Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31.016
Filtrar
1.
Intern Med ; 60(20): 3261-3265, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34657906

RESUMO

Renal cyst infection is a frequent and serious complication of autosomal dominant polycystic kidney disease (ADPKD) that is often difficult to treat and can be fatal. While nephrectomy is the standard therapy for severe refractory renal cyst infection, it can be associated with severe adverse events. We experienced a case of repetitive renal cyst infection in a 58-year-old Japanese man with ADPKD on dialysis. He underwent renal transcatheter arterial embolization (TAE) four months after the last episodes of renal cyst infection, and his renal cyst infection has not recurred since renal TAE. This case suggested that renal TAE is effective for preventing repetitive renal cyst infection.


Assuntos
Cistos , Embolização Terapêutica , Rim Policístico Autossômico Dominante , Cistos/diagnóstico por imagem , Cistos/etiologia , Cistos/terapia , Humanos , Rim , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Rim Policístico Autossômico Dominante/complicações , Rim Policístico Autossômico Dominante/terapia
2.
BMJ Case Rep ; 14(9)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593548

RESUMO

Pseudocysts are localised fluid collections, usually developing as a complication of acute or chronic pancreatitis. Pancreatic ductal or parenchymal calcifications are commonly seen in routine radiological imaging, but calcification of pseudocyst is extremely rare. Calcified pseudocysts have been reported in literature as case reports, but a calcified pseudocyst in the lesser sac, without underlying pancreatic calcification, has not been reported. We report a case of a pancreatic pseudocyst with a calcified wall, requiring surgical excision and histological examination confirming the diagnosis.


Assuntos
Cistos , Pseudocisto Pancreático , Pancreatite Crônica , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos , Pseudocisto Pancreático/complicações , Pseudocisto Pancreático/diagnóstico por imagem , Pseudocisto Pancreático/cirurgia , Pancreatite Crônica/complicações , Pancreatite Crônica/diagnóstico por imagem
3.
Anesth Prog ; 68(3): 168-177, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606575

RESUMO

Previously undiagnosed or asymptomatic epiglottic cysts may be coincidentally detected during intubation. This retrospective case series identified undiagnosed epiglottic cysts that were discovered during intubation in 4 patients who underwent oral surgery under general anesthesia at our hospital during a 6-year period. Including 2 additional cases, 1 previously diagnosed and 1 detected during preoperative imaging, epiglottic cysts were observed in 6 of 1112 cases (0.54%) total. Among the undiagnosed epiglottic cyst cases, mild dyspnea on effort or snoring was reported in 2 patients, but all others were asymptomatic. Upon discovering previously undiagnosed epiglottic cysts during intubation, it is essential to proceed cautiously, remain alert for potential airway management difficulties, and avoid injuring or rupturing the cysts. In addition, any available preoperative imaging should be reviewed as information pertinent to the airway and any abnormalities may be useful. This report discusses the anesthetic care of 6 patients with epiglottic cysts that were previously known or initially discovered during intubation.


Assuntos
Anestésicos , Cistos , Cistos/diagnóstico por imagem , Cistos/cirurgia , Epiglote/diagnóstico por imagem , Epiglote/cirurgia , Humanos , Intubação Intratraqueal , Estudos Retrospectivos
4.
Rev Bras Parasitol Vet ; 30(4): e011821, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34495044

RESUMO

Ascocotyle (Phagicola) longa is an etiological agent of human phagicolosis. Mugilids are the second intermediate host, the first being Heleobia australis, and mugilids predatory birds and mammals are its definitive hosts. The occurrence of cysts holding A. longa metacercariae is described in mugilids with a prevalence of up to 100%. The wide geographical distribution of A. longa and its intermediate hosts coupled with the rise in the consumption of raw or poorly cooked fish may elevate the risk of human infection. Therefore, in this study, we aimed to verify the distribution pattern of cysts holding A. longa in mugilids. The tissue and organ samples of these fish were processed in a domestic blender and examined under a stereoscopic microscope to identify the cysts holding the digenetic metacercariae. Of the 24 (100%) fish samples that were analyzed, 12 of Mugil curema and 12 of Mugil liza possessed cysts holding A. longa metacercariae. Digenetic cysts were identified to be present in the gills, heart, stomach, liver, intestines, mesentery, and muscular tissues collected from M. curema and M. liza. Conclusively, in M. curema, the cysts holding A. longa metacercariae were found to be distributed randomly throughout the fish body in almost every tissue and organ that was examined.


