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2.
BMC Surg ; 21(1): 154, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33743657

RESUMO

BACKGROUND: Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far. CASE PRESENTATION: This article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up. CONCLUSION: To the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).


Assuntos
Abdome/diagnóstico por imagem , Cistos/etiologia , Hemorragia/etiologia , Hidrocefalia/cirurgia , Derivação Ventriculoperitoneal/efeitos adversos , Idoso , Líquido Cefalorraquidiano , Cistos/diagnóstico por imagem , Cistos/cirurgia , Drenagem , Feminino , Humanos , Laparoscopia , Complicações Pós-Operatórias , Tomografia Computadorizada por Raios X
3.
Neurosciences (Riyadh) ; 26(1): 97-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33530051

RESUMO

Ventriculoperitoneal (VP) shunts are commonly used in neurosurgical procedures to treat hydrocephalus. Although shunt-associated abdominal complications are well documented, extrahepatic pseudocysts are a rare shunt complication in adult patients. Therefore, we herein report the case of a 54-year-old male patient who presented with a bulging mass around the previous surgical site at the right upper quadrant of the abdomen. He had a 4-year history of VP shunt surgery for posthemorrhagic hydrocephalus. A computed tomographic scan revealed a large extrahepatic pseudocsyt. Our case represented a rare entity of extrahepatic pseudocyst in adult patients underwent VP shunt surgery. The clinical presentation, diagnostic tools, and treatment methods were discussed.


Assuntos
Abdome/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Cistos/etiologia , Hidrocefalia/cirurgia , Doenças Peritoneais/etiologia , Derivação Ventriculoperitoneal/efeitos adversos , Abdome/cirurgia , Cistos/diagnóstico por imagem , Cistos/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Peritoneais/diagnóstico por imagem , Doenças Peritoneais/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541987

RESUMO

An 88-year-old man presented to the emergency department with exertional dyspnoea and orthopnoea. Clinical examination revealed mildly raised jugular venous pressure, increased respiratory rate, palpable non-tender hepatomegaly and reduced right basal breath sounds. Ultrasonography showed a large right simple hepatic cyst, multiple small left hepatic and renal cysts. A non-contrast CT scan revealed a large, right hepatic thin-walled cyst of volume 4.2 L, exhibiting few thin septae and tiny nodular mural calcifications. Pressure effects were elevated right haemidiaphragm, right atrial compression and adjacent atelectasis. He had a similar episode 2 years ago, treated by percutaneous needle aspiration. Giant simple hepatic cysts are rare and present when symptomatic due to pain, mass effect on adjacent organs, infection or rupture. These may unusually cause dyspnoea or orthopnoea by compressing cardiac chambers. Simple aspiration has a high recurrence rate. Percutaneous sclerosant injection, laparoscopic deroofing and cystectomy are better treatment modalities.


Assuntos
Cistos/complicações , Cistos/diagnóstico por imagem , Dispneia/etiologia , Fígado , Idoso de 80 Anos ou mais , Humanos , Masculino , Paracentese , Recidiva , Tomografia Computadorizada por Raios X , Ultrassonografia
5.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526516

RESUMO

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inheritable form of renal cystic disease and is associated with cysts in other organs. Prostatic cysts are rare though and have not been reported in the paediatric population. Reported is the presence of a prostatic cyst that was incidentally noted on routine sonogram in a 15 year old with ADPKD.


Assuntos
Cistos/diagnóstico por imagem , Rim Policístico Autossômico Dominante/diagnóstico por imagem , Doenças Prostáticas/diagnóstico por imagem , Adolescente , Cistos/complicações , Humanos , Masculino , Rim Policístico Autossômico Dominante/complicações , Doenças Prostáticas/complicações
6.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542027

RESUMO

Haemorrhagic suprarenal pseudocysts are very rare and are often incidental findings at surgery or autopsy, though they can sometimes present with predominantly gastrointestinal or endocrine symptoms, including intraperitoneal bleeding or sepsis. Our case report is of a 48-year-old man who presented at our primary healthcare centre with 2-month history of predominantly respiratory symptoms of cough and shortness of breath. CT scan revealed a suprarenal cyst measuring 14.2×13.5×13.1 cm for which he was operated and made a full recovery. A detailed literature review reveals that there has never been a case of a haemorrhagic suprarenal pseudocyst presenting with predominantly respiratory symptoms, which is why we decided to document this case report.


