1,648 results on '"pseudocyst"'
Search Results
2. A road to surgical success: a case report of huge retroperitoneal idiopathic non-pancreatic cyst in a 6-year-old child at tertiary hospital, Muhimbili National Hospital.
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Ibrahim, Maimuna, Chibwae, Alfred, Magoda, Benard, Philipo, Ayubu, Ramadhan, Shafii, and Salim, Mohamed
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RETROPERITONEUM , *COMPUTED tomography , *SURGERY , *PUBLIC hospitals , *IDIOPATHIC diseases - Abstract
In most reported cases, pancreatic pseudocysts are the most commonly reported cases and mostly occur in adults. Idiopathic non-pancreatic pseudocyst is rarely reported among children. We are reporting a rare case of retroperitoneal pseudocyst in a 6-year-old male with a 4-week history of abdominal swelling. He had asymmetrical abdominal distention on the right lumber and iliac regions with a smooth surface measuring 12 × 22 cm in its largest dimension. CT scan showed a mesenteric cyst, ipsilateral hydronephrosis, and intrahepatic duct dilatations. Intraoperatively, a retroperitoneal cystic mass was completely excised histologically confirmed pseudocyst. The patient was discharged home after fully recovery after 4 days of surgery. Surgical interventions remain to be the stay management of retroperitoneal pseudocysts with an earlier full recovery. Open surgical technique remains to be a preferred approach, especially for the large and complex retroperitoneal cysts. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Experience of a reference center on ventriculo-gallbladder shunt as an alternative treatment for peritoneal failure in children.
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Moreira, Alick Durão, Bellas, Antônio, Pousa, Marcelo, Fernandes, Darli, Guimarães, Luciano, and Protzenko, Tatiana
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CEREBROSPINAL fluid shunts , *TREATMENT failure , *INFECTION prevention , *OPERATIVE surgery - Abstract
Purpose: Ventriculo-peritoneal shunt is the gold standard for non-obstructive hydrocephalus. Despite advances in material, infection prevention, and valve technologies, failure can still occur. The aim of this article is to present a comprehensive study based on the experience of a reference center in pediatric neurosurgery in Rio de Janeiro with the use of the ventriculo-gallbladder shunt as an alternative to peritoneal failure. Methods: A retrospective study was conducted from January 2018 to December 2023 of patients diagnosed with cerebrospinal fluid shunt dysfunction due to peritoneal failure and submitted to ventriculo-gallbladder shunt as an alternative in a reference center of Rio de Janeiro. Results: From 2018 to 2023, 18 peritoneal failures were diagnosed. Among them, 10 patients (55.5%) were selected for ventriculo-gallbladder shunt (VGS). Different causes were responsible for the hydrocephalus in these patients. VGS was placed at a mean age of 35.4 months. Four patients had temporary complications: 2 self-limited diarrheas in the first month and 2 shunt infections. After the resolution of the infection, a new VGS was placed successfully. The average follow-up was 18.8 months (follow-up 9–68 months) without further issues. Conclusion: VGS is a viable option for patients facing peritoneal failure. This paper provides valuable insights into the surgical technique and outcomes associated with this alternative. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Multiple giant pancreatic pseudocysts, a rare complication of acute pancreatitis – A case report
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Albail Singh Yadav, Anant Agarwal, Ayush Maurya, and Gaurang Agarwal
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pseudocyst ,giant pseudocyst ,multiple pseudocyst ,multiplanar computed tomography ,surgical drainage ,Medicine - Abstract
A 34-year-old alcoholic male presented to our outpatient department with a complaint of persistent epigastric pain, radiating to the back with a swelling in the upper abdomen. He had 2 similar episodes in the past for which he was conservatively managed along the lines of acute pancreatitis. Now on physical examination, the patient had a massive lump in the upper abdomen reaching below the umbilicus. Examination findings were confirmed by computed tomography - abdomen (Plain and Contrast), two 13×10×09 cm and 9×8×7.8 cm, cystic lesions (Noncommunicating) were seen abutting the posterior wall of the stomach and into each other, suggestive of mature pseudocysts of the pancreas. The patient was admitted and after necessary investigations, surgical cystogastrostomy was done for the lower pseudocyst and cystocystostomy for the upper pseudocyst. The patient was discharged 5 days later with no complications. This case shows that multiple pseudocysts, a relatively rare complication of acute pancreatitis, are one of the differentials of acute abdomen. The treatment is a therapeutic challenge that depends on location, size, number as well as their relation to one another. Good drainage prevents resection procedures and further complications (exocrine and endocrine insufficiency).