Assuntos
Cistos , Doenças dos Peixes , Heterophyidae , Smegmamorpha , Trematódeos , Infecções por Trematódeos , Animais , Cistos/veterinária , Metacercárias , Infecções por Trematódeos/veterinária
5.
Rev Med Liege ; 76(9): 661-665, 2021 Sep.
Artigo em Francês | MEDLINE | ID: mdl-34477336

RESUMO

Cystic hepatic lesions are frequent and sometimes large. They are generally asymptomatic and discovered by chance. The differential diagnosis of these lesions includes congenital, post-traumatic, benign or malignant tumors, as well as infectious pathologies. Conventional or contrast ultrasonography, abdominal computed tomography and magnetic resonance imaging can be used to characterize them. Therapeutic abstention with or without iconographic monitoring constitutes the optimal management of many benign liver cysts without clinical repercussions. Treatments for symptomatic or potentially aggressive lesions may include fenestration, puncture with sclerotherapy, or surgical resection. In this article, the authors discuss how to diagnose and treat the various hepatic cystic lesions.


Assuntos
Cistos , Hepatopatias , Cistos/diagnóstico por imagem , Cistos/terapia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/terapia , Tomografia Computadorizada por Raios X , Ultrassonografia
7.
JNMA J Nepal Med Assoc ; 59(239): 716-718, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34508491

RESUMO

Cystic Echinococcosis or Hydatid disease is caused by the infection with the larval stage of long tapeworm, Echinococcus granulosus. This condition often remains asymptomatic for years before the cyst grows large enough to cause symptoms in affected organs. The most common organs involved are liver and lungs although the heart, brain, bone, central nervous system, and kidney may also be involved. This case is about a young woman who presented with left flank pain and urinary tract infection who was later diagnosed as having left renal hydatid cyst. The cyst was approximately 7.8×6.6×8cm with internal multiple septations at the lower pole cortex of the left kidney. Laparoscopic pericystectomy was performed and with no postoperative complications, she was discharged on albendazole and other supportive medication. With timely management using combination therapy, this condition is curable and the patient can live a healthy life with normal kidney function.


Assuntos
Cistos , Equinococose , Echinococcus granulosus , Neoplasias Renais , Albendazol/uso terapêutico , Animais , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Feminino , Humanos
8.
Vestn Otorinolaringol ; 86(4): 50-53, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34499448

RESUMO

The authors examined and operated on 64 patients with a diagnosis of cystic peritoneal cyst, with various concomitant diseases of the nose and SNP, in order to identify the peculiarities of the histological structure of cysts of percussion. In 18 patients, concomitant disease was allergic rhinitis, in patients with a violation of the aerodynamics of the nasal cavity, 14 patients with recurrent bacterial sinusitis. According to the histological structure, characteristic features of the structure of maxillary sinus cysts were revealed in various diseases of the nose and paranasal sinuses. Based on the histological structure of the maxillary sinus cysts, 3 types of the structure of cysts characteristic of a certain pathology were identified.


