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1.
J Cardiothorac Surg ; 19(1): 576, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39354627

RESUMEN

BACKGROUND: In this paper, a rare case is reported, where the patient is a 74-year-old man. He suffered from recurrent pneumothorax within half a year and experienced a relapse after receiving conservative treatments. CASE PRESENTATION: Diagnostic workup revealed a cystic lesion in the right middle lobe, which has been interpreted as a bulla during the initial chest CT scan. Due to recurrent pneumothorax and poor response to the conservative treatments, the patient underwent bullectomy and pleurodesis. The pathology showed that the wall of the cystic lesion was invasive adenocarcinoma. CONCLUSIONS: This case highlights the importance of monitoring cystic lesions in the lungs, especially in patients with a history of smoking and emphysema.


Asunto(s)
Adenocarcinoma , Neoplasias Pulmonares , Neumotórax , Tomografía Computarizada por Rayos X , Humanos , Masculino , Neumotórax/etiología , Anciano , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Recurrencia , Quistes/cirugía , Quistes/diagnóstico por imagen , Quistes/diagnóstico , Adenocarcinoma del Pulmón/diagnóstico , Adenocarcinoma del Pulmón/patología , Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma del Pulmón/cirugía , Pleurodesia
2.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 38(10): 935-939;946, 2024 Oct.
Artículo en Chino | MEDLINE | ID: mdl-39390933

RESUMEN

Objective:To explore the differences in clinical presentation and therapeutic outcomes between vocal fold fibrocystic degeneration and other common benign lesions, such as vocal fold polyp and cyst. Methods:Vocal function was assessed before and after surgery in 10 cases of vocal fold fibrocystoids, 30 cases of vocal fold polyps and 10 cases of vocal fold cysts at Department of Voice Medicine, Xiamen University Zhongshan Hospital. The voice Assessments included GRBAS(G-scale), VHI-10 scale, Reflux Symptom Index(RSI) scale, stroboscope, acoustic objective analysis, and aerodynamics measurements. The acoustice analysis parameters included fundamental frequency(F0), fundamental frequency perturbation(Jitter), amplitude perturbation(Shimmer) and voice disturbance severity index(DSI), while the maximum phonation time(MPT) was assessed for aerodynamics. Stroboscopic parameters included vocal fold straightness, vocal fold color, glottic closure and mucosal wave. All three groups underwent phonomicrosurgery and a follow-up review was conducted one month later. Pre-and post-operative function assessment parameters were compared across the three groups. Results:Significant differences were founded in the G grade, Jitter, Shimmer, DSI, glottic closure and mucosal wave between the vocal fold fibrocystic degeneration group and the vocal fold polyp and vocal fold cyst group(P<0.05). Most voice function parameters in all three groups showed significant improvement after surgery(P<0.05). The improvement of VHI(10), RSI and mucosal wave scores in the vocal fold fibrocystic lesion group was significantly different from that of the vocal fold polyp group(P<0.05). Conclusion:Vocal fold fibrocystic degeneration is a more severe than that of vocal fold polyps and cysts, which are two common benign vocal fold lesions. Phonomicrosurgery is an effective treatment for vocal fold fibrocystic degeneration, but its curative effect are less favorable compared to those for vocal fold polyps and vocal fold cysts. Therefore, a detailed preoperative evaluation is essential for predicting surgical outcomes.


Asunto(s)
Quistes , Enfermedades de la Laringe , Pliegues Vocales , Calidad de la Voz , Humanos , Pliegues Vocales/cirugía , Pliegues Vocales/patología , Quistes/cirugía , Enfermedades de la Laringe/cirugía , Femenino , Masculino , Pólipos/cirugía , Persona de Mediana Edad , Adulto , Resultado del Tratamiento
3.
World J Surg Oncol ; 22(1): 231, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39232740

RESUMEN

BACKGROUND: Splenic cysts are uncommon and very rarely malignant therefore their treatment isn't standardized. In case of symptomatic cysts different surgical approaches have been suggested. Primary malignant lymphoma of the spleen comprises less than 1% of non-Hodgkin's lymphomas. To our knowledge, only 203 cases of splenic large B-cell lymphoma (LBCL) have been reported to date and only 2 of them were fibrin-associated splenic cysts. CASE PRESENTATION: 27-year-old model with a 19 × 13 cm splenic cyst without data of malignancy in the preliminary study and therefore treated with laparoscopic deroofing. After histological diagnosis of LBCL with a fibrin/EBV-associated splenic pseudocyst, the patient received 4 cycles of Rituximab and a laparoscopic splenectomy was performed due to resurgence of the pseudocyst. No evidence of malignancy has been found during follow up (EBV viral load every 3 months during the first year, PET-CT every 6 months during the first year and annual afterwards) performed after the splenectomy. DISCUSSION AND CONCLUSIONS: The value of tumor markers and radiology for diagnosis of splenic cysts is put into question. Only 60 cases of Fibrin-associated LBCL (FA-LBCL) have been described in the literature therefore there are no treatment guidelines for them even though surgery together with systemic treatment has been the prevalent route with good results in most cases.


