scholarly journals CLINICAL CASE OF APPENDIX MUCOCELL, COMPLICATED BY PERFORATION AND THE FORMATION OF RETROPERITONEAL SPACE PHLEGMON

2020 ◽  
pp. 110-114
Author(s):  
О. А. Povch ◽  
Е. N. Shepetko ◽  
О. V. Коvalchuk ◽  
R. О. Leleta ◽  
S. О. Rebenkov
Keyword(s):  
Preoperative Diagnosis ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Retroperitoneal Space ◽  
Medical Attention ◽  
Timely Manner ◽  
Gradual Improvement ◽  
Mucocele Of The Appendix ◽  
The Right

Summary. The aim. To analyze the anamnestic data, clinical symptoms, preoperative diagnosis, features of surgical intervention and the results of histological examination in a patient with mucocele of the appendix (MA), complicated by necrosis and perforation of the wall and formation of retroperitoneal space phlegmon (FRS). Material and methods. An analysis of the case of MA, which was complicated by the atypical course and the development of retroperitoneal space phlegmon, which was diagnosed after multispiral computered tomography of the abdominal cavity (MSCT AC). Results. The patient, despite periodic atypical complaints of discomfort in the right iliac region, did not seek medical attention and was not examined. Operated urgently after performing MSCT AC. Intraoperatively, a rupture of the MA was diagnosed with formation of FRS, which significantly complicated the course of the operation and the course of the postoperative period. Appendectomy, drainage of the abdominal cavity and retroperitoneal space were performed. Gradual improvement and recovery. Conclusions: The acute situation resulting from the rupture of the MA, led to a complex operation. Performing MSCT AC at the prehospital stage makes it possible to diagnose the problem and perform the operation in a timely manner, without waiting for serious complications.

scholarly journals Diagnostic difficulties and features of endovideosurgical treatment of a patient with mucocele of the appendix

2020 ◽  
Vol 12 (2) ◽  
pp. 85-90
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Elguja L. Lataria ◽  
Alexey A. Kurkov ◽  
Vyacheslav A. Melnikov ◽  
...  
Keyword(s):  
Benign Tumor ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Vermiform Appendix ◽  
Diagnostic Methods ◽  
Number Of Patients ◽  
Mucocele Of The Appendix ◽  
Diagnostic Difficulties ◽  
Life Threatening ◽  
The Right

The mucocele of the appendix is the expansion of the appendix with the accumulation of a large amount of mucus. The mechanism and causes of mucocele are not fully understood. According to some authors, such changes in the appendix can occur due to cicatricial narrowing of the lumen of the appendix, compression or blockage of its base. Other authors believe that the mucocele of the appendix is a benign tumor that develops from the remnants of primitive mesenchyme and is sometimes prone to malignancy. Clinical manifestations of mucocele of the appendix are nonspecific. In a number of patients, this disease causes pain in the right abdomen, more often pulling, intermittent. However, the disease is often asymptomatic. In this regard, diagnosis is established only during performing an operation, most often, regarding acute appendicitis. Nevertheless, instrumental diagnostic methods such as ultrasound and computed tomography of the abdominal and pelvic organs make it possible to suspect mucocele. Despite the frequent asymptomatic, non-aggressive course, a number of life-threatening complications can become the outcome of the mucocele of the vermiform appendix. The most formidable complication is the rupture of the appendix with mucus entering free abdominal cavity, followed by the development of peritoneal pseudomyxoma due to implantation of mucus-forming cells. The only option for radical treatment of the mucocele of the appendix is a surgical intervention. A presented clinical case demonstrates the difficulties of diagnosis, as well as the features of surgical treatment of a patient with a mucocele of the appendix.

scholarly journals PSEUDOMYXOMA ON APPENDICULAR MUCOCELE

2020 ◽  
Vol 8 (12) ◽  
pp. 842-846
Author(s):  
Yehouenou Tessi T. Romeo ◽  
◽  
Asaad El Bakkari ◽  
Adeyemi A. Boris ◽  
Khadija Ben El Hosni ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Iliac Fossa ◽  
Disease Onset ◽  
Vermiform Appendix ◽  
Complete Resection ◽  
Mucocele Of The Appendix ◽  
Thin Walled ◽  
Ct Density ◽  
The Right ◽  
Underlying Pathology