Assuntos
Cistos , Doenças dos Seios Paranasais , Seios Paranasais , Sinusite , Cistos/diagnóstico , Humanos , Seio Maxilar/diagnóstico por imagem , Cavidade Nasal , Doenças dos Seios Paranasais/diagnóstico , Doenças dos Seios Paranasais/etiologia
9.
FASEB J ; 35(10): e21897, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34473378

RESUMO

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the development of bilateral renal cysts which enlarge continuously, leading to compression of adjacent intact nephrons. The growing cysts lead to a progressive decline in renal function. Cyst growth is driven by enhanced cell proliferation and chloride secretion into the cyst lumen. Chloride secretion is believed to occur mainly by the cAMP-activated cystic fibrosis transmembrane conductance regulator (CFTR), with some contribution by the calcium-activated chloride channel TMEM16A. However, our previous work suggested TMEM16A as a major factor for renal cyst formation. The contribution of CFTR to cyst formation has never been demonstrated in an adult ADPKD mouse model. We used mice with an inducible tubule-specific Pkd1 knockout, which consistently develop polycystic kidneys upon deletion of Pkd1. Cellular properties, ion currents, and cyst development in these mice were compared with that of mice carrying a co-deletion of Pkd1 and Cftr. Knockout of Cftr did not reveal any significant impact on cyst formation in the ADPKD mouse model. Furthermore, knockout of Cftr did not attenuate the largely augmented cell proliferation observed in Pkd1 knockout kidneys. Patch clamp analysis on primary renal epithelial cells lacking expression of Pkd1 indicated an only marginal contribution of CFTR to whole cell Cl- currents, which were clearly dominated by calcium-activated TMEM16A currents. In conclusion, CFTR does not essentially contribute to renal cyst formation in mice caused by deletion of Pkd1. Enhanced cell proliferation and chloride secretion is caused primarily by upregulation of the calcium-activated chloride channel TMEM16A.


Assuntos
Anoctamina-1/metabolismo , Regulador de Condutância Transmembrana em Fibrose Cística/metabolismo , Cistos/metabolismo , Rim Policístico Autossômico Dominante/metabolismo , Canais de Cátion TRPP/metabolismo , Animais , Anoctamina-1/genética , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Cistos/genética , Cistos/patologia , Modelos Animais de Doenças , Técnicas de Silenciamento de Genes , Camundongos , Camundongos Knockout , Rim Policístico Autossômico Dominante/genética , Rim Policístico Autossômico Dominante/patologia , Canais de Cátion TRPP/genética
10.
Zhonghua Zhong Liu Za Zhi ; 43(9): 973-978, 2021 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-34530582

RESUMO

Objective: To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors. Methods: The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management. Results: Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed. Conclusion: Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.


Assuntos
Cistos , Teratoma , Humanos , Imageamento por Ressonância Magnética , Reoperação , Teratoma/diagnóstico por imagem , Teratoma/cirurgia
11.
BMC Womens Health ; 21(1): 345, 2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34583677

RESUMO

BACKGROUND: Isolated fallopian tube torsion (IFTT) is a rare cause of gynecological acute abdomen, is easily misdiagnosed and often has a delay in diagnosis. IFTT with paraovarian cysts is most frequently reported in studies. Here, we reported a patient diagnosed with IFTT associated with a paraovarian cyst, and we conducted a literature review for IFTT, aiming to identify valuable information that will be helpful for diagnosis and treatment for fallopian tube torsions. CASE PRESENTATION: A 13-year-old girl presented with a 10-day history of right lower abdominal pain that worsened 2 days before presentation. On presentation, ultrasound showed a 5.8 * 5.5 cm hypoechoic cyst adjacent to the right ovary, and between the cyst and ovary, a tortuous thickened tube was visualized. Laparoscopy revealed a triple torsion of the right fallopian tube with a 6-cm paraovarian cyst, and tubal conservation surgery was performed. The postoperative course was uneventful. Histopathological diagnosis revealed serous papillary cystadenoma. CONCLUSION: Paraovarian cystic dilatation often occurs in adolescence and can induce fallopian torsion when the size of the cyst reaches 5-cm. In our review, the median age of patients diagnosed with IFTT with paraovarian cysts was 15 years old, and the main clinical manifestation was emergency abdominal pain. The associated symptoms were variable, and vomiting was the most commonly associated symptom. Salpingectomy was the most common procedure performed; however, timely surgical intervention can effectively avoid salpingectomy.