Assuntos
Doenças das Glândulas Suprarrenais/complicações , Cistos/diagnóstico por imagem , Cistos/cirurgia , Hemorragia , Doenças Raras/complicações , Cistos/complicações , Dispneia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
9.
Medicina (Kaunas) ; 57(1)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33435540

RESUMO

The detection of a renal mass is a relatively frequent occurrence in the daily practice of any Radiology Department. The diagnostic approaches depend on whether the lesion is cystic or solid. Cystic lesions can be managed using the Bosniak classification, while management of solid lesions depends on whether the lesion is well-defined or infiltrative. The approach to well-defined lesions focuses mainly on the differentiation between renal cancer and benign tumors such as angiomyolipoma (AML) and oncocytoma. Differential diagnosis of infiltrative lesions is wider, including primary and secondary malignancies and inflammatory disease, and knowledge of the patient history is essential. Radiologists may establish a possible differential diagnosis based on the imaging features of the renal masses and the clinical history. The aim of this review is to present the contribution of the different imaging techniques and image guided biopsies in the diagnostic management of cystic and solid renal lesions.


Assuntos
Nefropatias/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Abscesso/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Adenoma Oxífilo/diagnóstico por imagem , Angiomiolipoma/diagnóstico por imagem , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células de Transição/diagnóstico por imagem , Meios de Contraste , Cistos/classificação , Cistos/diagnóstico por imagem , Humanos , Leiomioma/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Plasmocitoma/diagnóstico por imagem , Pielonefrite/diagnóstico por imagem , Pielonefrite Xantogranulomatosa/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia , Ultrassonografia Doppler em Cores
10.
AJR Am J Roentgenol ; 216(2): 403-411, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33356432

RESUMO

OBJECTIVE. The purpose of our study was to identify the imaging features that differentiate a hepatic mucinous cystic neoplasm (MCN) from a simple biliary cyst. MATERIALS AND METHODS. Surgically resected hepatic MCNs and simple biliary cysts over a 20-year period (October 29, 1997-January 23, 2018) with preoperative CT, MRI, or both were retrospectively identified. Included cases underwent histopathologic confirmation of diagnosis based on the 2010 World Health Organization criteria and blinded imaging review. Various imaging features, including cyst shape and septal enhancement, were assessed for performance. For septate cysts, the relationship of the septation to the cyst wall-that is, arising from the wall without an indentation versus arising from an external macrolobulation-was recorded. Statistical analysis was performed for the imaging features with the chi-square test. RESULTS. The study group comprised 22 hepatic MCNs and 56 simple biliary cysts. A unilocular hepatic cystic lesion was highly predictive of a simple biliary cyst (positive predictive value = 95.2%). The imaging feature of septations arising only from macro-lobulations was 100% specific for a simple biliary cyst on CT (p = 0.001). The presence of septations arising from the cyst wall without indentation was 100% sensitive for hepatic MCN but was only 56.3% specific on CT. Septal enhancement reached 100% sensitivity for hepatic MCN on MRI (p = 0.018). CONCLUSION. The presence of septations, relationship of the septations to the cyst wall, and septal enhancement were sensitive imaging features in the detection of hepatic MCN. The imaging feature of septations arising only from macrolobulations in the cyst wall was specific for simple biliary cysts on CT and helped differentiate simple biliary cysts from hepatic MCNs.


Assuntos
Doenças dos Ductos Biliares/diagnóstico por imagem , Cistos/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças dos Ductos Biliares/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Adulto Jovem
11.
Urologiia ; (6): 132-136, 2020 12.
Artigo em Russo | MEDLINE | ID: mdl-33377692

RESUMO

The article present the clinical observation of 4 year old boy with scrotal hypospadias. Previous surgery management had unsatisfactory results due to complications of the cyst of the prostatic utricle. Laparoscopic removal of the cyst of the prostatic utricle was performed. The next step was urethral plastic. The results of the operation were satisfactory. A brief review of the literature is provided.