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- 2024
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5. Recurrent gastric intramural pseudocyst: A case report and comprehensive literature review of reported cases
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Amirhossein Soltani, MD, Mohsen Salimi, MD, Maryam Nemati, MD, and Ali Mirshamsi, MD
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Intramural gastric pseudocyst ,Pancreatic pseudocyst ,Pseudocyst ,Chronic pancreatitis ,Necrotizing pancreatitis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Intramural gastric pseudocysts are extremely rare and are often associated with pancreatitis and pancreatic pseudocysts; they can lead to complex clinical presentations requiring careful diagnosis and management. We present a case of a 57-year-old man with a history of pancreatitis and pancreatic pseudocysts who was diagnosed with intramural gastric pseudocysts. The patient was diagnosed with multiple gastric intramural pseudocysts at different locations during separate admissions and imaging studies. This indicates a recurrence of gastric intramural pseudocysts. In these cases, studies rarely discuss recurrence and its underlying causes. This highlights a significant gap in the existing literature.To provide a broader understanding, we reviewed the literature by searching major databases (PubMed, Scopus, and Web of Science) and then extracted and analyzed data from 18 articles, reaching 24 similar cases. Of the 25 patients studied (including our case), 92% were male and 8% were female. Cases had a mean age of 47.68 ± 14.82 years. Additionally, 84% of the patients had a history of alcohol consumption, and 88% had a positive history of pancreatitis. Common symptoms were abdominal pain (especially in the epigastric region), vomiting, nausea, and weight loss. In conclusion, results showed that intramural gastric pseudocysts generally occur in middle-aged men with a history of chronic or heavy alcohol consumption and pancreatitis.
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- 2024
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6. Alcoholic Acute Pancreatitis, a Retrospective Study about Clinical Risk Factors and Outcomes—A Seven-Year Experience of a Large Tertiary Center.
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Gűnșahin, Deniz, Edu, Andrei Vicențiu, Pahomeanu, Mihai Radu, Mitu, Tudor Ștefan, Ghiță, Andreea Irina, Odorog, Anamaria Simona, Preda, Carmen Monica, and Negreanu, Lucian
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NECROTIZING pancreatitis ,PANCREATITIS ,INTENSIVE care units ,MEDICAL care costs ,ALCOHOL drinking ,HOSPITAL mortality - Abstract
(1) Background: Alcohol consumption is one of the main causes of acute pancreatitis. (2) Material and Methods: In this unicentric retrospective cohort study, we selected 1855 patients from the Bucharest Acute Pancreatitis Index (BUC-API) who presented with acute pancreatitis. We investigated correlations between Alcoholic Acute Pancreatitis (AAP) and the rate of complications, cost, length of hospitalization and rate of recurrence. (3) Results: We found a moderately strong association between AAP and recurrence (p < 0.01) and observed that the disease is likelier to evolve with pseudocysts and walled-off necrosis than other forms of AP. Patients with AAP are less likely to have a morphologically normal pancreas than patients suffering from AP of other causes (p < 0.01), but a low probability of requiring intensive care unit admission (p < 0.01) significantly lowers daily cost (Md = 154.7 EUR compared to Md = 204.4 EUR) (p < 0.01). (4) Conclusions: This study's data show that patients with AAP have a greater rate of pseudocyst occurrence, lower intensive care unit admittance rate and lower cost of hospitalization than patients with AP of other causes. Typical Sketch: A middle-aged male tobacco smoker with recurrent AP, lower risk of in-hospital mortality and complications such as pseudocysts; treated in a gastroenterological ward and discharged at-will. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Cytological Features of Fibrin-associated Diffuse Large B-cell Lymphoma Arising in Retroperitoneal Pseudocyst: The First Case Report.