Assuntos
Cistos , Doenças das Tubas Uterinas , Adolescente , Doenças das Tubas Uterinas/diagnóstico , Doenças das Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/diagnóstico por imagem , Tubas Uterinas/cirurgia , Feminino , Humanos , Salpingectomia , Anormalidade Torcional/complicações , Anormalidade Torcional/diagnóstico , Anormalidade Torcional/cirurgia
12.
BMJ Case Rep ; 14(9)2021 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493562

RESUMO

Enteric duplication cysts (EDCs) are congenital malformations of the gastrointestinal tract. EDCs can present as tubular or spherical cystic lesions of the abdomen. The tubular variant of EDC arises as an outpouching from the bowel wall, whereas the spherical variant rarely shows bowel communication. EDCs are known to harbour heterotopic pancreatic parenchyma or gastric mucosa. We present a case of EDC of the ileum (tubular type) with heterotopic gastric mucosa in a 7-year-old child who came with malena and abdominal discomfort. CT revealed focal abnormal dilatation of the ileal loop with polypoidal mucosal thickening. Differential diagnosis of lymphoma, bowel polyps and Meckel's diverticula with gastric heterotopia (GH) were considered. Subsequent surgery followed by histopathology revealed it to be EDC with GH. We discuss this case to familiarise radiologists with the atypical imaging features of EDC, to prevent misdiagnosis and initiate prompt treatment in appropriate clinical settings.


Assuntos
Cistos , Divertículo Ileal , Criança , Cistos/diagnóstico por imagem , Cistos/cirurgia , Mucosa Gástrica , Humanos , Íleo/diagnóstico por imagem , Íleo/cirurgia , Estômago
13.
Pan Afr Med J ; 39: 141, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527157

RESUMO

Gastric duplication cyst (GDC) is a rare congenital malformation of the gastrointestinal (GI) tract. Despite being benign in the entity, its complications vary from an asymptomatic abdominal mass to fulminant or massive GI bleeding. A 28-year-old lady presented with unexplained GI haemorrhage, in which the upper endoscopy showed a classic feature of GI stromal tumour. The preoperative diagnosis was also confirmed by the computed tomography. She subsequently underwent surgical resection and the final histopathology was consistent with a benign entity of GDC.


Assuntos
Cistos/diagnóstico , Hemorragia Gastrointestinal/etiologia , Estômago/anormalidades , Adulto , Cistos/congênito , Cistos/cirurgia , Endoscopia Gastrointestinal , Feminino , Hemorragia Gastrointestinal/diagnóstico , Neoplasias Gastrointestinais/diagnóstico , Tumores do Estroma Gastrointestinal/diagnóstico , Humanos , Estômago/cirurgia
14.
Neurol Sci ; 42(11): 4471-4487, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34482485

RESUMO

Leukoencephalopathy with cerebral calcifications and cysts (LCC) is a neurological disorder characterized by the radiological triad of white matter abnormalities, intracranial calcifications and cystic lesions variable in size resulting from a diffuse cerebral microangiopathy. Typically, progressive focal neurological deficits and seizures are the first clinical manifestation, but the severity of symptoms can vary according to the size and location of the cystic lesions holding compressive effects on the surrounding brain tissue. The most common histopathological finding is diffuse microangiopathy, which might be associated to pathogenic mutations in SNORD118 gene causing Labrune syndrome. Similar neuroradiological appearances have been found in the Coats plus syndrome, a systemic disorder caused by a genetic diffuse microangiopathy that affects not only the brain but also the retina and multiple organs, with a more complex clinical picture that address the diagnosis; biallelic mutations in CTC1 gene, encoding the conserved telomere maintenance component 1 (CTC1), are responsible of this systemic disorder. The aim of this contribution is to review the existing literature focusing on the neuroimaging characteristics by reporting cases in which radiological findings were highly suggestive for LCC.