Mucocele of the appendix is a descriptive term for mucinous distension of the appendiceal lumen (vermiform appendix) regardless of the underlying pathology. It refers to the progressive retrograde dilatation of the vermiform appendix with concomitant intraluminal accumulation of the mucoid substance. It is an uncommon pathology that occurs in both sexes. it especially poses the problem of differential diagnosis in particular in women because of the location of clinical symptoms in the right iliac fossa. The incidence is estimated between 0.2 % and 0.4 % of the appendectomied specimens.The estimated incidence is approximately 1/1 000 000/year. The disease onset is usually after the age of 40 years and more frequently affects females.The means of medical imaging are mainly ultrasound and scanner. On CT typical mucocele appears as a cecal-based, rounded and well-defined mass, thin-walled, with fine parietal calcifications CT density is variable, from fluid to tissue. A stercolith is sometimes visible at the base of the appendix. The wall of the mucocele may be thickened, irregular, taking the contrast there may be peri-appendicular inflammation, which may be inflammatory or tumor, without specificity.The treatment of unbroken appendicular mucocele is surgical, preferably by laparotomy than laparoscopy. The appendectomy is performed, without breaking the appendix, with complete resection of the meso-appendix, and sampling for cytology of the peritoneal fluid.

scholarly journals HugeNon-Organ Retroperitoneal Tumor inCombination with aCystoma of Uterine Appendages

2019 ◽  
Vol 4 (2) ◽  
pp. 140-143
Author(s):  
N. I. Bogomolov ◽  
A. G. Goncharov ◽  
N. N. Tomskikh ◽  
Y. Y. Goncharova
Keyword(s):  
Intestinal Anastomosis ◽  
Abdominal Cavity ◽  
Lymph Node Biopsy ◽  
Tumor Formation ◽  
Retroperitoneal Space ◽  
Abdominal Tumor ◽  
Mesenteric Vessels ◽  
Median Laparotomy ◽  
Horizontal Portion ◽  
The Right

The article describes the experience of successful diagnostics and treatment of giant non-organ extraperitoneal tumor combined with a cystoma of uterine appendages.Patient P., 43 years old, was hospitalized in the oncology department, diagnosed with “Abdominal tumor, right ovary?” The state was satisfactory, after palpation of the abdomen, a lumpy formation of a densely elastic consistency, from the womb to the epigastric region, was found. An ultrasound revealed a homogeneous tumor formation 30×28 cm from the border of the uterus to the liver. When performing median laparotomy, a dumbbell-shaped tumor (36×26×20 cm) was found in the retroperitoneal space with involvement of the mesentery of the small intestine, lower horizontal portion of the duodenum, mesentery of the transverse colon, superior mesenteric vessels, aorta and jejunum. In the right appendages, a cystoma 12–15 cm in diameter was found, with inversion and necrosis. Adnexectomy was performed. An express lymph node biopsy revealed cells suspicious for malignancy. The tumor was mobilized and removed as a single unit with retroperitoneal tissue, lymph nodes in combination with resection of 70 cm of the jejunum and fenestrated resection of the duodenum. The resulting gut defect 9×7 cm was sutured with a precision single-row suture. Inter-intestinal anastomosis “endto-end” was formed. Nasointestinal intubation was performed. The abdominal cavity was sutured, and two tubular drainages were installed. The postoperative period was uneventful. The histological conclusion: fibrous histiocytoma of the mesentery of the intestine with malignancy in the center of the node, in the ovary – total hemorrhagic infiltration of all layers, edema. The tumor conference consultation was recommended. After 1.5 years, the patient was admitted with the same clinical picture. During laparotomy, a tumor recurrence was discovered, the nodes of which were located in the retroperitoneal space, in the abdominal cavity with invasion to organs and large vessels. The case was recognized as inoperable, the laparotomic wound was closed completely. Sixteen days after surgery the patient was discharged.