Asunto(s)
Quistes , Esplenectomía , Enfermedades del Bazo , Neoplasias del Bazo , Humanos , Esplenectomía/métodos , Adulto , Quistes/cirugía , Quistes/patología , Enfermedades del Bazo/cirugía , Enfermedades del Bazo/patología , Neoplasias del Bazo/cirugía , Neoplasias del Bazo/patología , Neoplasias del Bazo/complicaciones , Masculino , Pronóstico , Laparoscopía/métodos , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/cirugía , Linfoma de Células B Grandes Difuso/complicaciones , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B/cirugía , Linfoma de Células B/patología , Linfoma de Células B/complicaciones , Linfoma de Células B/diagnóstico , Rituximab/administración & dosificación , Rituximab/uso terapéutico
4.
BMC Pediatr ; 24(1): 580, 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39272011

RESUMEN

BACKGROUND: Prenatally diagnosed hepatic hilar cysts are a challenging finding for the clinician. They can either be a sign of cystic biliary atresia (BA) or a choledochal cyst (CC), two diagnoses with different postnatal management and prognosis. Based on a case report of four patients, we aim to propose a management algorithm for prenatally diagnosed "hepatic hilar cysts". CASE PRESENTATION: A hepatic hilar cyst, ranging from 5 to 25 mm, was detected prenatally in all four girls confirmed postnatally along with the presence of a gallbladder. Stool color was normal until two weeks of life at which time the stool color became lighter, and the patients developed cholestasis. All were operated before seven weeks of life: Case 1 had a CC with patent but irregular intrahepatic bile ducts at intraoperative cholangiogram, and no communication with the duodenum. A Roux-en-Y bilioenteric anastomosis was performed. The cyst showed complete epithelial lining loss, and liver pathology showed BA features. Case 2 had the final diagnosis of cystic BA with patent but abnormal intrahepatic bile ducts. She underwent two operations: the first operation at four weeks as described for case 1, since intraoperative findings were similar, as was histology. As cholestasis increased postoperatively, she underwent a Kasai hepato-porto-enterostomy six weeks later, where distinct BA findings were found with complete scarring of the hilar plate. Case 3 had a cystic BA with the cyst located within the common bile duct and atretic bile ducts proximal to the porta hepatis. It exhibited no communication with the liver or duodenum. A Kasai operation was performed, with histology showing complete epithelial loss within the cyst wall and scarring of the hilar plate. Case 4 had a cystic BA presenting a completely obliterated hepatic duct with the cyst lying within the common bile duct. A Kasai procedure was performed. Histology showed a common bile duct with a residual lumen of 0.1 mm. CONCLUSIONS: The spectrum of disease from CC to BA in the setting of a prenatally discovered hepatic hilar cyst is emphasized. Even if cholangiogram differentiates most patients with BA from those with CC, caution is advised for transitional types.


Asunto(s)
Atresia Biliar , Quiste del Colédoco , Vesícula Biliar , Humanos , Quiste del Colédoco/cirugía , Quiste del Colédoco/diagnóstico por imagen , Femenino , Atresia Biliar/cirugía , Atresia Biliar/diagnóstico , Atresia Biliar/complicaciones , Vesícula Biliar/anomalías , Vesícula Biliar/patología , Vesícula Biliar/cirugía , Recién Nacido , Embarazo , Ultrasonografía Prenatal , Diagnóstico Diferencial , Quistes/cirugía , Quistes/diagnóstico por imagen , Lactante
5.
Clin Radiol ; 79(11): 842-850, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39237391