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KIYONG NA, SO-WOON KIM, and HYUN-SOO KIM
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DIFFUSE large B-cell lymphomas ,RETROPERITONEUM ,FIBRIN ,LAPAROSCOPIC surgery ,CYTOPLASM - Abstract
Background/Aim: Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is frequently associated with the Epstein-Barr virus (EBV) and manifests as non-massforming microscopic lesions within fibrin-rich lesions. Herein, we describe the cytological features of FA-DLBCL. Case Report: A 72-year-old man presented with a large retroperitoneal cystic mass that was treated by cyst aspiration and laparoscopic excision. Individually dispersed large, atypical cells in a necrotic background contained scant cytoplasm and hyperchromatic nuclei with irregular nuclear contours, frequent karyorrhectic debris, and mitotic figures. A fibrinous exudate with necrotic material attached to the inner surface of the cystic mass contained large, atypical cells that were individually scattered or arranged in small clusters. These were positive for cluster of differentiation 20 and Epstein-Barr virus-encoded RNA in situ hybridization. Conclusion: We cytologically characterized FA-DLBCL as large, atypical cells that were individually scattered or arranged in small clusters in a necrotic background. To the best of our knowledge, we revealed the cytological features of FA-DLBCL. [ABSTRACT FROM AUTHOR]
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- 2024
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8. A Systematic Review of Treatment Protocols in Auricular Pseudocysts
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George, Shajul, George, Shibu, Madhavan, Rajeev Kumar, and Asha, C. S.
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- 2024
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9. Giant intraperitoneal non-pancreatic pseudocyst: a case report
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Yohannis Derbew Molla, Aklilu Yiheyis Abraha, Yilkal Ademe Belay, Bewketu Abebe Alemu, Hirut Tesfahun Alemu, and Samuel Addisu Abera
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Non-pancreatic ,Pseudocyst ,Bladder ,Inflammatory ,Case report ,Medicine - Abstract
Abstract Introduction Non-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may show signs of calcifications and inflammatory changes. The fluid inside them can vary, ranging from hemorrhage and pus to serous or sometimes chylous content. In most cases, these cysts appear as a result of trauma, surgery, or infection. Case presentation A 35-year-old male patient from Ethiopia presented with swelling in his lower abdomen that had been present for 2 years. Initially, the swelling was small but gradually increased in size. The patient experienced frequent urination but no pain or difficulty during urination, urgency, intermittent urination, or blood in the urine. The swelling was initially painless but became painful 2 months prior to his presentation. Abdominal computed tomography scans revealed a well-defined, lobulated peritoneal lesion measuring 16 × 12 × 10 cm, consisting primarily of fluid-filled cysts with a thick, enhancing wall and septa. Additionally, there was a large, heterogeneous enhancing soft tissue component measuring 8 × 6 cm. As a result, the cystic mass was surgically removed in its entirety with partial removal of the bladder wall, and the patient was discharged in an improved condition. Conclusion Primary non-pancreatic pseudocysts are extremely rare lesions that must be differentiated from other possible causes of cystic lesions within the peritoneal or retroperitoneal regions. Surgeons should be aware of the potential occurrence of these lesions, which may have an unknown origin.
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- 2024
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10. Unusual Configuration of a Giant Trans-Spatial Pancreatic Pseudocyst with Spontaneous Shrinkage: A Rare Case Report
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Abera MT, Damtew HD, Yaynishet YA, and Adela AY
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pseudocyst ,giant pseudocyst ,pancreatitis ,multiplanar ct ,spontaneous drainage ,Medicine (General) ,R5-920 - Abstract
Michael Teklehaimanot Abera,1 Henok Dessalegn Damtew,1 Yodit Abraham Yaynishet,1 Amanuel Yegnanew Adela1– 3 1Department of Radiology, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Radiology, University of Gondar, Gondar, Ethiopia; 3Ethiopian Federal Police Commission Referral Hospital, Addis Ababa, EthiopiaCorrespondence: Michael Teklehaimanot Abera, Addis Ababa University, College of Health Sciences, Department of Radiology, P.O. Box 9080, Addis Ababa, Ethiopia, Email michael.thaimanot@aau.edu.et; th.miki8441@gmail.comAbstract: Pancreatic pseudocysts are benign lesions that typically originate within the pancreatic parenchyma, or peripancreatic tissue. They commonly occur following recurrent episodes of pancreatitis or trauma. In this article, we