Assuntos
Neoplasias Encefálicas , Doenças de Pequenos Vasos Cerebrais , Cistos , Leucoencefalopatias , Cistos/complicações , Cistos/diagnóstico por imagem , Cistos/genética , Humanos , Leucoencefalopatias/diagnóstico por imagem , Leucoencefalopatias/genética , Imageamento por Ressonância Magnética , Neuroimagem
15.
FASEB J ; 35(10): e21865, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34486178

RESUMO

Autosomal dominant polycystic kidney disease is a common inherited renal disorder that results from mutations in either PKD1 or PKD2, encoding polycystin-1 (PC1) and polycystin-2 (PC2), respectively. Downregulation or overexpression of PKD1 or PKD2 in mouse models results in renal cyst formation, suggesting that the quantity of PC1 and PC2 needs to be maintained within a tight functional window to prevent cystogenesis. Here we show that enhanced PC2 expression is a common feature of PKD1 mutant tissues, in part due to an increase in Pkd2 mRNA. However, our data also suggest that more effective protein folding contributes to the augmented levels of PC2. We demonstrate that the unfolded protein response is activated in Pkd1 knockout kidneys and in Pkd1 mutant cells and that this is coupled with increased levels of GRP94, an endoplasmic reticulum protein that is a member of the HSP90 family of chaperones. GRP94 was found to physically interact with PC2 and depletion or chemical inhibition of GRP94 led to a decrease in PC2, suggesting that GRP94 serves as its chaperone. Moreover, GRP94 is acetylated and binds to histone deacetylase 6 (HDAC6), a known deacetylase and activator of HSP90 proteins. Inhibition of HDAC6 decreased PC2 suggesting that HDAC6 and GRP94 work together to regulate PC2 levels. Lastly, we showed that inhibition of GRP94 prevents cAMP-induced cyst formation in vitro. Taken together our data uncovered a novel HDAC6-GRP94-related axis that likely participates in maintaining elevated PC2 levels in Pkd1 mutant cells.


Assuntos
Cistos/patologia , Retículo Endoplasmático/metabolismo , Nefropatias/patologia , Glicoproteínas de Membrana/metabolismo , Fator de Transcrição PAX8/fisiologia , Canais de Cátion TRPP/fisiologia , Animais , Cálcio/metabolismo , Cistos/etiologia , Cistos/metabolismo , Nefropatias/etiologia , Nefropatias/metabolismo , Glicoproteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Resposta a Proteínas não Dobradas
16.
Rev Med Liege ; 76(7-8): 588-591, 2021 Jul.
Artigo em Francês | MEDLINE | ID: mdl-34357708

RESUMO

We report the cases of two female newborns who present, at the first day, a interlabial mass. In both cases, the antenatal scans were normal, and the clinical examination in the delivery room didn't reveal any other abnormality. Similar features may suggest the same diagnosis. However, in the first case, it is a paraurethral cyst which causes the bulging of vaginal introitus whereas, in the second infant, it is an imperforated hymen. Paraurethral cysts are uncommon and even more so among infants. The diagnosis is primarily clinical, and ultrasound confirms the diagnosis and verifies the absence of other associated anomalies. These cysts usually resolve spontaneously. Rarely, they can lead to urinary retention. The second diagnosis, imperforate hymen, is the most common congenital malformation of the female genital tract. It can lead to hydrocolpos with the upstream accumulation of vaginal secretion and sometimes induce a hydrometrocolpos, with vaginal and uterine dilatation. The resulting mass can cause obstruction of surrounding urinary or digestive structures. Surgical management is generally necessary.