Management of the Patients with Acute Deep Vein Thrombosis in Need for Surgical Intervention on the Organs of Abdominal Cavity or Retroperitoneal Space

Flebologiia ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 30
Author(s):  
O. I. Efremova ◽  
V. V. Andriyashkin ◽  
I. S. Lebedev ◽  
A. V. Andriyashkin ◽  
I. A. Zolotukhin ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Retroperitoneal Space ◽  
Vein Thrombosis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

scholarly journals Diagnostic program and tactical approaches to treatment of patients with obturative colonic obstruction of tumor genesis

2012 ◽  
Vol 93 (3) ◽  
pp. 426-431
Author(s):  
I S Malkov ◽  
M M Toltoev
Keyword(s):  
Bowel Obstruction ◽  
Surgical Intervention ◽  
Primary Anastomosis ◽  
Colonic Obstruction ◽  
Abdominal Cavity ◽  
Digital Rectal Examination ◽  
Postoperative Mortality ◽  
Diagnostic Procedures ◽  
Results Of Treatment ◽  
The Right

Aim. To determine the value of ultrasound investigations, colonoscopy and laparoscopy in the complex diagnosis of acute obturative colonic obstruction of tumor genesis and in selecting the optimal treatment strategy. Methods. Conducted was an anlysis of results of treatment of 112 patients with obturative colonic obstruction of tumor genesis. A set of diagnostic procedures was carried out for every admitted patient: digital rectal examination, radiography of the abdomen, ultrasound examination, fiber colonoscopy, and laboratory studies. Results. Based on the clinical and radiographic the diagnosis of obturative colonic obstruction was established in 64.3%, ultrasound investigation revealed the presence of bowel obstruction without specifying its location in 92% of the cases. Emergency colonoscopy was informative only in 55.5% of cases due to inadequate prior preparation of the colon. Using the developed methodology of preparing the colon, it was possible to perform colonoscopy up to the level of the tumor in 26 patients (92.9%) out of 28 patients. In the 32 cases minimal surgical intervention were performed by way of formation of an ileotransverse anastomosis by-pass, double-barreled ileostomy or colostomy. 80 patients underwent resection of the bowel with the tumor, including operations with the formation of a primary anastomosis, which were performed in 20 patients when the tumor was located in the right segments of the colon. In 22 patients an intraoperative colonic lavage was performed. Postoperative complications were recorded in 30 (26.8%) patients. Postoperative mortality was 24.1% (27 patients). Conclusion. Based on the radiographic and ultrasound investigations of the abdominal cavity it is possible to establish the presence of bowel obstruction without specifying the localization of the obstruction zone; in order to determine the cause of the obturative colonic obstruction it is necessary to perform an emergency colonoscopy with rigorous preparation of the colon according to the developed technique, while the volume of surgical intervention should be determined in each case individually.

scholarly journals Urinary bladder fistula following laparoscopic inguinal hernioplasty: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ken Hagiwara ◽  
Shigeoki Hayashi ◽  
Takeki Suzuki ◽  
Keio Song ◽  
Tadatoshi Takayama
Keyword(s):  
Urinary Bladder ◽  
Rare Case ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Fluid Collection ◽  
Mesh Erosion ◽  
Fistula Formation ◽  
Mesh Removal ◽  
The Right ◽  
Fluid Culture

Abstract Background Fistula formation due to mesh erosion into hollow viscera, such as the urinary bladder, is uncommon. To date, there have been no reports of fistula formation into the urinary bladder without evidence of mesh erosion after hernioplasty; herein, we report one such rare case, in which the clinical symptoms improved without any surgical intervention. Case presentation A 73-year-old man underwent a trans-abdominal preperitoneal repair for bilateral direct inguinal hernia. One month later, the patient experienced a painful induration in the right inguinal region, and computed tomography revealed fluid collection in this region. A culture of the aspirated fluid yielded no bacteria. Seven months later, he experienced another episode of painful induration in the same region. However, blood examination revealed a normal white blood cell count and C-reactive protein level. Moreover, no organisms were detected by aspirated fluid culture. Although the painful induration subsided after aspiration of the fluid collection, he developed gross hematuria and dysuria a month later. Cystoscopy revealed a fistula in the right wall of the urinary bladder that discharged a purulent fluid. Culture of the fluid revealed no bacteria, and there was no evidence of mesh erosion. Hematuria improved without therapeutic or surgical intervention. The patient’s clinical symptoms improved without mesh removal. Moreover, cystoscopy revealed that the fistula was scarred 12 months after the initial appearance of urinary symptoms. No further complications were observed during a 42-month follow-up period. Conclusions We report a rare case of a fistula in the urinary bladder without evidence of mesh erosion after laparoscopic hernioplasty. The patient’s condition improved without mesh removal. Fluid collection due to foreign body reaction to meshes can cause fistula formation in the urinary bladder without direct mesh contact.