present a case of a giant pancreatic pseudocyst with unusual trans-spatial extensions and spontaneous size decrement in a 40-year-old male patient with a history of alcohol abuse. He presented with chronic epigastric pain, and a physical examination showed only mild abdominal tenderness. Initial computed tomography showed a giant (18.4cm in its largest axis) pancreatic pseudocyst with left subdiaphragmatic and gastrohepatic extensions and concurrent splenic cysts. On follow-up ultrasound, the pseudocyst showed a significant spontaneous size decrement to less than half of its initial size. The giant size and trans-spatial characteristics of the pseudocyst, along with a relatively benign symptomatology and subsequent spontaneous shrinkage, constitute unique aspects of this case.Keywords: pseudocyst, giant pseudocyst, pancreatitis, multiplanar CT, spontaneous drainage
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- 2024
11. Multicenter study of the efficacy and safety of electrocautery-enhanced lumen-apposing metal stents for the internal drainage of pancreatic fluid collections
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Chen-Shuan Chung, Yu-Ting Kuo, Yi-Chun Chiu, Yang-Chao Lin, Chi-Ying Yang, Kuan-Chih Chen, Szu-Chia Liao, Cheuk-Kay Sun, Yen-Chih Lin, and Hsiu-Po Wang
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Endoscopic ultrasound ,Lumen-apposing metal stent ,Pancreatitis ,Pseudocyst ,Walled-off necrosis ,Medicine ,Science - Abstract
Abstract Pancreatic fluid collections (PFCs) including pancreatic pseudocyst (PP) and walled-off necrosis (WON) are complications after acute pancreatitis. We aimed to evaluate the efficacy and safety of endoscopic ultrasound (EUS)-guided lumen-apposing metal stent (LAMS) placement to manage PFCs. Between June 2019 and May 2023, patients with symptomatic PFCs who underwent EUS-guided electrocautery-enhanced LAMS drainage were enrolled retrospectively from eight tertiary centers in Taiwan. In total, 33 [14 (42.42%) PP and 19 (57.58%) WON] patients were enrolled. Gallstones (27.27%) and abdominal pain (72.73%) were the most common etiology and indication for drainage. The technical and clinical success rates were 100% and 96.97%, respectively, and the mean procedure time was 30.55 (± 16.17) min. Complications included one (3.03%) case of self-limited bleeding; there were no cases of mortality. Seven (21.21%) patients had recurrence. Patients with disconnected pancreatic duct syndrome (DPDS) had a higher recurrence rate than those without (71.43% vs. 38.46%, p = 0.05). After replacing LAMSs with transmural double-pigtail plastic stents (DPSs) in the DPDS patients, the DPS migration rate was higher in the patients with recurrence (100% vs. 33.33%, p = 0.04). In conclusion, drainage of symptomatic PFCs with EUS-guided electrocautery-enhanced LAMS appears to be efficient and safe. Replacing LAMSs with DPSs in DPDS patients was associated with a lower recurrence rate.
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- 2024
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12. A location-based anatomic classification system for acute pancreatic fluid collections: Roadmap for optimal intervention in the step-up era
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Clancy J. Clark, MD, FACS, Jonathan W. Ray, MD, Swati Pawa, MD, Darius Jahann, MD, MaryAlyce McCullough, MD, Preston Miller, MD, FACS, Nathan Mowery, MD, FACS, Michael Miller, MD, Ted Xiao, MD, Nicholas Koutlas, MD, and Rishi Pawa, MD
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Acute pancreatitis ,Walled-off necrosis ,Necrotizing pancreatitis ,Acute pancreatic fluid collections ,Pseudocyst ,Surgery ,RD1-811 - Abstract
Walled-off pancreatic necrosis (WOPN) is a local complication of acute necrotizing pancreatitis frequently requiring intervention. Treatment is typically through the coordinated efforts of a multidisciplinary team. Current management guidelines recommend a step-up approach beginning with minimally invasive techniques (percutaneous or transmural endoscopic drainage) followed by escalation to more invasive procedures if needed. Although the step-up approach is an evidence-based treatment paradigm for management of pancreatic fluid collections, it lacks guidance regarding optimal invasive technique selection based on the anatomic characteristics of pancreatic fluid collections. Similarly, existing cross-sectional imaging-based classification systems of pancreatic fluid collections have been used to predict disease severity and prognosis; however, none of these systems are designed to guide intervention. We propose a novel classification system which incorporates anatomic characteristics of pancreatic fluid collections (location and presence of disconnected pancreatic duct) to guide intervention selection and clinical decision making. We believe adoption of this simple classification system will help streamline treatment algorithms and facilitate cross-study comparisons for pancreatic fluid collections.