Assuntos
Cistos , Hidrocolpos , Doenças Uterinas , Cistos/diagnóstico por imagem , Feminino , Humanos , Hidrocolpos/diagnóstico por imagem , Hímen , Lactente , Recém-Nascido , Gravidez , Ultrassonografia
17.
Gan To Kagaku Ryoho ; 48(8): 1061-1063, 2021 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-34404077

RESUMO

A 70s woman with pancreatic metastases of HER2-negative breast cancer was being treated with bevacizumab plus paclitaxel. Tumor markers decreased after treatment initiation. After 8 months of treatment, the patient developed abdominal pain and distention, along with loss of appetite. Contrast-enhanced abdominal CT scan images showed the presence of a large 25 cm pseudopancreatic cyst and disappearance of the pancreatic metastatic lesions. Endoscopic ultrasound-guided cystogastrostomy was performed and an AXIOS stent was placed in the lower part of the gastric body. Subsequently, the cyst disappeared and her abdominal symptoms improved. The patient was able to resume treatment with other drugs and did not experience any recurrence of pancreatitis. Four months later, the AXIOS stent was removed. Bevacizumab plus paclitaxel is reportedly effective against HER2-negative metastatic breast cancer. Bevacizumab is a molecular targeted therapy against vascular endothelial growth factor, and the mechanism of its antitumor effect and complications are different from those of conventional drugs. Paclitaxel has also been reported to cause pancreatitis in rare cases. In this case, the mechanism of response to bevacizumab plus paclitaxel for metastatic pancreatic lesions or the development of drug-induced pancreatitis was considered to be the cause of pseudopancreatic cyst formation.


Assuntos
Neoplasias da Mama , Cistos , Neoplasias Pancreáticas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Metástase Neoplásica , Recidiva Local de Neoplasia/tratamento farmacológico , Paclitaxel/uso terapêutico , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Fator A de Crescimento do Endotélio Vascular
18.
J Med Case Rep ; 15(1): 421, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34340688

RESUMO

BACKGROUND: Polycystic liver disease is a clinical feature of autosomal dominant polycystic kidney disease, and it can sometimes cause health damage more serious than polycystic kidney. Dialysis therapy can be used for renal failure, but liver transplantation is the only method available for liver failure. Thus, giant and multiple hepatic cysts may affect mortality. However, liver transplantation is not indicated in many cases because of the preserved liver function. CASE PRESENTATION: A 54-year-old Japanese woman with polycystic liver disease was transferred back to our hospital for abdominal pain caused by liver cyst infection with abdominal wall herniation. She had been diagnosed with polycystic liver disease associated with sporadic autosomal dominant polycystic kidney disease 25 years earlier. Although she had several surgical interventions to reduce her liver volume, including right hepatic lobectomy and fenestration for liver cysts in another hospital, she needed further repair of the recurrent incisional herniation with patch graft surgery using fascia lata to cover the herniation site. However, new herniation sites reemerged in the fragile abdominal wall area around the patch, and therefore, she reduced the recurrent abdominal wall herniation by herself. Recurrent intestinal obstructions were luckily released by fasting with decompression treatment via nasogastric tube insertion, but multiple skin ulcers around the enlarged hernia sac gradually developed, and ascites was extremely difficult to control with any medication. At final admission, her abdominal wall was even more prominent, causing shortness of breath, and it spontaneously ruptured many times, which was accompanied by discharge of around 5 liters of ascites each time. She died from sepsis caused by drug-resistant Enterococcus. CONCLUSIONS: We report a case of autosomal dominant polycystic kidney disease with ruptured abdominal wall resulting from a hepatic cyst enlargement despite multiple laparotomy operations. Throughout the entire disease course, her liver volume increased rapidly, and her quality of life was severely impaired, but she could not undergo liver transplantation after readmission to our hospital. We will discuss the therapeutic strategy for this patient, including the timing and indication for liver transplantation.


