Laparoscopic Management of Phrenic Endometriosis

2011 ◽  
Vol 3 (4) ◽  
pp. 213-217
Author(s):  
Cassia Gisele Terrassani Silveira ◽  
Admir Agic ◽  
Markus Kleemann ◽  
Hartmut Merz ◽  
Daniela Hornung

Introduction Extrapelvic endometriosis is a rare condition typically associated with variable symptomatology and complex diagnosis. Case report: Here, we report a rare case of phrenic endometriosis manifested insidiously in a woman of reproductive age after a prolonged history of endometriosis with several surgical interventions, including laparoscopic bowel resection a few months ago. The patient presented with menstrual-related, cyclical, right upper abdominal pain. Results Accurate surgical inspection during the laparoscopic procedure enabled the identification and full resection of a deep infiltrating endometriotic lesion growing from the peritoneum into the phrenic tissue, which was suspected by symptomatology. No pulmonary complications were detected before or after surgery except for a small right-sided pneumothorax, which did not require drainage and disappeared spontaneously after five days. Conclusions The rare case reported here emphasizes the importance of a very exact conversation with the patient before surgery, a systematic and accurate surgical exploration for the diagnosis, and the successful laparoscopic treatment of a symptomatic phrenic disease in a woman with a longstanding history of endometriosis.

2020 ◽  
Vol 13 (2) ◽  
pp. 923-928
Author(s):  
Hang Thi Thuy Nguyen ◽  
Hung Huy Hoang ◽  
Anh Thi Van Le

Choriocarcinoma is a malignant tumor that typically appears in gonadal organs and primarily occurs in women of reproductive age. Being a primary extragonadal choriocarcinoma, primary pulmonary choriocarcinoma (PPC) is an extremely rare condition. Due to the rarity of PPC, no standardized treatment has been established so far. However, surgery combined with adjuvant chemotherapy appears to be the most optimal treatment. Here, we report a rare case of a man with PPC that was successfully treated with surgery followed by chemotherapy.


2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Nonso Osakwe ◽  
Diane Johnson ◽  
Natalie Klein ◽  
Dalia Abdel Azim

Background. Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient. Case Presentation. A 70-year-old Asian male patient with history of stable HIV on medications with CD 4 cell count above 200 presented with cough and fever and was initially treated for pneumonia as an outpatient. Persisting symptoms prompted presentation to the hospital. The patient was found to have anemia which persisted despite repeated transfusion of packed red cells. A bone marrow biopsy to investigate anemia revealed hemophagocytosis. A CT scan revealed multiple enlarged lymph nodes and hepatosplenomegaly. An excisional lymph node biopsy revealed HHV-8 associated multicentric Castleman disease. The patient deteriorated despite initiation of treatment. Conclusion. HLH can occur at any stage of HIV, rapid diagnosis to identify possible underlying reactive infectious etiology and prompt initiation of treatment is crucial to survival.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Abdullah A. Alarfaj ◽  
Ali R. AlHayek ◽  
Rashid Alghanim ◽  
Nasser A. Al-Jazan

Traumatic macroglossia is an extremely rare condition characterized by a sudden edematous swelling of the tongue due to trauma. We report a rare case of traumatic macroglossia in a 37-year-old male with known trisomy 21 and epilepsy who presented to the emergency room with a huge protruded tongue due to aggressive behavior and a history of multiple tongue tractions, leading to sudden severe tongue swelling without any respiratory distress symptoms. The examination was unremarkable; fixable nasolaryngoscopy relieved bilateral vocal cord movement, and there was no laryngeal edema. The patient was managed immediately by endotracheal intubation to secure the airway, and corticosteroids were used to diminish and stop the tongue swelling. We describe the clinical management for such patients, highlighting the different causes of traumatic macroglossia. A few cases have been reported in the literature, but this is the first case to report self-induced traumatic macroglossia in a seizure-free patient managed successfully by endotracheal intubation, corticosteroids, a bite block, and warm wet dressing.


2017 ◽  
Vol 3 (1) ◽  
pp. 25-27
Author(s):  
Ajit Reddy ◽  
Anil K Shukla ◽  
Sowmya Anand ◽  
Nitish Suresh

ABSTRACT Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the most common malignant neoplasms of the diaphragm; however, only a few (less than 20) cases have been reported to date. We present a case of an extremely rare tumor of the diaphragm. A 65-year-old woman presented with history of vague upper abdominal pain since 2 months and distension for 2 weeks. Ultrasonography features were in favor of a mass arising from left dome of diaphragm with evidence of vascularity on Doppler; lesion was displacing spleen inferiorly. Contrast-enhanced computed tomography scan of the abdomen revealed a mass located in the region of the left dome of diaphragm and deriving blood supply from the branches of abdominal aorta. Surgical excision was planned, keeping in mind the diagnosis of a left diaphragmatic tumor. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen. How to cite this article Anand S, Suresh N, Reddy AK, Shukla AK. Imaging of a Rare Case of Diaphragmatic Tumor. J Med Sci 2017;3(1):25-27.


2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Masanori Kudoh ◽  
Ken Omura ◽  
Arata Satsukawa ◽  
Koshi Matsumoto ◽  
Takahide Taguchi ◽  
...  