RESUMEN

AIM: Due to the rarity of lung cancer with cystic imaging manifestations, we explore the clinical features and survival prognosis of such tumors. MATERIALS AND METHODS: Imaging characteristics were used to categorize 3,556 patients who underwent surgery for isolated primary lung cancer into one of three groups: those with cystic lung cancer (149), solid lung cancer (1,399), and ground-glass lung cancer (1,160). Propensity score matching by sex and age was performed to analyze the differences in clinical characteristics of lung cancer among the three groups and the correlation between clinical characteristics of cystic lesions and progression-free survival (PFS). RESULTS: The three groups of patients differed in various aspects, including pathological type, smoking history, tumor stage, type of surgery, histological grading, and PFS (P < 0.05). The results of the multifactorial analysis indicated that lung cancer type, pathological type, lymph node metastasis, tumor stage, and histologic grading were independent prognostic factors for lung cancer (P < 0.05). After comparison, there was a difference in prognosis between cystic lung cancer and ground-glass lung cancer (P < 0.05). CONCLUSION: The clinical features of cystic lung cancer are significantly different from those of ground-glass lung cancer and solid lung cancer. Cystic lesions are independent influencing factors affecting lung cancer, and the prognosis of cystic lung cancer is worse than that of ground-glass lung cancer.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Humanos , Masculino , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/patología , Femenino , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Pronóstico , Persona de Mediana Edad , Anciano , Quistes/diagnóstico por imagen , Quistes/patología , Quistes/cirugía , Tomografía Computarizada por Rayos X/métodos , Estudios Retrospectivos , Adulto , Estadificación de Neoplasias
6.
J Med Case Rep ; 18(1): 444, 2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39307876

RESUMEN

BACKGROUND: Intestinal duplication cyst is an infrequent congenital malformation that can involve all the segments of the gastrointestinal tract. The cases of intestinal duplication cyst involving the colon, appendix, and ileum in children are particularly uncommon. The symptoms of abdominal pain are similar to other acute abdominal diseases in children, such as appendicitis, intussusception, and intestinal obstruction, so sometimes its diagnosis is challenging and leads to misdiagnosis. CASE PRESENTATION: We report a 4-year-old Asian boy who presented to the pediatric emergency department with abdominal pain and vomiting but no fever, peritonitis, or mass. No abdominal abnormality was found via radiology and ultrasonography. After 2 days' anti-inflammatory therapy, the patient was discharged with pain relief. A total of 9 months later, he was readmitted to the pediatric emergency department for the same complaint as the first admission. Abdominal physical examination and ultrasound examination were still negative. Barium examination found a large mass in the colon. Colonoscopy was performed before operation to confirm the rare co-cavity intestinal duplication cyst involving the colon, appendix, and ileum. After resection of intestinal duplication and ileocolonic anastomosis, the patient's abdominal pain and vomiting has not recurred for 5 years postoperatively. CONCLUSIONS: The diagnosis of intestinal duplication cyst in children is difficult, especially the rare co-cavity and long segmental intestinal duplication, which is easily misdiagnosed. Colonoscopy may be an effective auxiliary diagnostic method, especially for diseases that are difficult to diagnosed clinically, such as recurrent abdominal pain.


Asunto(s)
Dolor Abdominal , Apéndice , Colonoscopía , Quistes , Humanos , Masculino , Preescolar , Dolor Abdominal/etiología , Quistes/diagnóstico por imagen , Quistes/cirugía , Quistes/complicaciones , Quistes/diagnóstico , Quistes/congénito , Apéndice/anomalías , Apéndice/diagnóstico por imagen , Íleon/anomalías , Íleon/diagnóstico por imagen , Recurrencia , Colon/anomalías , Colon/diagnóstico por imagen
7.
J Investig Med High Impact Case Rep ; 12: 23247096241271986, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39215676

RESUMEN

We report a case of a 26-year-old type 1 diabetic woman presenting with acute lower abdominal pain, bloating, and vomiting. Initial examination revealed right lower quadrant tenderness and a suprapubic mass. Computed tomography (CT) imaging identified a 12-cm cystic structure suggestive of a dilated bowel loop with an adjacent inflamed 7-cm small bowel segment. Surgical exploration uncovered a Merkel's diverticulum-associated duplication cyst originating from the Meckel's diverticulum. Subsequent complications included an anastomotic leak, requiring relook laparotomy and the formation of a double-barrel stoma. The patient recovered and was discharged on day 13. This case highlights the diagnostic challenge of Meckel's diverticulum-associated duplication cysts, emphasizing the need for vigilance in managing complex abdominal presentations.


Asunto(s)
Abdomen Agudo , Quistes , Divertículo Ileal , Tomografía Computarizada por Rayos X , Humanos , Divertículo Ileal/complicaciones , Divertículo Ileal/cirugía , Divertículo Ileal/diagnóstico por imagen , Femenino , Abdomen Agudo/etiología , Adulto , Quistes/cirugía , Quistes/complicaciones , Quistes/diagnóstico por imagen
8.
Clin Neurol Neurosurg ; 245: 108498, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39116794

RESUMEN

BACKGROUND: The Hydrocephalus Clinical Research Network-quality group (HCRNq) historically defined all abdominal pseudocysts associated with a ventriculoperitoneal shunt as a surgical site infection regardless of culture result. METHODS: We retrospectively reviewed broad-range polymerase chain reaction (BRPCR) results sent between January 2017 and July 2023 from abdominal pseudocyst fluid sent from hospitals around the country to a reference laboratory to help further characterize these collections. RESULTS: A total of 19 samples were tested via BRPCR between 1/2017 and 7/2023. Two (10.5 %) had organisms identified; one with Staphylococcus epidermidis and one with Candida parapsilosis. No fastidious organisms that would be expected to not grow with typical culture techniques were identified. CONCLUSIONS: Few abdominal pseudocysts had organisms identified by BRPCR, suggesting that not all pseudocysts are due to infectious causes. Consideration should be given to alternate causes of pseudocyst development when cultures are negative.