Assuntos
Cistos , Hipospadia , Laparoscopia , Pré-Escolar , Cistos/diagnóstico por imagem , Cistos/cirurgia , Humanos , Hipospadia/cirurgia , Masculino , Sáculo e Utrículo
12.
BMC Surg ; 20(1): 332, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317482

RESUMO

BACKGROUND: Benign foregut cysts usually develop in the thorax most of all in the mediastinum. Rare cases involving various abdominal organs, such as liver, stomach or pancreas have been previously published, mostly occurring in the retroperitoneum. CASE PRESENTATION: We herein present an adenocarcinoma of a foregut cyst involving the left side of the diaphragm, left lower lobe of the lung, and left lobe of the liver, successfully removed through multivisceral resection. In between drug holidays, postoperative oncological treatment has been ongoing for nearly 4 years. In terms of chemotherapy, FOLFOX 4 regime, capacitabine monotherapy and later on next generation sequencing has been attempted, although the patient refused the later treatment option. Despite multimodality (combined surgical and oncological) treatment, local- and later on loco-regional recurrence has been detected on follow-up staging, influencing further chemotherapy regime. Taking both the fairly unknown type of the tumor and uncertain response rate to oncological therapy into account, prolonged tumor pace with fairly stable general patient state was reached throughout the course of the disease. CONCLUSION: Through surgical tumor resection, and postoperative chemotherapy the patient managed to maintain an acceptable quality of life without major symptoms during ongoing treatment. During our own case, with multiple organ involvement, multivisceral resection, with multimodality treatment had considerable effect in prolonging the lifespan of the patient.


Assuntos
Dor Abdominal/etiologia , Adenocarcinoma/patologia , Cistos/patologia , Diafragma/patologia , Dor Abdominal/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Biópsia por Agulha Fina , Cistos/diagnóstico por imagem , Diafragma/diagnóstico por imagem , Feminino , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Qualidade de Vida
14.
No Shinkei Geka ; 48(11): 1035-1042, 2020 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-33199661

RESUMO

A 69-year-old woman presented on an emergency basis, with headache and left hemiparesis. Initial head CT at the time of admission revealed a large subcortical hematoma with perihematomal edema extending from the right parietal to the occipital lobe. A small part of the hematoma extended toward the trigone of the right lateral ventricle. CT angiography revealed no vascular abnormalities. Emergency craniotomy was erformed, and the patient's initial postoperative course was unremarkable. However, the patient's neurological symptoms worsened 10 days postoperatively, and CT revealed a new low-density cystic lesion with perifocal edema at the site of hematoma removal, in addition to severe cerebral compression. We performed a reoperation, and intraoperatively we observed hematoma fluid mixed with cerebrospinal fluid without any abnormal blood vessels or neoplastic lesions in the hematoma cavity. We identified the choroid plexus deep within the surgical field, and slight leakage of cerebrospinal fluid was detected from the ventricular aspect, indicating the formation of a small passage between the hematoma cavity and the ventricle. After the second operation, her postoperative course was uneventful without recurrent cyst formation. An early symptomatic expanding porencephalic cyst in the hematoma cavity after removal of an intracerebral hematoma is rare, and only a few cases have been reported in the literature. Based on literature review and considering the likely mechanism of cyst development, we speculated that progressive cyst expansion could be attributed to a check valve mechanism between the ventricle and the cavity from which the hematoma was removed, as observed in the present case.


Assuntos
Cistos , Hematoma , Adulto , Idoso , Hemorragia Cerebral , Plexo Corióideo , Cistos/complicações , Cistos/diagnóstico por imagem , Cistos/cirurgia , Feminino , Hematoma/diagnóstico por imagem , Hematoma/etiologia , Hematoma/cirurgia , Humanos , Tomografia Computadorizada por Raios X
16.
Monaldi Arch Chest Dis ; 90(4)2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32945644

RESUMO

The coronavirus disease 2019 (COVID-19) is a recent pandemic that affected more than 5 million people worldwide. Chest high resolution computed tomography (HRCT) is an essential tool in diagnosis and management of the disease. Pulmonary parenchymal opacity is a typical sign of the disease, but not the only one. Pneumothorax, pneumomediastinum, bronchiectasis and cysts are probably underrated complications of COVID-19 that can worsen prognosis, in terms of prolonged hospitalization and need of oxygen therapy. In our single center case series, we outline four different manifestations of pneumothorax, pneumomediastinum and cysts in hospitalized patients with COVID-19 pneumonia.


