Percutaneous Treatment of Non-parasitic Splenic Cysts: Long-Term Results for Single- Versus Multiple-Session Treatment.

PURPOSE: The aim of this study was to investigate the efficacy and safety of percutaneous sclerotherapy for non-parasitic splenic cysts (NPSCs). The secondary aims were to introduce puncture-aspiration-injection-reaspiration (PAIR) technique in the treatment of NPSCs and to compare multiple- and single-session techniques. MATERIALS AND METHODS: This retrospective study included 24 (17 females, 7 males) patients, treated between the years 1997 and 2015. Three techniques were used. Group A (n = 8), Group B (n = 6) and Group C (n = 10) were treated by PAIR, single-session catheterization and multiple-session catheterization, respectively. Since both PAIR and single-session catheterization techniques are carried out in a single session, Group A and Group B were evaluated in one group (Group A + B). Group A + B was compared with Group C in terms of patient demographics, the initial volume of the cysts, follow-up periods, complication and hospitalization rates and follow-up results. Recurrence and reduction rates were evaluated for two groups. RESULTS: Technical success rate was 100%. The mean follow-up period was 68.9 months. Recurrence detected in 7 (29.1%) patients. Final reduction rate was between 40.7 and 100% (median 96.4%) with a significant difference in cyst volume (p < 0.05). There was no significant difference regarding recurrence rates (p = 1) and the final reduction rates (p = 0.51) between the two groups. CONCLUSION: Percutaneous sclerotherapy is a minimally invasive technique, preserving maximum tissue while effectively treating NPSCs. Single-session sclerotherapy which reduces hospitalization days and increases patient comfort is as effective as multi-session sclerotherapy as the initial procedure. This study supports that single-session sclerotherapy should be a valid treatment option.

Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases.

PURPOSE: Cystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE. MATERIALS AND METHODS: Twelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique. RESULTS: Eight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5-117 months (mean, 44.8 months), with no recurrence observed. CONCLUSION: The advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

Percutaneous Treatment of Simple Hepatic Cysts: The Long-Term Results of PAIR and Catheterization Techniques as Single-Session Procedures.

PURPOSE: The purpose of our study is to evaluate results of percutaneous aspiration with alcohol sclerotherapy in symptomatic patients with simple hepatic cysts by employing single-session techniques either by a needle or a catheter. MATERIALS AND METHODS: We retrospectively included 39 simple hepatic cysts in 35 patients treated via percutaneous aspiration and single-session alcohol sclerotherapy between years 1993 and 2012. Indications were pain (n = 28) or ruling out cystic echinococcus (CE) disease (n = 7). 29 cysts in 26 patients were treated by needle technique (Group A) and ten cysts in nine patients were treated by single-session catheter technique (Group B). Patients were followed for 4-173 months (median: 38 months). RESULTS: All patients were successfully treated. Before procedure, cyst volumes were 21-676 cc (median: 94 cc). Post-procedure cyst volumes at last follow-up were 0-40 cc (median: 1 cc). The mean decrease in cyst volume was 95.92 ± 2.86 % in all patients (95.96 ± 3.26 % in Group A and 95.80 ± 6.20 % in Group B). There was no statistically significant difference between the volume reduction rates of Group A and Group B. Only one patient, in Group B, developed a major complication, an abscess. Hospitalization period was 1 day for all patients. CONCLUSIONS: For patients with symptomatic simple hepatic cysts smaller than 500 cc in volume by using puncture, aspiration, injection, and reaspiration (PAIR) technique with only needle, single-session alcohol sclerotherapy of 10 min is a safe and effective procedure with high success rate.

Takayasu's arteritis in a case diagnosed as Crohn's disease.

Takayasu's arteritis is a chronic granulomatous vasculitis of unknown etiology that primarily affects the great arteries; the aorta and its branches, and pulmonary and coronary arteries are the most commonly affected. Takayasu's arteritis and inflammatory bowel disease in the same individual has been occasionally reported in the literature. We report a case with Takayasu's arteritis and Crohn's disease.