ◽  
Emiel Salaets ◽  
Jurgen Lemiere ◽  
Lieven Lagae ◽  
...  
Keyword(s):  
Aqueductal Stenosis ◽  
Maximum Diameter ◽  
Benign Tumors ◽  
Term Outcome ◽  
Adequate Treatment ◽  
Long Term Outcome ◽  
Tectal Plate ◽  
The Mean

<b><i>Introduction:</i></b> Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. <b><i>Methods:</i></b> We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. <b><i>Results:</i></b> In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (<i>p</i> = 0.031) and the estimated tumor volume with 35% (<i>p</i> = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, <i>U</i> = 3, <i>p</i> &#x3c; 0.01, <i>z</i> = −2.71), performance (TPG= 100, IAS = 85, <i>U</i> = 7, <i>p</i> = 0.03, <i>z</i> = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, <i>U</i> = 2, <i>p</i> &#x3c; 0.00, <i>z</i> = −2.87) as well as working memory (TPG = 109.5, IAS = 77, <i>U</i> = 0.5, <i>p</i> = 0.01, <i>z</i> = −2.46). <b><i>Conclusion:</i></b> Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

scholarly journals Mortality in Patients with Brainstem Cavernous Malformations

2021 ◽  
pp. 1-7
Author(s):  
Julia Velz ◽  
Marian Christoph Neidert ◽  
Yang Yang ◽  
Kevin Akeret ◽  
Peter Nakaji ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Cavernous Malformations ◽  
Patient Cohort ◽  
Actual Risk ◽  
Single Center Study

<b><i>Objective:</i></b> Brainstem cavernous malformations (BSCM)-associated mortality has been reported up to 20% in patients managed conservatively, whereas postoperative mortality rates range from 0 to 1.9%. Our aim was to analyze the actual risk and causes of BSCM-associated mortality in patients managed conservatively and surgically based on our own patient cohort and a systematic literature review. <b><i>Methods:</i></b> Observational, retrospective single-center study encompassing all patients with BSCM that presented to our institution between 2006 and 2018. In addition, a systematic review was performed on all studies encompassing patients with BSCM managed conservatively and surgically. <b><i>Results:</i></b> Of 118 patients, 54 were treated conservatively (961.0 person years follow-up in total). No BSCM-associated mortality was observed in our conservatively as well as surgically managed patient cohort. Our systematic literature review and analysis revealed an overall BSCM-associated mortality rate of 2.3% (95% CI: 1.6–3.3) in 22 studies comprising 1,251 patients managed conservatively and of 1.3% (95% CI: 0.9–1.7) in 99 studies comprising 3,275 patients with BSCM treated surgically. <b><i>Conclusion:</i></b> The BSCM-associated mortality rate in patients managed conservatively is almost as low as in patients treated surgically and much lower than in frequently cited reports, most probably due to the good selection nowadays in regard to surgery.

T03.01.5 AGE, OVERWEIGHT, DIABETES AND INITIAL CYST SIZE ARE ASSOCIATED WITH THE RISK OF PROGRESSION OF BD-IPMN UNDERGOING FOLLOW-UP

2020 ◽  
Vol 52 ◽  
pp. S96-S97
Author(s):  
G. Capurso ◽  
M. Traini ◽  
G. Zerboni ◽  
P. Zaccari ◽  
G. Vanella ◽  
...  
Keyword(s):  
Cyst Size ◽  
Risk Of Progression

The Definition, Diagnosis, and Management of Growth-Discordant Twins: An International Census Survey

1991 ◽  
Vol 40 (3-4) ◽  
pp. 345-351 ◽  
Author(s):  
I. Blickstein
Keyword(s):  
Stress Testing ◽  
Expectant Management ◽  
Doppler Velocimetry ◽  
Diagnosis And Management ◽  
Clear Cut ◽  
Biophysical Profile ◽  
Per Se ◽  
Discordant Twins ◽  
Discordant Twin

AbstractIn order to establish a protocol considering the definition, diagnosis, and management of growth-discordant twin gestations, a questionnaire was sent to 96 authors of twin-related obstetric articles. The views of the 61 responders comprise this international census survey. The data suggest that a clear cut-off value for discordancy is still needed; however, the data indirectly supported a two-grade definition, namely, mild (> 15% and < 25% birth-weight disparity) and severe (> 25%) growth discordants. Expectant management was advocated by the majority of participants with out-patient follow-up for mild discordants, while severe discordants may preferably be hospitalized. Follow-up should be done by non-stress testing (daily - 2/wk), biophysical profile (1-2/wk), Doppler velocimetry (1/wk - bi-weekly) and sonographic biometry (bi-weekly). The opinions considering termination of pregnancy because of intertwin growth discordancy were divided; however, discordancy per se, was not considered an indication for cesarean delivery. An adapted management flowchart that summarizes the survey's data is presented and may be used as a standard for future investigations.

scholarly journals Structural brain injury in sports-related concussion

2012 ◽  
Vol 33 (6) ◽  
pp. E6 ◽  
Author(s):  
Scott L. Zuckerman ◽  
Andrew Kuhn ◽  
Michael C. Dewan ◽  
Peter J. Morone ◽  
Jonathan A. Forbes ◽  
...  
Keyword(s):  
Brain Injury ◽  
Literature Review ◽  
Brain Injuries ◽  
Case Reports ◽  
Head Injuries ◽  
Health Concern ◽  
Prevalence Data ◽  
Small Series ◽  
Structural Brain

Object Sports-related concussions (SRCs) represent a significant and growing public health concern. The vast majority of SRCs produce mild symptoms that resolve within 1–2 weeks and are not associated with imaging-documented changes. On occasion, however, structural brain injury occurs, and neurosurgical management and intervention is appropriate. Methods A literature review was performed to address the epidemiology of SRC with a targeted focus on structural brain injury in the last half decade. MEDLINE and PubMed databases were searched to identify all studies pertaining to structural head injury in sports-related head injuries. Results The literature review yielded a variety of case reports, several small series, and no prospective cohort studies. Conclusions The authors conclude that reliable incidence and prevalence data related to structural brain injuries in SRC cannot be offered at present. A prospective registry collecting incidence, management, and follow-up data after structural brain injuries in the setting of SRC would be of great benefit to the neurosurgical community.

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