Asunto(s)
Reacción en Cadena de la Polimerasa , Infección de la Herida Quirúrgica , Derivación Ventriculoperitoneal , Humanos , Derivación Ventriculoperitoneal/efectos adversos , Infección de la Herida Quirúrgica/microbiología , Estudios Retrospectivos , Abdomen/cirugía , Masculino , Quistes/microbiología , Quistes/cirugía , Femenino , Candida parapsilosis/genética , Staphylococcus epidermidis/genética , Persona de Mediana Edad , Anciano , Candidiasis/microbiología , Infecciones Estafilocócicas/microbiología
9.
Clin Neurol Neurosurg ; 245: 108517, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39173493

RESUMEN

We present the case of a patient with leukoencephalopathy with calcifications and cysts (LCC), who experienced progressive severe hemiparesis despite multiple neurosurgical interventions of a large contralateral cyst. Bevacizumab was proposed as an ultimate treatment option based on prior case reports. While awaiting reimbursement approval for bevacizumab, major improvement occurred in both clinical and radiological disease manifestations. The disease course of LCC is variable and unpredictable; neurosurgical treatment should be reserved for severe and progressive neurological deficits. Bevacizumab has been reported as a promising alternative treatment option. Importantly, in our case the observed clinical improvement would have been attributed to the effects of bevacizumab, if started when requested. Our case underscores the need for a natural history study for LCC and the necessity of validating treatment efficacy by systematic evaluation through appropriate clinical trials rather than relying on anecdotal evidence from published case reports.


Asunto(s)
Calcinosis , Leucoencefalopatías , Humanos , Leucoencefalopatías/diagnóstico por imagen , Leucoencefalopatías/complicaciones , Leucoencefalopatías/tratamiento farmacológico , Calcinosis/diagnóstico por imagen , Calcinosis/tratamiento farmacológico , Calcinosis/cirugía , Calcinosis/complicaciones , Quistes/cirugía , Quistes/complicaciones , Quistes/diagnóstico por imagen , Masculino , Bevacizumab/uso terapéutico , Persona de Mediana Edad , Imagen por Resonancia Magnética , Femenino , Quistes del Sistema Nervioso Central/cirugía , Quistes del Sistema Nervioso Central/complicaciones , Quistes del Sistema Nervioso Central/diagnóstico por imagen , Quistes del Sistema Nervioso Central/tratamiento farmacológico
10.
BMJ Case Rep ; 17(8)2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39097321

RESUMEN

Enteric duplication has cystic and tubular varieties. A male infant presented with a large cystic, well-demarcated mass in the right flank. On exploratory laparotomy, multiple cystic and tubular lesions were present adjacent to the mesenteric border of the small bowel along with malrotation of the small bowel. The tubule-cystic structure was excised along with the involved normal bowel segment and Ladd's procedure was performed. Histopathological evaluation revealed an intestinal duplication cyst. The occurrence of midgut malrotation and volvulus along with duplication is uncommon. The cyst's substantial size could have been an aetiological factor for malrotation and volvulus. The child's small bowel had adapted remarkably with time. This case highlights a new variant of duplication cysts.


Asunto(s)
Vólvulo Intestinal , Humanos , Masculino , Lactante , Vólvulo Intestinal/cirugía , Vólvulo Intestinal/diagnóstico , Intestino Delgado/anomalías , Intestino Delgado/cirugía , Intestino Delgado/patología , Quistes/cirugía , Laparotomía/métodos , Anomalías del Sistema Digestivo/cirugía , Anomalías del Sistema Digestivo/complicaciones , Anomalías del Sistema Digestivo/diagnóstico por imagen
11.
Afr J Paediatr Surg ; 21(3): 184-187, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-39162752

RESUMEN

ABSTRACT: Tailgut cysts are rare congenital abnormalities that develop due to failure of embryologic tailgut to involute. This generally manifests as a presacral, retrorectal and multicystic mass. It has a high propensity in female patients including paediatric age group. The clinical presentation varies depending on the age of patient, location and size of the cyst. The symptoms are mostly due to mass effects and rarely complications such as malignancy. Being a rare entity, it is generally misdiagnosed. Differential diagnosis mostly includes rectal duplication cyst, sacrococcygeal teratoma and anterior meningocele. Radiological imaging such as computed tomography scan and magnetic resonance imaging is useful in the diagnosis. The treatment of choice is complete excision to prevent recurrence, infection and malignant degeneration. We have reviewed previous literature and given our valuable information regarding the same.


