preoperative diagnosis
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2022 ◽  
Author(s):  
Catarina Eloy ◽  
Gilles Russ ◽  
Voichita Suciu ◽  
Sarah J. Johnson ◽  
Esther Diana Rossi ◽  
...  

2022 ◽  
pp. 205141582110481
Author(s):  
Subramanya Kattepura ◽  
Attibele Mahadevaiah Shubha ◽  
Kanishka Das

Introduction: Distal ureteral atresia is a rare urinary tract anomaly generally associated with ipsilateral renal dysplasia and abnormalities such as multicystic dysplastic kidney, hydronephrosis and megaureter in the contralateral kidney. Despite burgeoning investigation modalities, definitive preoperative diagnosis of this condition is rarely feasible, also the embryological disarray of events that result in the development of this anomaly and the associated malformations is not clearly understood. Case presentation: We hereby report two cases of distal ureteral atresia and discuss the diversity in their presentations, diagnosis, atypical associations and management and review the possible embryological mal-development. Conclusion: Distal ureteral atresia with urogenital sinus as in Case 1 has not been documented so far and a plausible embryological explanation is deduced regarding its occurrence. The course of the affected kidney following timely and adequate relief of obstruction in Case 2 is depicted, highlighting the eventual management. Level of evidence: Not applicable


2022 ◽  
pp. 153857442110697
Author(s):  
Andre S. Dubois ◽  
Joyce M. Mathew ◽  
Sotirios A. Makris ◽  
Bryce Renwick

Inferior mesenteric artery (IMA) aneurysms represent the minority of visceral aneurysm presentations. A 57-year-old female was admitted with a symptomatic IMA aneurysm secondary to atherosclerotic disease. She was treated with open excision which revealed a contained ruptured of a true aneurysm. This case highlights the challenges of an accurate preoperative diagnosis of IMA aneurysm and the correct position of the recent guidelines on visceral aneurysms issued by the Society of Vascular Surgery (SVS).


2022 ◽  
Author(s):  
Brendan Santyr ◽  
Mohamad Abbass ◽  
Alan Chalil ◽  
Amirti Vivekanandan ◽  
Margaret Lauren Tindale ◽  
...  

Introduction: Chronic facial pain is a prevalent group of conditions and when refractory to common treatments poses a social and economic burden. The last decade has seen a multitude of advancements in the multimodal management of pain. Ablative or neuromodulatory interventions targeting the nucleus caudalis (NC) of the trigeminocervical complex is one such treatment that has remained underutilized. Methods: Here we present a systematic review of the literature and historical perspective regarding interventions targeting the NC. We examine the various intervention techniques, clinical indications, and procedural efficacy. A novel outcome reporting scheme was devised to allow comparison between studies using differing outcome reporting methods. Results: A review of the literature revealed 49 retrospective studies published over the last 80 years, reporting on 858 patients. The most common technique was the open NC dorsal root entry zone nucleotomy/tractotomy (n=515, 60.0%); however, there has been an emergence of novel approaches such as endoscopic (n=6, 0.7%) and spinal cord stimulation (n=20, 2.3%) in the last 10 years. Regardless of intervention technique or preoperative diagnosis, 90.4% of patients demonstrated some improvement from treatment. Conclusion: This systematic review highlights recent advancements in NC intervention technique and the wide range of facial pain syndromes for which these interventions show promising efficacy. New and less invasive techniques continue to emerge, however prospective studies remain absent in the literature. Future work should address efficacy comparisons between intervention type and preoperative diagnosis.


2022 ◽  
Vol 27 (1) ◽  
pp. 71
Author(s):  
Amit Gupta ◽  
Amit Kumar ◽  
Rajiv Chadha ◽  
PartapSingh Yadav ◽  
Vikram Khanna ◽  
...  

2021 ◽  
Vol 27 (4) ◽  
pp. 38-42
Author(s):  
Tamajyoti Ghosh ◽  
Ajay Sebastian Carvalho

Introduction: Hemangiopericytomas are rare CNS Neoplasms constituting <1% of CNS tumours. They are more commonly seen in cranium than in spine where they present as Intradural extramedullary in location. They rarely metastasize to Lung and Bone.World Health Organization Classification of Tumors of the Central Nervous System (CNS WHO) assigned the combined term solitary fibrous tumor/ hemangiopericytoma (SFT/HPC) to such lesions in 2016 due to their same genetic makeup. Case report: Our case is about a 61-year-old diabetic male who presented with insidious onset, gradually progressive thoracic backache and asymmetric weakness with tightness and numbness of both lower limbs for last 6 months with no sphincter incontinence and bed bound for last 15 days. Clinically he had asymmetric spastic paraparesis of lower limb. His MRI Dorsal spine showed a 1.5 ґ 2 cm heterogeneously contrast enhancing Intradural lesion at D6-D7 compressing the cord from dorsolaterally with extensive cord edema from C5 to L2. Preoperative diagnosis of Meningioma/ Metastasis was made and patient underwentD5-D7 laminectomy and tumour excision. Intraoperative findings, there was no dural attachment, there were multiple tortuous blood vessels overlying greyish pink, fleshy, suckable, highly vascular, capsulated tumor posterolateral to cord. The superior aspect of tumor was adherent to cord with no clear interface. Tumor was seen separate from Left D7 nerve root. Post operatively patient improved symptomatically and neurologically. His HPE was suggestive of Hemangiopericytoma WHO Grade II (IHC markers CD34 and CD 31 was positive and KI 67% index of 10-15%). Patient has been on follow up and planned for metastatic workup. Conclusion: Spinal Hemangiopericytoma are rare disease with nonspecific radiological features making preoperative diagnosis difficult. Differential diagnosis of hemangiopericytoma should be kept in case of atypical and high - grade radiological features. Gross total resection without compromising the neurological status should be the goal to prevent local recurrence. Proper consensus regarding the follow up and adjuvant therapies of spinal Hemangiopericytoma are still lacking.