Symmetric lipomatosis is definitively characterized by symmetric, tumorous lipomatous proliferation of adipose tissue that often develops in the head and neck, shoulders, and upper trunk. However, in the oral region, symmetric lipomatosis of the tongue (SLT) is an extremely rare condition related to generalized lipidosis that is often caused by chronic alcoholism. It is characterized by multiple symmetric lipomatous nodules and diffuse bilateral swelling located within the tongue. We report an extremely rare case of SLT arising in an 80-year-old man with a long history of alcoholic liver cirrhosis. He exhibited multiple soft nodular protrusions on the bilateral margin of the tongue presenting as macroglossia for years. Although MR imaging showed multiple fatty masses on both sides of the tongue, there was no elevated tumor mass on the bilateral margin. The patient underwent bilateral partial glossectomy under general anesthesia. Histopathologically, the resected tumor exhibited diffuse infiltration with mature adipose tissue lacking a fibrous capsule. Due to the lipidosis and the unusual presentation of multiple lesions, the lesion was ultimately diagnosed as SLT. At present, after surgery, the patient wears a full-denture and is in excellent condition, with no sign of recurrence, improved QOL, and recovery of masticatory, articulatory, and speech intelligibility functions.


2016 ◽  
Vol 9 (3) ◽  
pp. 633-638 ◽  
Author(s):  
Nishat Fatema ◽  
Neeru Vinod Arora ◽  
Fatma Majid Al Abri ◽  
Yaseer Muhammad Tareq Khan

Haemoperitoneum in women of reproductive age usually suggests either ruptured ectopic pregnancy or ruptured ovarian cysts. Metastatic choriocarcinoma is considered the least common cause of haemoperitoneum in women of childbearing age. We report a rare case of pancreatic and hepatic metastasis of choriocarcinoma in a young, 30-year-old female who had delivered 10 months prior at term gestation with no previous history of gestational trophoblastic disease or molar pregnancy. She had a short history of fever and pain in the right hypochondrium, with findings of hypovolaemic shock due to intraperitoneal haemorrhage. Unfortunately, the patient expired with massive uncontrolled bleeding from liver metastasis despite 2 emergency laparotomies within 12 h. This case report is an apt reminder to clinicians to include metastatic choriocarcinoma on the list of differential diagnoses for haemoperitoneum with a positive pregnancy test in women of reproductive age to diagnose early and to avoid life-threatening consequences.


Author(s):  
Goli Golpayegani ◽  
Mehrdad Jafari ◽  
Anita Karimi

Arhinia is an extremely rare condition reported in less than 100 cases so far. We report a case of arhinia with bilateral anophthalmia. In physical examination, only alar portions of the nose were partially formed. No septal, lower, upper lateral cartilages or nasal bones were detectable. Both nostrils were atretic. The orbital area was covered with skin, and eyebrows were partially formed. Bilateral complete cleft lip and palate were evident. Surgical interventions should be considered not only for reconstruction of the external nose but for timely creation of a lacrimal passage and repair of the accompanying cleft lip and palate.


2021 ◽  
Author(s):  
Leila Pourali ◽  
Hamidreza Ghorbani ◽  
Atiyeh Vatanchi ◽  
Sedigheh Ayati ◽  
Ghazal Ghasemi ◽  
...  

Uterine prolapse and bladder exstrophy (BE) during pregnancy is a rare condition. The aim of this study was to present a rare case of pregnancy complicated by both bladder exstrophy and uterine prolapse. A 39-year-old pregnant woman (gravida 2, para 1) presented to the maternity department at 39 weeks of gestation with labor pain. Physical examination showed regular uterine contractions; the cervix was completely out of the vaginal opening with dilatation of 3 cm and effacement of 30%. She had a history of multiple surgeries for correction of bladder exstrophy and also suffered from uterine prolapse. In active labor, abnormal fetal heart rate tracing happened, so an emergent cesarean section was planned, and a healthy neonate with the normal Apgar score was born. At regular follow-up until four months after delivery, there was no sign or symptom of uterine proplase. Multidisciplinary management of patients with BE and uterine prolapse may result in optimal perinatal outcomes. Uterine prolapse may disappear after delivery, even in the complicated case of bladder exstrophy.


2019 ◽  
Vol 160 (38) ◽  
pp. 1510-1513
Author(s):  
Călin Molnar ◽  
Tibor Sárközi ◽  
Cedric Kwizera ◽  
Marian Botoncea ◽  
Opriș Zeno ◽  
...  

Abstract: Gallbladder agenesis is a rare congenital malformation due to an embryological defect of the biliary system. In most cases it is asymptomatic, but it can also mimic biliary colic. We report the case of a 72-year-old Caucasian woman with a medical history of cardiovascular disease and hypercholesterolemia, under cholesterol-lowering and hypotensive treatment, who presented symptoms suggesting biliary colic. She underwent laparoscopic surgery that confirmed the final diagnosis. We present our approach in this rare case as well as a brief review of medical literature. The surgeon should decide intraoperatively whether to continue and search for a possible ectopic gallbladder or investigate further with imaging studies. Gallbladder agenesis is a rare condition that the surgeon must be aware of. In the cases of inconclusive or indirect signs of cholelithiasis, the best approach is complementary imaging investigations such as magnetic resonance cholangiopancreatography in order to avoid surgery. Orv Hetil. 2019; 160(38): 1510–1513.


2020 ◽  
Vol 13 (9) ◽  
pp. e233159
Author(s):  
Gregg Neagle ◽  
Emma Bhatti ◽  
Martyn Hawkins ◽  
Chris Rodger

The presence of a cerebrospinal fluid (CSF) shunt was previously considered a contra-indication to laparoscopic surgery, however, case reports appeared that describe laparoscopic surgery proceeding with no adverse outcomes in such patients. The majority of these reports relate to laparoscopic cholecystectomy. Here we present what we believe to be only the second report of a patient undergoing laparoscopic bowel resection in the presence of a lumbo-peritoneal shunt. With this case we aim to add to the evidence that more major laparoscopic procedures can be performed safely in the presence of CSF shunts and with a brief review of the current evidence, have suggested appropriate monitoring and precautionary measures for approaching these procedures.


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