Asunto(s)
Quistes , Humanos , Quistes/cirugía , Quistes/diagnóstico , Diagnóstico Diferencial , Femenino , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Niño , Recto/cirugía , Recto/diagnóstico por imagen , Región Sacrococcígea
12.
Medicine (Baltimore) ; 103(33): e39287, 2024 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-39151515

RESUMEN

RATIONALE: Multilocular cystic hemangioma is a rare benign tumor classified as an atypical hemangioma. Currently, there are limited imaging reports available, and the imaging characteristics can be challenging to distinguish from other malignant multilocular cystic liver diseases such as cystadenocarcinoma, necessitating confirmation through pathological diagnosis. Here, we discuss the imaging features of 3 cases of multilocular cystic hemangiomas. PATIENT CONCERNS AND DIAGNOSES: Case 1 was a 24-year-old young female, and Case 2 involved a 60-year-old elderly male. Both patients were asymptomatic and physical examination revealed hepatic space-occupying lesions. Imaging findings revealed multilocular cystic lesions in the left liver with septa, calcification, a high diffusion-weighted magnetic resonance imaging (DWI) signal at the edge of the lesion, and progressive enhancement of the cyst wall and septa. Case 3 involved a 50-year-old male patient with epigastric distending pain for 1 month and sudden severe abdominal pain for 14 hours. Imaging results revealed a multilocular cystic lesion in the left liver with septa and tumor bleeding, a high DWI signal, and an enhanced cyst wall and septa. The pathological diagnosis confirmed a hepatic hemangioma. INTERVENTIONS: All 3 patients underwent liver tumor resection. OUTCOMES: All 3 patients recovered successfully without any intraoperative or postoperative complications during the follow-up periods of 5 years, 6 months, and 5 months. There were no signs of recurrence. LESSONS: Liver imaging revealed multilocular cystic lesions with features, such as compartmentalization, calcification, or bleeding. Multilocular cystic hemangiomas should be considered in imaging diagnosis. Enhancing our understanding of multilocular cystic hemangiomas can aid in improving the differential diagnosis of other malignant multilocular cystic liver diseases, ultimately reducing unnecessary liver resection.


Asunto(s)
Hemangioma , Neoplasias Hepáticas , Humanos , Masculino , Persona de Mediana Edad , Hemangioma/cirugía , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagen , Hemangioma/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/cirugía , Neoplasias Hepáticas/diagnóstico , Femenino , Adulto Joven , Diagnóstico Diferencial , Quistes/diagnóstico por imagen , Quistes/cirugía , Quistes/patología , Quistes/diagnóstico , Hígado/patología , Hígado/diagnóstico por imagen , Tomografía Computarizada por Rayos X
13.
BMC Musculoskelet Disord ; 25(1): 620, 2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39095720

RESUMEN

BACKGROUND: The Internal Fixator (INFIX) is a popular method, known for its minimal invasiveness and short operation time, for treating anterior pelvic ring fractures. Studies have shown that postoperative complications may occur, including anterolateral femoral cutaneous nerve injury, the femoral nerve paralysis, and delayed fracture healing. These complications are believed to be related to surgical stimulation, an excessively long lateral end of the connecting rod, a small distance between the screw and bone surface, insufficient pre-bending of the connecting rod, and difficulties in fracture reduction. CASE PRESENTATION: We report two unique cases of lower abdominal pseudocyst complicated with suspected infection after INFIX treatment of pelvic fractures at our trauma center. Following surgical removal of the internal fixation, resolution of the cysts was observed in both patients, and subsequent postoperative follow-up revealed the absence of any residual sequelae. These cases have not been reported in previous literature reviews. DISCUSSION: The lower abdominal cysts, potentially arising from the dead space created during intraoperative placement of the INFIX rod, may increase infection risk. The etiology remains uncertain, despite the presence of abnormal inflammation markers in both cases, and staphylococcus aureus found in one. These cysts were confined to the lower abdomen, not involving the internal fixation, and hence, only the INFIX was removed. Postoperative oral cefazolin treatment was successful, with resolved pseudocysts and no subsequent discomfort. CONCLUSION: We report two unprecedented cases of post-INFIX abdominal cysts, with a suspected link to intraoperative dead space. Despite uncertain etiology, successful management involved INFIX removal and oral cefixime therapy. These findings necessitate further exploration into the causes and management of such complications.


