RESUMEN
Another name for the Puestow surgery is a lateral pancreaticojejunostomy. The primary pancreatic duct, which runs from the head to the tail of the organ, is opened, exposing the pancreas. In order to allow the pancreas to empty straight into the intestines, the opening of the pancreatic duct is subsequently joined to a tiny intestinal loop. For more than 50 years, this process has been used to effectively relieve pain caused by chronic pancreatitis. This technique has a very low mortality rate and a low rate of surgical complications, and a high success rate. The gradual fibrosis of the pancreas resulting in the loss of exocrine and endocrine function is known as chronic pancreatitis. Intense pain is the disease's most typical symptom. It is unclear what causes the discomfort in chronic pancreatitis. Nonetheless, a large number of these patients have dilated ducts that are made up of intervening structures and saccular dilations, a condition known as the "chain of lakes" phenomenon. Radiological investigations can be used for diagnosis in these patients. Lateral pancreaticojejunostomy is the most effective treatment option for these individuals. Preservation of endocrine and exocrine pancreatic function is another benefit of lateral pancreaticojejunostomy. With lateral pancreaticojejunostomy, chronic fibrocalcific pancreatitis that manifests as pancreatic ductal dilatation and persistent discomfort can be effectively treated. Excellent early outcomes have been observed in terms of pain alleviation as well as post-operative morbidity and mortality; however, the patient's overall outcome and long-term follow-up have not been as well defined.
RESUMEN
This case report explores the complex diagnostic dilemma between the Chilaiditi sign and the pneumoperitoneum. The patient presented with chronic complaints of vague abdominal pain, abdominal distension, and breathlessness. A chest X-ray indicated an elevated right hemidiaphragm with transverse colon interposition, leading to the diagnosis of Chilaiditi's sign. Subsequent imaging, including abdominal ultrasound and contrast-enhanced computed tomography, revealed a large non-enhancing multilobulated multicystic mass adherent to the anterior wall of the uterus, raising suspicions of malignancy. Managed by gynecologists, the patient underwent a total abdominal hysterectomy, mass excision, and bilateral salpingo-oophorectomy. The discussion delves into Chilaiditi's sign, its historical context, and its complex pathophysiology involving intestinal, hepatic, and/or diaphragmatic components. Various anatomical and functional factors contributing to this condition are explored. This case highlights the importance of considering the Chilaiditi sign in patients with radiologic evidence of subdiaphragmatic air. It emphasizes the need for timely and accurate diagnosis to differentiate it from more severe conditions like pneumoperitoneum. Such consideration aids in optimizing management strategies and preventing unnecessary investigations.
RESUMEN
Chronic lower limb lymphedema is a challenging and often debilitating medical condition characterized by the abnormal accumulation of lymphatic fluid in the extremities, leading to persistent swelling and discomfort. While this condition can be caused by various underlying factors, early diagnosis, and appropriate management are crucial for improving the patient's quality of life. This case report presents the successful surgical management of chronic lower limb lymphedema in a 30-year-old male patient who had been grappling with this condition for a decade. The patient's journey from the onset of symptoms, including swelling and difficulty in walking, to the eventual diagnosis and treatment is documented herein. Despite seeking medical care from allopathic and homeopathic sources, the patient's condition continued to deteriorate over the years, underscoring the complexity of chronic lower limb lymphedema and its challenges in clinical management. This case highlights the importance of accurate diagnosis, multidisciplinary evaluation, and a comprehensive surgical approach in addressing the complexities of chronic lower limb lymphedema. It also sheds light on the potential complications that may arise during treatment and the postoperative care required to achieve a favorable outcome. By sharing this case, we aim to contribute to understanding this condition and provide insights into the effective management of chronic lower limb lymphedema.
RESUMEN
Breast fibroadenomas, common benign conditions, exhibit distinct clinical and histopathological features. This review highlights clinical presentation and histology correlations, providing insights for healthcare providers. Palpable masses, pain, and changes in breast appearance align with glandular and stromal components, emphasizing accurate diagnosis. Mammography, ultrasound, and MRI guide tailored treatment decisions. Challenges in differentiating atypical fibroadenomas highlight the need for meticulous histopathological evaluation. Clinical implications stress patient-centered care, shared decision-making, and ongoing follow-up. Future research focuses on genetic investigations and long-term studies. A multidisciplinary approach to breast fibroadenomas ensures comprehensive care for improved outcomes in both medical and emotional aspects.