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- 2024
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13. Giant intraperitoneal non-pancreatic pseudocyst: a case report.
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Molla, Yohannis Derbew, Abraha, Aklilu Yiheyis, Belay, Yilkal Ademe, Alemu, Bewketu Abebe, Alemu, Hirut Tesfahun, and Abera, Samuel Addisu
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COMPUTED tomography , *URINATION , *HOSPITAL admission & discharge , *OMENTUM , *MESENTERY - Abstract
Introduction: Non-pancreatic pseudocysts are rare lesions that typically form from the omentum and mesentery. These cysts have a thick fibrotic wall made up of fibrous tissue and may show signs of calcifications and inflammatory changes. The fluid inside them can vary, ranging from hemorrhage and pus to serous or sometimes chylous content. In most cases, these cysts appear as a result of trauma, surgery, or infection. Case presentation: A 35-year-old male patient from Ethiopia presented with swelling in his lower abdomen that had been present for 2 years. Initially, the swelling was small but gradually increased in size. The patient experienced frequent urination but no pain or difficulty during urination, urgency, intermittent urination, or blood in the urine. The swelling was initially painless but became painful 2 months prior to his presentation. Abdominal computed tomography scans revealed a well-defined, lobulated peritoneal lesion measuring 16 × 12 × 10 cm, consisting primarily of fluid-filled cysts with a thick, enhancing wall and septa. Additionally, there was a large, heterogeneous enhancing soft tissue component measuring 8 × 6 cm. As a result, the cystic mass was surgically removed in its entirety with partial removal of the bladder wall, and the patient was discharged in an improved condition. Conclusion: Primary non-pancreatic pseudocysts are extremely rare lesions that must be differentiated from other possible causes of cystic lesions within the peritoneal or retroperitoneal regions. Surgeons should be aware of the potential occurrence of these lesions, which may have an unknown origin. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
- View/download PDF
14. AUTOIMMUNE PANCREATITIS ASSOCIATED WITH PANCREATIC PSEUDOCYST: A CASE REPORT.
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Naeem, Hammad, Badshah, Aliena, Haider, Iqbal, and Bibi, Sidra
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PANCREATIC cysts , *PANCREATITIS , *CHRONIC pancreatitis , *DYSLIPIDEMIA , *INHIBIN , *HOSPITAL admission & discharge , *IMMUNOSTAINING - Abstract
Autoimmune pancreatitis is a sub-type of chronic pancreatitis. It has 2 further types; type I and II. Type I is associated with IgG4 disease. We describe a case of chronic pancreatitis that ultimately turned out to be IgG4 disease. A 45-year-old female with no co-morbidities presented on 18th November 2022 with epigastric pain, left hypochondrium pain, vomiting, and fever for 5 days. She had previously been admitted twice to the hospital with similar complaints and was diagnosed with acute pancreatitis. Examination revealed tenderness in the epigastrium and left hypochondrium; Laboratory investigations revealed serum Lipase 405 U/L, serum Amylase; 178 U/L, Lipid profile. cholesterol; 242 mg/dL triglycerides; 218 mg/dL HDL; 42 mg/dL LDL; 169 mg/dL. HbA1c; 9.53%. and IgG4 level; 1657mg/liter. CT abdomen with pancreatic protocol showed a cystic lesion in the body and tail of the pancreas suggestive of an infected pseudocyst or localized acute pancreatitis. The patient was diagnosed with type 1 autoimmune pancreatitis and a multidisciplinary team (MDT) was taken on board for further management. The patient was not deemed appropriate for percutaneous or endoscopic drainage of the pseudocyst. She therefore underwent distal pancreatectomy and splenectomy. The biopsy showed features favoring mucinous cystic neoplasm of the pancreas with no evidence of malignancy. On immunohistochemical stains, the reactivity pattern was positive for ER, inhibin, and CD 10 which highlighted the ovarian stroma and cytokeratin. The patient was discharged on 25th November 2022 on supportive treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
15. Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions.