Asunto(s)
Quistes , Fijación Interna de Fracturas , Fracturas Óseas , Huesos Pélvicos , Humanos , Antibacterianos/uso terapéutico , Quistes/etiología , Quistes/cirugía , Fijación Interna de Fracturas/efectos adversos , Fracturas Óseas/cirugía , Fracturas Óseas/complicaciones , Huesos Pélvicos/lesiones , Huesos Pélvicos/cirugía , Huesos Pélvicos/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/diagnóstico
14.
Rev Med Inst Mex Seguro Soc ; 62(1): 1-6, 2024 Jan 08.
Artículo en Español | MEDLINE | ID: mdl-39116267

RESUMEN

Background: Adrenal gland cysts are a rare entity, with a reported incidence in post-mortem series of 0.06-0.18%. However, the incidence seems to be increasing in recent years. The presentation of adrenal gland cysts is usually asymptomatic, but those cases in which symptoms are present are usually non-specific, which makes adrenal cysts generally recognized as incidentalomas. The finding is mainly made by computed tomography. The main objective of this article was to describe the clinical course of a patient with an adrenal gland pseudocyst, which is accompanied by symptoms of compression and persistent pain of long evolution in the left flank. Clinical case: A 65-year-old female patient attended the emergency room of a second-level hospital due to an increase in volume of the abdominal region with a sensation of fullness, heartburn, vomiting and pain. Computed tomography was performed, which reported a cystic mass and, later, exploratory laparotomy plus adrenalectomy were carried out. The pathology analysis reported a diagnosis of a 10 x 15 x 14 cm solid, cystic, and adherent tumor, coinciding with a pseudocyst of the adrenal gland. Conclusions: Adrenal gland cysts are rare. Computed tomography is recommended for its diagnosis and the standard of treatment is surgical intervention in the presence of symptoms.


Introducción: los quistes de glándula suprarrenal son una entidad rara, con un reporte en la incidencia de series post mortem de 0.06-0.18%. Sin embargo, la incidencia parece ir en aumento en los últimos años. La presentación de los quistes de glándula suprarrenal es habitualmente asintomática, pero en aquellos casos en que se presentan síntomas, estos suelen ser inespecíficos, lo cual hace que los quistes suprarrenales generalmente sean reconocidos como incidentalomas. El hallazgo se hace principalmente mediante tomografía computarizada. El objetivo principal de este artículo fue describir el curso clínico de una paciente con un pseudoquiste de glándula suprarrenal, que se acompaña de síntomas de compresión y dolor persistente de larga evolución en el flanco izquierdo. Caso clínico: mujer de 65 años que acudió a urgencias de un hospital de segundo nivel por aumento de volumen de región abdominal con sensación de plenitud, pirosis, vómito y dolor. Se realizó tomografía computarizada que reportó masa quística; posteriormente se realizó laparotomía exploradora y adrenalectomía. El análisis de patología reportó diagnóstico de tumor de 10 x 15 x 14 cm, sólido, quístico y adherido, coincidente con pseudoquiste de glándula suprarrenal. Conclusiones: los quistes de glándula suprarrenal son raros. Para su diagnóstico se recomienda realizar tomografía computarizada y el estándar de tratamiento es la intervención quirúrgica ante la presencia de sintomatología.


Asunto(s)
Enfermedades de las Glándulas Suprarrenales , Quistes , Humanos , Femenino , Anciano , Enfermedades de las Glándulas Suprarrenales/diagnóstico , Enfermedades de las Glándulas Suprarrenales/cirugía , Quistes/diagnóstico , Quistes/cirugía
15.
Acta Neurochir (Wien) ; 166(1): 323, 2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39096400

RESUMEN

BACKGROUND: Our aim was to determine whether the Apparent Diffusion Coefficient is able to predict the presence of a symptomatic pineal cyst by detecting cerebral edema. METHODS: We retrospectively analyzed MRIs of 45 patients with pineal cysts before and after resection and 51 patients without pineal cysts, comparing ADC values of thalamus, central, periventricular and subcortical white matter. Furthermore we evaluated cyst size and morphology and analyzed its correlation to ADC values in corresponding patients. RESULTS: Differences between patients with symptomatic pineal cyst and control group were not significant (p = 0.200 - 0.968). ADC ratios did not change significantly after resection of the cyst (p = 0.575 - 0.862). Cyst size showed no significant correlation to ADC ratios (p = 0.071 - 0.918). Raw data analyses revealed more significance, especially periventricularly and in central white matter, which resulted in significant interhemispheric differences in ADC ratios in both subgroups (p < 0.001 and p = 0.031). MRI of 1.5T showed consistently higher values than 3T but mostly insignificant. CONCLUSION: Our analysis revealed no evidence that pineal cysts lead to intracerebral edema caused by venous compression. Since variability was higher than the differences seen, ADC sequences do not appear to be an appropriate diagnostic tool for symptomatic pineal cysts.