scholarly journals Syndrome of complete insensitivity to androgens of the 4-years-old child

2020 ◽  
Vol 10 (1) ◽  
pp. 89-94
Author(s):  
Vasily P. Gavrilyuk ◽  
Stanislav V. Kostin ◽  
Maria I. Statina ◽  
Dmitry A. Severinov ◽  
Elena O. Ageeva
Keyword(s):  
Vas Deferens ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Outpatient Basis ◽  
Female Reproductive System ◽  
Bilateral Inguinal Hernia ◽  
Pelvic Organs ◽  
Hernial Sac ◽  
Risk Of Malignancy ◽  
The Right

To demonstrate an interesting and rare case in the clinical practice of testicular feminization syndrome in a child, as an accidental finding when performing a planned surgical intervention. A mother with a child E., born in 2010 (at the time the child was 4 years old) was hospitalized with the mothers complaints about the presence of protrusions in both inguinal areas from birth, the mother denied cases of infringement. The child was examined on an outpatient basis and the next day a scheduled surgical intervention was prescribed hernia repair on both sides. At the opening of the hernial sac on the right, the contents were the testicle, 1.6 1.6 1.0 cm in size, with an appendage and vas deferens. Then an opening of the hernial sac was performed on the left, the contents of the hernial sac was also a testicle measuring 1.8 1.2 1.0 cm with an appendage and d. deference. Examination was performed: on an ultrasound of the pelvic organs the bladder is full, the effusion in the pelvis is up to 1215 mm high, the uterus and ovaries are not located at the time of the examination. In the abdominal cavity (in the iliac regions), ovarian testicles with mediastinum are located on both sides 19 11 mm on the right, 16 10 mm on the left. The clinical case that we have provided will be of interest to pediatric surgeons and geneticists in view of the unusual and complex clinical diagnosis of this condition. In the presence of a female phenotype, the child completely lacked the organs of the female reproductive system, this disease was detected only due to the presence of a concomitant pathology in the child, a bilateral inguinal hernia. The early diagnosis of STF is especially important given the risk of malignancy of the gonads in the post-pubertal period.

Dysgenetic male pseudohermaphroditism

2012 ◽  
Vol 153 (8) ◽  
pp. 303-307 ◽  
Author(s):  
László Ságodi ◽  
Janka Jakab ◽  
Ákos Kiss ◽  
Erzsébet Ladányi ◽  
Erzsébet Balogh ◽  
...  
Keyword(s):  
Gonadal Dysgenesis ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Testicular Tissue ◽  
Male Pseudohermaphroditism ◽  
Histological Evaluation ◽  
Surgical Removal ◽  
Pelvic Magnetic Resonance Imaging ◽  
The Right