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Olar, Miruna Patricia, Iacobescu, Maria, Bolboacă, Sorana D., Pojoga, Cristina, Moșteanu, Ofelia, Seicean, Radu, Rusu, Ioana, Banc, Oana, Iuga, Cristina Adela, and Seicean, Andrada
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LIPOCALIN-2 , *LIPOCALINS , *ENDOSCOPIC ultrasonography , *NEEDLE biopsy - Abstract
Undetermined pancreatic cystic lesion (PCL) differentiation benefits from endoscopic ultrasound (EUS) based on morphology and cyst fluid analysis, but room for new biomarkers exists. Our aim was to assess the intracystic and serum diagnostic value of neutrophil gelatinase-associated lipocalin (Ngal) and interleukin 1 beta (IL-1β) for differentiation of PCLs. This prospective study included patients from one tertiary hospital, evaluated between April 2018 and May 2020. EUS fine-needle aspiration or pancreatic pseudocysts drainage was the source of PCL intracystic liquid. The final diagnosis was based on surgery or EUS results (morphology, cytology, glucose, and CEA—carcinoembryogenic antigen). The intracystic samples were tested for Ngal, IL-1β, glucose, and CEA, and serum for Ngal and IL-1β. We evaluated 63 cysts, 33 pseudocysts, and 30 non-inflammatory cysts. The diagnostic sensitivity and specificity for mucinous PCL was 70.8% and 92.3% for intracystic Ngal (cut-off: 500–800 ng/dL), without correlation with serum Ngal, no matter the inclusion of infected pseudocysts. After exclusion of infected pseudocysts, the sensitivity and specificity for glucose were 87% and 75%, respectively, and for CEA, they were 87.1%, and 96.8%, respectively. Intracystic Ngal shows promise in differentiating mucinous PCLs, but researchers need to conduct further studies to confirm its effectiveness. Intracystic IL-1β and serum Ngal made no diagnostic contribution. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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16. Multicenter study of the efficacy and safety of electrocautery-enhanced lumen-apposing metal stents for the internal drainage of pancreatic fluid collections.
- Author
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Chung, Chen-Shuan, Kuo, Yu-Ting, Chiu, Yi-Chun, Lin, Yang-Chao, Yang, Chi-Ying, Chen, Kuan-Chih, Liao, Szu-Chia, Sun, Cheuk-Kay, Lin, Yen-Chih, and Wang, Hsiu-Po
- Subjects
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ENDOSCOPIC ultrasonography , *DRAINAGE , *HOLMIUM , *PANCREATIC duct , *DISEASE relapse , *FLUIDS - Abstract
Pancreatic fluid collections (PFCs) including pancreatic pseudocyst (PP) and walled-off necrosis (WON) are complications after acute pancreatitis. We aimed to evaluate the efficacy and safety of endoscopic ultrasound (EUS)-guided lumen-apposing metal stent (LAMS) placement to manage PFCs. Between June 2019 and May 2023, patients with symptomatic PFCs who underwent EUS-guided electrocautery-enhanced LAMS drainage were enrolled retrospectively from eight tertiary centers in Taiwan. In total, 33 [14 (42.42%) PP and 19 (57.58%) WON] patients were enrolled. Gallstones (27.27%) and abdominal pain (72.73%) were the most common etiology and indication for drainage. The technical and clinical success rates were 100% and 96.97%, respectively, and the mean procedure time was 30.55 (± 16.17) min. Complications included one (3.03%) case of self-limited bleeding; there were no cases of mortality. Seven (21.21%) patients had recurrence. Patients with disconnected pancreatic duct syndrome (DPDS) had a higher recurrence rate than those without (71.43% vs. 38.46%, p = 0.05). After replacing LAMSs with transmural double-pigtail plastic stents (DPSs) in the DPDS patients, the DPS migration rate was higher in the patients with recurrence (100% vs. 33.33%, p = 0.04). In conclusion, drainage of symptomatic PFCs with EUS-guided electrocautery-enhanced LAMS appears to be efficient and safe. Replacing LAMSs with DPSs in DPDS patients was associated with a lower recurrence rate. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