Asunto(s)
Edema Encefálico , Quistes , Glándula Pineal , Humanos , Estudios Retrospectivos , Femenino , Masculino , Adulto , Glándula Pineal/diagnóstico por imagen , Glándula Pineal/cirugía , Glándula Pineal/patología , Persona de Mediana Edad , Quistes/diagnóstico por imagen , Quistes/cirugía , Quistes/patología , Edema Encefálico/diagnóstico por imagen , Adulto Joven , Adolescente , Anciano , Imagen por Resonancia Magnética/métodos , Niño , Quistes del Sistema Nervioso Central/diagnóstico por imagen , Quistes del Sistema Nervioso Central/cirugía , Quistes del Sistema Nervioso Central/patología , Imagen de Difusión por Resonancia Magnética/métodos , Biomarcadores/análisis
16.
World J Gastroenterol ; 30(27): 3278-3283, 2024 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-39086743

RESUMEN

Gastric cancer presents a significant global health burden, as it is the fifth most common malignancy and fourth leading cause of cancer mortality worldwide. Variations in incidence rates across regions underscores the multifactorial etiology of this disease. The overall 5-year survival rate remains low despite advances in its diagnosis and treatment. Although surgical gastrectomy was previously standard-of-care, endoscopic resection techniques, including endoscopic mucosal resection and endoscopic submucosal dissection (ESD) have emerged as effective alternatives for early lesions. Compared to surgical resection, endoscopic resection techniques have comparable 5-year survival rates, reduced treatment-related adverse events, shorter hospital stays and lower costs. ESD also enables en bloc resection, thus affording organ-sparing curative endoscopic resection for early cancers. In this editorial, we comment on the recent publication by Geng et al regarding gastric cystica profunda (GCP). GCP is a rare gastric pseudotumour with the potential for malignant progression. GCP presents a diagnostic challenge due to its nonspecific clinical manifestations and varied endoscopic appearance. There are several gaps in the literature regarding the diagnosis and management of GCP which warrants further research to standardize patient management. Advances in endoscopic resection techniques offer promising avenues for GCP and early gastric cancers.


Asunto(s)
Resección Endoscópica de la Mucosa , Gastroscopía , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/patología , Neoplasias Gástricas/mortalidad , Resección Endoscópica de la Mucosa/métodos , Resección Endoscópica de la Mucosa/efectos adversos , Gastroscopía/métodos , Gastroscopía/efectos adversos , Resultado del Tratamiento , Quistes/cirugía , Quistes/patología , Gastropatías/cirugía , Gastropatías/patología , Gastrectomía/métodos , Gastrectomía/efectos adversos , Mucosa Gástrica/cirugía , Mucosa Gástrica/patología
18.
J Med Case Rep ; 18(1): 376, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39155375

RESUMEN

BACKGROUND: Intussusception with intestinal malrotation is termed as Waugh's syndrome. The incidence of Waugh's syndrome is less than 1%. There are very few reported cases. Once presented, it is a pediatric surgical emergency. CASE PRESENTATION: We present here two cases of Waugh's syndrome: an 11-month-old male patient of Punjabi descent and a 4-month-old female patient of Afghan descent who presented to us with abdominal pain and bleeding per rectum. Abdominal sonography revealed an intussusception with a target sign. They were explored and perioperatively had intestinal malrotation alongside intussusception, thus a diagnosis of Waugh's syndrome was made. A right hemicolectomy and Ladd's procedure was performed. CONCLUSION: Waugh syndrome is a rare congenital anomaly but can present with vague abdominal symptoms. Once presented, it is a pediatric surgical emergency. The patient should be optimized followed by surgical exploration.


