ABSTRACT
Malignant sweat gland tumors are very rare. Hidradenocarcinoma is an uncommon malignancy arising from the intradermal ductal epithelium of eccrine sweat glands, usually in the sun-exposed parts of the body. It usually arises de novo but may develop from a benign hidradenoma. The diagnosis of hidradenocarcinoma is clinically challenging as it presents with varied consistency and clinically mimics other skin lesions such as chronic sebaceous cysts or epidermoid cysts. Hidradenocarcinoma is a highly aggressive tumor with a tendency for regional and distant spread. It is difficult to treat hidradenocarcinoma as it has high rates of morbidity and mortality and a very high incidence of recurrence. Here, we report a rare case of a 45-year-old woman who presented with a recurrent lump over the left arm diagnosed as primary hidradenocarcinoma.
ABSTRACT
A persistent sciatic artery (PSA) is a rare congenital vascular anomaly with an extremely low incidence of about 0.04%-0.06%. It is due to the persistence of the embryological axial limb artery, representing a continuation of the internal iliac artery into the thigh through the greater sciatic foramen below the piriformis muscle and down the thigh alongside the sciatic nerve. In normal embryologic development of the lower limb, the axial artery normally regresses after week 12. Persistent sciatic artery is often asymptomatic until a complication develops, it can be classified into two types, complete and incomplete. PSA can cause serious lower limb complications such as acute or critical limb ischemia.
RésuméUne artère sciatique persistante (APS) est une anomalie vasculaire congénitale rare avec une incidence extrêmement faible d'environ 0,04 % à 0,06 %. Cela est dû à la persistance de l'artère axiale embryologique des membres, représentant une continuation de l'artère iliaque interne dans la cuisse à travers la grande foramen sciatique sous le muscle piriforme et le long de la cuisse le long du nerf sciatique. Dans le développement embryologique normal de la partie inférieure membre, l'artère axiale régresse normalement après la semaine 12. L'artère sciatique persistante est souvent asymptomatique jusqu'à ce qu'une complication se développe, elle peut être classés en deux types, complets et incomplets. Le PSA peut entraîner des complications graves des membres inférieurs telles qu'une ischémie aiguë ou critique des membres.
Subject(s)
Iliac Artery , Humans , Iliac Artery/abnormalities , Iliac Artery/diagnostic imaging , Male , Female , Treatment Outcome , Vascular Malformations/diagnosis , Vascular Malformations/diagnostic imaging , Lower Extremity/blood supply , Thigh/blood supply , Sciatic Nerve/abnormalities , Sciatic Nerve/blood supply , Sciatic Nerve/diagnostic imagingABSTRACT
Background and Objective: Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is usually preferred surgical treatment for ulcerative colitis (UC). Although treated primarily medically, some refractory and complicated cases of UC may require surgical intervention. It eliminates chronic UC and the risk of colonic cancer. This research aims to study the risk factors associated with the development of postoperative complications. Methodology: For this cohort study, we included all the patients who underwent RPC-IPAA in the Department of Gastroenterology, Sheth Vadilal Sarabhai General Hospital, Ahmedabad, over 6 years. Data of the patients were obtained retrospectively from the medical records. We collected the data and analyzed using appropriate statistical tests to look for preoperative patient variables associated with late complications. Late complications were defined as those developed after 1 month. Results: Out of 32 patients, 19 were male and 13 were female, with an average age of 32.3 years at the time of operation. Thirteen patients developed complications such as pouchitis (n = 6), incisional hernia (n = 3), bowel obstruction (n = 2), pouch leakage (n = 1), and erectile dysfunction (n = 1). We found serum albumin <3 mg/dl and pancolitis associated with more postoperative late complications with P = 0.007 and 0.04, respectively, which is statistically significant. Conclusion: This study demonstrates that low preoperative albumin level and pancolitis are risk factors for late complications of IPAA. Preoperative nutritional support, especially albumin, could reduce late complications.
Résumé L'IPAA (iléopouch-anal anastomose) est une procédure chirurgicale complexe qui, lorsqu'elle est réalisée par un chirurgien expérimenté, peut donner d'excellents résultats. De plus, il est important de comprendre les complications et leur prise en charge. Nos résultats mettent en lumière les facteurs associés aux complications chez les patients ayant subi une IPAA (iléopouch-anal anastomose) pour la CU (colite ulcéreuse). Dans notre population d'échantillon, une concentration sérique d'albumine préopératoire inférieure à 3 mg/dl et une pancolite ont été associées à des complications postopératoires. Cette étude démontre que des taux d'albumine préopératoires bas et la pancolite sont des facteurs de risque de complications tardives de l'IPAA. Un soutien nutritionnel préopératoire, en particulier l'albumine, pourrait réduire les complications tardive. Mots-clés: Iléite de reflux, Hypoalbuminemia, pancolite, colite ulcéreuse, pouchite.