Assuntos
Parede Abdominal , Cistos , Hepatopatias , Rim Policístico Autossômico Dominante , Cistos/complicações , Cistos/diagnóstico por imagem , Cistos/cirurgia , Feminino , Humanos , Hepatopatias/etiologia , Hepatopatias/cirurgia , Pessoa de Meia-Idade , Rim Policístico Autossômico Dominante/complicações , Qualidade de Vida
19.
Medicine (Baltimore) ; 100(32): e26797, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397882

RESUMO

RATIONALE: Polycystic liver disease is a rare disease characterized by the growth of numerous cysts in the liver. The liver function remains well preserved, but liver volumes can grow very large, and some patients ultimately need a liver transplantation. Other treatment options are limited and there is an unmet need for new therapeutic options. PATIENT CONCERNS: We describe a 59-year-old patient with pain in the abdomen, especially when bending forward. Five years ago, she was diagnosed with breast cancer and as an incidental finding a couple of large liver cysts were diagnosed, explaining her abdominal pain. DIAGNOSIS: Polycystic liver disease with several large liver cysts. INTERVENTIONS: The patient was treated with tamoxifen, an estrogen receptor modulator, as treatment for her hormone receptor positive breast cancer. One of the liver cysts was aspirated. OUTCOMES: In the 4.6 years after the start of tamoxifen treatment, 20 mg once daily, the volume of her liver cysts decreased remarkably. There was a reduction of combined cyst volume from 311 mL to 22 mL without percutaneous drainage. LESSONS: Epidemiological as well as experimental evidence supports a pivotal role for estrogens as a driver for growth of polycystic livers. Estrogen antagonism has often been proposed as a therapeutic target, but supporting evidence is lacking in the literature. We hypothesize that the decrease in cyst size in this patient was caused by tamoxifen therapy, suggesting an in vivo antagonistic effect on cystic cholangiocytes. This is an important finding because tamoxifen could be a promising new treatment option for polycystic liver disease.


Assuntos
Cistos/tratamento farmacológico , Hepatopatias/tratamento farmacológico , Tamoxifeno/uso terapêutico , Antineoplásicos Hormonais/uso terapêutico , Cistos/diagnóstico , Feminino , Seguimentos , Humanos , Hepatopatias/diagnóstico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
20.
Pan Afr Med J ; 38: 353, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34367432

RESUMO

Gastrointestinal duplications are defined as tubular or cystic malformations of a segment of the digestive tract, from the oral cavity to the anus. They are rare. Prenatal diagnosis ca be made in patients with a voluminous cyst. We here report the case of a 33-year-old primiparous woman with no previous medical-surgical history who was poorly screened. She just underwent ultrasound scan at 8 weeks of amenorrhea (WA). During the third trimester of pregnancy ultrasound showed anechoic nonvascularized cyst measuring 3cm located in the upper pelvis. It was anteriorly located; the kidneys and the bladder were not involved. Then magnetic resonance imaging (MRI) of the fetus was performed to better interpret ultrasound results. This showed well-defined cyst in contact with the small bowel loops along the mesenteric side. The diagnosis of gastrointestinal duplication was strongly suspected. C-section was done at 39 weeks' gestation because the woman had a history of primary infertility (7 years). Delivery proceeded without complications. Postnatal ultrasound results reinforced the hypothesis of gastrointestinal duplication, showing a cystic mass with a multi-bulkhead-like structure at the level of the left hypochondrium, measuring 45 mm x 19 mm, which could be consistent with gastrointestinal duplication. The new-born was referred to the Paediatric Surgery for better management and surgery in the first 6 months of life. The discovery of fetal anechoic cyst poses a challenge in etiology and diagnosis on the one hand and of follow-up and postnatal management on the other hand.


Assuntos
Cistos/diagnóstico por imagem , Anormalidades do Sistema Digestório/diagnóstico por imagem , Ultrassonografia Pré-Natal , Adulto , Cistos/congênito , Cistos/cirurgia , Anormalidades do Sistema Digestório/cirurgia , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Gravidez , Diagnóstico Pré-Natal/métodos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...