2021 ◽  
Author(s):  
Jinming Liu ◽  
Jiayi Wu ◽  
Anran Liu ◽  
Yannan Bai ◽  
Hong Zhang ◽  
...  

Abstract Preoperative diagnosis of bile duct tumor thrombus (BDTT) is clinically important as the surgical prognosis of hepatocellular carcinoma (HCC) patients with BDTT is significantly different from that of patients without BDTT. The current diagnosis of BDTT is usually based on identifying dilated bile ducts (DBDs) on medical images (eg., CT and MRI images). However, it is easy for doctors to ignore DBDs when reporting imaging scan results, leading to a high misdiagnosis rate in practice. The aim of the present study was to develop an artificial intelligence (AI) pipeline for diagnosing HCC patients with BDTT using medical images. The proposed AI pipeline includes two stages. First, the object detection neural network Faster R-CNN is adopted to identify DBDs; then, an HCC patient is diagnosed to have BDTT if the proportion of images with at least one identified DBD exceeds some threshold value. The proposed AI pipeline was applied to a real dataset consisting of 2,611 CT images collected from 34 HCC patients (16 with BDTT and 18 without BDTT). The average true positive rate for identifying DBDs per patient was 0.92, while the patient-level true positive rate for diagnosing BDTT was 0.94. The area under ROC curve for patient-level diagnosis of BDTT was 0.92 (95% CI: 0.83, 1.00), compared with 0.71 (95% CI: 0.52, 0.89) by random forest based on preoperative clinical variables. These results demonstrated that the proposed AI pipeline is successful in the diagnosis of BDTT. The automatic detection of DBDs is a key step in early diagnosis of HCC patients with BDTT, and is helpful in the treatment and prognosis of these patients.


2021 ◽  
Vol 9 (1) ◽  
pp. 239
Author(s):  
Birma Ram ◽  
Manoj Gopinath ◽  
Saroj Chaudhary ◽  
Desymol Johnson

Spigelian hernia is a relatively uncommon hernia of anterior abdominal wall, occurring in different anatomical tissue planes. It is a variant of inter-parietal hernia. Preoperative diagnosis of obstructed inter-parietal hernia is based on imaging. Once correctly diagnosed it is easily amenable to surgical repair. We present a case of Spigelian hernia presenting as right iliac fossa lump with features of small bowel obstruction.


2021 ◽  
pp. 1-4
Author(s):  
Hakan Kaya ◽  
Hakan Kaya ◽  
Fatma Tokat ◽  
Saran Duren ◽  
Burak Ertas

Carcinoma showing thymus-like differentiation (CASTLE) is a rare neoplasm of the thyroid or the adjacent tissues in the neck. It was first described by Miyauchi et al. in 1985 as an intrathyroidal epithelial thymoma. In 1991 Chan and Rosai classified these tumors into four types including CASTLE. World Health Organization (WHO) declared it as an independent clinicopathologic entity in 2004. The tumor arises from ectopic thymus tissue or remnants of branchial pouch. Both sexes are affected similarly with a slight female dominance. It is usually encountered in the fourth and fifth decades of life. It does not have specific symptoms or radiologic findings which makes preoperative diagnosis difficult. It has a higher tendency to be located in the lower poles of thyroid lobes. Immunohistochemistry helps differentiate it from other malignant neoplasms, CD5 being an important marker. The tumor is negative for thyroid specific markers as thyroglobulin, TTF-1 or calcitonin. Surgery is considered the mainstream therapy. Radiotherapy may be reserved for gross disease or recurrence. The role of chemotherapy is unclear. The prognosis of CASTLE is favourable.


2021 ◽  
Vol 33 (4) ◽  
pp. 300-302
Author(s):  
Özen Esra Karaman ◽  
Çetin Kılıççı ◽  
Pelin Özdemir Önder

Castleman’s disease was first described by Castleman et al. in 1956 as a non-lymphoproliferative disease. Castleman’s disease (CD), or angiofollicular lymphoid hyperplasia, is a rare disease with unknown etiology that can be easily misdiagnosed as lymphoma, neoplasm, or infection. Very few cases of pelvic origin and observed in pregnancy have been reported in the literature and are usually asymptomatic. Preoperative diagnosis is very difficult due to nonspecific imaging findings and rarity; most cases are diagnosed based on postoperative pathological examination. In this paper, a case of a 36-year-old pregnant woman suspected of adnexal origin in the uterine posterolateral, which was detected incidentally by ultrasound, was presented. The patient underwent a successful mass excision. Pathology of mass observed to be in the pelvic retroperitoneum was detected as localized unicentric and hyaline vascular CD. The study was conducted to discuss the diagnostic tools and perioperative management needed to identify the retroperitoneal unicentric Castleman case


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