Assuntos
Bronquiectasia/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Cistos/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Enfisema Mediastínico/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumotórax/diagnóstico por imagem , Adulto , Betacoronavirus , Bronquiectasia/etiologia , Infecções por Coronavirus/complicações , Cistos/etiologia , Humanos , Itália , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Masculino , Enfisema Mediastínico/etiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumotórax/etiologia , Enfisema Subcutâneo/diagnóstico por imagem , Enfisema Subcutâneo/etiologia , Tomografia Computadorizada por Raios X
19.
Asian Cardiovasc Thorac Ann ; 28(8): 500-503, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32757656

RESUMO

A regular check up on a 59-year-old man showed a high carcinoembryonic antigen level in his blood. A computed tomography scan showed tumors in the right atrium. We performed tumor resection successfully. The resected specimen was found to be blood cysts that had developed from the right atrium to the inferior vena cava. Intracardiac blood cysts are generally observed in infants, spontaneously disappear during the first 6 months of life, and are located in the left side of heart and on atrioventricular valves. Therefore, this case is extremely rare. Also, it is worth considering the timing of this surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cistos/cirurgia , Átrios do Coração/cirurgia , Cardiopatias/cirurgia , Tempo para o Tratamento , Cistos/diagnóstico por imagem , Cistos/patologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/patologia , Cardiopatias/diagnóstico por imagem , Cardiopatias/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
20.
J Comput Assist Tomogr ; 44(5): 780-783, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32842059

RESUMO

INTRODUCTION: Vernix caseosa peritonitis (VCP) is a rare peripartum complication secondary to the introduction of fetal vernix into the maternal peritoneal cavity. Vernix caseosa peritonitis typically manifests a few hours to days after a cesarian section and is often initially misdiagnosed as a more common disease process resulting in delayed diagnosis. We report the computed tomography (CT) findings in 2 patients with VCP and reviewed the previously reported CT findings of VCP. CASES: Two patients, aged 17 and 24 years, presented with signs and symptoms of peritonitis within days of undergoing a cesarian section. In both cases, CT scans of the abdomen and pelvis demonstrated ascites and multiple small, well-defined, peripherally enhancing, cystic peritoneal nodules which were most prominent around the liver and became larger and more numerous over time. Antibiotic therapy was not effective, subsequent laparoscopic peritoneal biopsy demonstrated VCP, and patients were successfully treated with lavage and the addition of intravenous steroids. CONCLUSIONS: Vernix caseosa peritonitis is an underrecognized disorder that is most often mistaken for other more common causes of peritonitis. In the setting of peripartum peritonitis, the CT findings of ascites with multiple small, well-defined, peripherally enhancing, cystic peritoneal nodules, especially adjacent to the liver, which grow in size and number strongly suggests VCP.


Assuntos
Reação a Corpo Estranho/diagnóstico por imagem , Peritonite/diagnóstico por imagem , Complicações na Gravidez/diagnóstico por imagem , Verniz Caseoso , Abdome/diagnóstico por imagem , Adolescente , Adulto , Cesárea/efeitos adversos , Cistos/diagnóstico por imagem , Cistos/patologia , Cistos/cirurgia , Feminino , Reação a Corpo Estranho/patologia , Reação a Corpo Estranho/cirurgia , Humanos , Laparoscopia , Peritonite/patologia , Peritonite/cirurgia , Gravidez , Complicações na Gravidez/patologia , Complicações na Gravidez/cirurgia , Tomografia Computadorizada por Raios X , Verniz Caseoso/citologia , Verniz Caseoso/imunologia , Adulto Jovem
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