Asunto(s)
Intususcepción , Humanos , Intususcepción/cirugía , Intususcepción/diagnóstico por imagen , Masculino , Femenino , Lactante , Vólvulo Intestinal/cirugía , Vólvulo Intestinal/complicaciones , Vólvulo Intestinal/diagnóstico por imagen , Enfermedades del Ciego/cirugía , Enfermedades del Ciego/complicaciones , Enfermedades del Ciego/diagnóstico por imagen , Quistes/cirugía , Quistes/complicaciones , Quistes/diagnóstico por imagen , Dolor Abdominal/etiología , Colectomía , Ultrasonografía , Síndrome , Ciego/anomalías , Ciego/cirugía , Ciego/diagnóstico por imagen
19.
Med J Malaysia ; 79(Suppl 4): 91-94, 2024 08.
Artículo en Inglés | MEDLINE | ID: mdl-39215423

RESUMEN

Splenic cysts are uncommon and classified into parasitic and non-parasitic origins. Non-parasitic cysts are further categorised into primary and secondary forms; primary cysts develop congenitally and progress into adulthood and secondary cysts result from factors such as abdominal trauma, infection or ischemia. This case series presents three instances of splenic cysts in children. The first case involves a splenic epidermoid cyst, the second a pseudocyst and the third a splenic epithelial cyst. All patients exhibited an abdominal lump in the left quadrant that increased in size over time, without additional symptoms. The third patient had a history of abdominal blunt trauma a year prior to symptom onset. Treatment approaches varied: the first and third patients underwent total splenectomy, while the second patient underwent aspiration drainage with frozen section analysis and partial splenectomy. All patients, first, second and third, were discharged 6, 3 and 5 days postoperatively, respectively, without complications. Splenic epithelial cyst (SEC) emerged as the predominant primary non-parasitic splenic cyst type, with an unclear pathogenesis. Typically asymptomatic, splenic cysts are commonly detected incidentally during imaging or exploratory laparotomy. Histopathology stands as the gold standard diagnostic method for splenic cysts. Although rare, paediatric splenic cysts should be considered in cases of abdominal trauma. Imaging serves a vital role in diagnosis, guiding decisions between conservative or surgical interventions based on cyst size, symptoms and associated complications.


Asunto(s)
Quistes , Enfermedades del Bazo , Humanos , Enfermedades del Bazo/diagnóstico , Enfermedades del Bazo/cirugía , Niño , Masculino , Quistes/diagnóstico , Quistes/cirugía , Quistes/diagnóstico por imagen , Femenino , Adolescente , Esplenectomía , Preescolar
20.
Jt Dis Relat Surg ; 35(3): 645-653, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39189575

RESUMEN

OBJECTIVES: The aim of this study was to investigate whether the presence and size of fibrous cysts affected postoperative results in patients undergoing hip arthroscopy. PATIENTS AND METHODS: Between January 2010 and December 2019, a total of 261 patients (138 males, 123 females; mean age: 39.5±11.9 years; range, 18 to 66 years) who underwent hip arthroscopy with the diagnosis of cam-pincer-mixed-type femoroacetabular impingement (FAI) and labral pathologies were retrospectively analyzed. The study groups (impingements and labral pathologies) and the presence of cyst (or cyst size: <5 mm, 5-8 mm, >8 mm) were used as the fixed effects, and the analysis was adjusted for baseline age, sex, and preoperative scores. Pre- and postoperative modified Harris Hip Score (mHHS) and Visual Analog Scale (VAS) scores that were applied to all patients were used as an indication of clinical results. RESULTS: The mean preoperative mHHS score of the patients with a cyst was significantly lower compared to the patients without a cyst (56.8±12.3 vs. 60.3±12.7, p=0.026). The mean change in the mHHS score and the mean percentage change in VAS score were significantly higher in the patients with a cyst compared to the patients without a cyst (mHHS score: 28.1±14.0 vs. 22.5±14.1, p=0.002; VAS score: 61.9±30.2 vs. 52.6±47.4, p=0.038). The increase in mHHS score over time for patients with a cyst was significantly higher than the patients without cysts in the pincer group (38.1±11.1 vs. 19.3±13.5, p<0.001). The patients with a cyst size of >8 mm had a significantly higher increase in the mHHS scores compared to the patients with a cyst size of <5 mm (29.5±12.9 vs. 23.5±13.8, p=0.043). CONCLUSION: Subchondral cysts in the femoral head and neck junction accompanied cam-type and mixed-type FAI, while subchondral cysts in the acetabulum accompanied pincer-type impingement. In all groups, the mean increase in mHHS scores and the mean decrease in VAS scores were higher in patients with subchondral cysts than in patients without cysts. In patients with subchondral cysts, if the lesion causing FAI is treated arthroscopically, it can positively affect the functional results.


Asunto(s)
Artroscopía , Quistes , Pinzamiento Femoroacetabular , Articulación de la Cadera , Humanos , Femenino , Masculino , Artroscopía/métodos , Persona de Mediana Edad , Adulto , Pinzamiento Femoroacetabular/cirugía , Pinzamiento Femoroacetabular/patología , Estudios Retrospectivos , Adolescente , Adulto Joven , Anciano , Quistes/patología , Quistes/cirugía , Articulación de la Cadera/cirugía , Articulación de la Cadera/patología , Resultado del Tratamiento
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