The authors report a case of a dysgenetic male pseudohermaphroditism with a 45,X/46,XY karyotype in a mosaic form, which was diagnosed in an infant. The one-week-old infant was evaluated because of proximal hypospadias and retention of the right testis. The results of hormonal tests were the followings: serum FSH 5.2 mU/ml; LH: 2.0 mU/ml; testosterone: 144.3 ng/dl; androstendione: 0.42 µg/l; 17-hydroxyprogesterone: 1.12 ng/ml. Chromosomal analysis revealed 45,X/46,XY karyotype. Fluorescent in vitro hybridization showed that 51% of the lymphocytes had the Y chromosome and the SRY gene. Analysis of the SRY showed no deletion in the AZF a,b,c regions. Pelvic magnetic resonance imaging indicated the presence of vagina between the bladder and the rectum, and it showed a mass measuring 15×8 mm in the right inguinal canal as well as an oval gonadal mass with a size of 13×7 mm in the left scrotum. During surgical intervention, performed at the age of one, the right gonad was removed and biopsy of the scrotal testis was performed. Histological examination revealed dysgenetic testis in both sides. The authors emphasize the necessity of cytogenetic and endocrinological investigations of newborns with perineoscrotal hypospadia and bilateral or unilateral maldescent testes immediately after birth. Surgical removal of the dysgenetic testicular tissue located in the abdominal cavity and its histological evaluation provides separation of mixed gonadal dysgenesis, dysgenetic male pseudohermaphroditism, bilateral gonadal dysgenesis and ovotestis in the 45,X/46,XY mosaic cases. An accurate evaluation is necessary for a correct sex assignment and for surgical intervention to prevent neoplastic degeneration of the dysgenetic gonad. Orv. Hetil., 2012, 153, 303–307.

scholarly journals A Case of Renal Inflammatory Pseudotumor Leading to Nephrectomy

2021 ◽  
Vol 9 ◽  
pp. 232470962110032
Author(s):  
Le Tuan Linh ◽  
Nguyen Minh Duc ◽  
Thieu-Thi Tra My ◽  
Phan Nhan Hien ◽  
Tran Ngoc Minh ◽  
...  
Keyword(s):  
Preoperative Diagnosis ◽  
Inflammatory Pseudotumor ◽  
Renal Carcinoma ◽  
Clinical Symptoms ◽  
Definitive Diagnosis ◽  
Pathological Examination ◽  
Unknown Etiology ◽  
Resonance Imaging ◽  
The Right ◽  
Fat Stranding

Inflammatory pseudotumor (IPT) of the kidney is a rare benign disorder with unknown etiology. In IPT patients, some nonspecific symptoms might present, such as fever, hematuria, and back pain. As it can appear on computed tomography and magnetic resonance imaging as a hypovascular mass with surrounding fat stranding, IPT can be misdiagnosed as a primary tumor. Since the clinical symptoms, radiographic features, and preoperative findings can be inconsistent, it is imperative to confirm IPT based on histopathological assessment. In the present study, we describe a case of renal IPT in a 13-year-old girl. The patient was treated with nephrectomy of the right kidney since the preoperative diagnosis was renal carcinoma. Pathological examination revealed an IPT. This article emphasizes the importance of preoperative definitive diagnosis in avoiding unnecessary nephrectomy.

Surgical treatment of alveolar echinococcosis: a single centre experience and systematic review of the literature

2019 ◽  
Vol 98 (4) ◽  
pp. 167-173
Keyword(s):  
Case Report ◽  
Echinococcus Multilocularis ◽  
Alveolar Echinococcosis ◽  
Lymphatic System ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Safety Margin ◽  
Surgical Removal ◽  
Single Centre Experience ◽  
Therapeutic Procedures

Introduction: Alveolar echinococcosis (AE) is a zoonosis caused by Echinococcus multilocularis. AE is primarily localised in the liver. Echinococcus multilocularis imitates tumour-like behaviour. It can metastasise through blood or lymphatic system to distant organs. Echinococcosis often remains asymptomatic due to its long incubation period and indistinct symptoms. Clinical symptoms are determined by the parasite’s location. Diagnosis of echinococcosis is based on medical history, clinical symptoms, laboratory tests, serology results, imaging methods and final histology findings. Surgical removal of the cyst with a safety margin, followed by chemotherapy is the therapeutic method of choice. Case report: We present a case report of alveolar echinococcosis in a thirty-year-old female patient in whom we surgically removed multiple liver foci of alveolar echinococcosis. The disease recurred after two years and required another surgical intervention. Conclusions: Alveolar echinococcosis is a disease with a high potential for a complete cure provided that it is diagnosed early and that the recommended therapeutic procedures are strictly adhered to.

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