17. Umbilical cord cysts: Classification, diagnosis, prognosis, and pregnancy recommendations.
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Chen, Huiling, Jia, Mingzhu, Yang, Shuqi, Zou, Juan, and Xiao, Xue
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UMBILICAL cord , *LITERATURE reviews , *EMBRYOLOGY , *CYSTS (Pathology) , *PROGNOSIS - Abstract
Umbilical cord cysts (UCCs)—cysts located in the umbilical cord that are derived from an abnormal embryonic development process—are typically an incidental discovery during prenatal ultrasound. It can be described as either a pseudocyst or a true UCC, which results from focal edema or degeneration of Wharton jelly or the remnants of embryonic development, respectively. Due to the relative rarity of the UCC, the clinical guidance of UCCs is not yet available. Herein, the aim of this paper is to discuss the classification, diagnosis, prognosis, and clinical management of UCCs through a literature review, in order to improve the understanding of UCCs among clinical obstetricians and pediatricians. Synopsis: The classification, diagnosis, prognosis, and clinical management of UCC. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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18. Auto-immune pancreatitis with unusual presentations -- A case series.
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Girish, Muppa Indrakeela, Dahale, Amol S., Banerjee, Debabrata, Bhate, Prasad, and Karad, Abhijeet
- Abstract
Auto-immune pancreatitis (AIP) is a rare benign disease commonly presented with painless obstructive jaundice and biliary obstruction with rare complications like pseudocyst. We present a case series of two patients of AIP with unusual presentations; one case presented with periorbital swelling, jaundice, and pseudocyst, and the other case presented with abdominal pain and biliary obstruction without jaundice; both showed good response with steroids. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
19. A CLINICAL STUDY OF PSEUDO CYST OF PANCREAS, CHALLENGES AND ITS OUTCOMES: A TERTIARY CARE CENTRE STUDY.
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Saxena, Nishant and Boobily, Amal Mariadas
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GASTRIC outlet obstruction , *PANCREATIC cysts , *TERTIARY care , *COMPUTED tomography , *SURGICAL drainage , *CHRONIC pancreatitis , *SYMPTOMS , *GASTRIC bypass - Abstract
Background: Since the first surgical internal drainage in 1921, surgery remained until recently the cornerstone in the management of PP. Pancreatic pseudocysts may arise as a complication of either acute or chronic pancreatitis. The evolving landscape of pseudocyst comprehension can be attributed to the progress in radiology and the advent of novel treatment approaches. This research aimed to evaluate the clinical characteristics, etiology, and diverse management strategies employed for pseudocysts within a tertiary care hospital setting. Materials and Methods:This is a prospective study involving 82 adult patients conducted over a span of one year, in the Department of surgery, Government Medical College, Orai, Jalaun, India. Results and Observations: Pseudocysts exhibit a higher prevalence in males, with alcohol identified as the most common associated etiology. Initial radiological assessments consisted of ultrasound, followed by contrast-enhanced computed tomography (CECT) of the abdomen for all patients. Complications linked to pseudocysts included gastric outlet obstruction and ascites. Internal drainage emerged as the predominant intervention. Post-drainage complications, notably infections, were addressed through antibiotic therapy, with endoscopic drainage implemented in cases of recurrence. Pain emerged as a significant post-operative issue. The preference for endoscopic drainage is growing, given its less invasive nature, higher long-term success rate, shorter hospital stay, and enhanced patient comfort. Conclusion: Notably, pseudocysts exhibit a higher prevalence in males than females, with a concentration in the age group of 21-30 years, followed by individuals aged between 31-40 years. Management of PPs has evolved over the years, from an aggressive approach, to a more conservative management. Pancreatic pseudocysts predominantly afflict males, often associated with alcoholism. The clinical presentation varies, with abdominal pain being the most prevalent grievance, followed by nausea and vomiting. Initial intervention involves supportive care, but persistent symptoms and complications may necessitate surgical drainage, the most frequently employed management approach. Emerging treatment modalities, such as endoscopic interventions, offer distinct advantages, including reduced pain, shorter hospital stays, and lower recurrence rates. Management of PPs has evolved over the years, from an aggressive approach, to a more conservative management. In cases of symptomatic or complicated pseudocysts, a plethora of techniques and types of drainage can lead to almost 100% primary and overall success of pseudocyst drainage. [ABSTRACT FROM AUTHOR]
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- 2024
20. Auto-immune pancreatitis with unusual presentations – A case series
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Muppa Indrakeela Girish, Amol S Dahale, Debabrata Banerjee, Prasad Bhate, and Abhijeet Karad
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auto-immune pancreatitis ,periorbital swelling ,pseudocyst ,steroids ,Medicine - Abstract
Auto-immune pancreatitis (AIP) is a rare benign disease commonly presented with painless obstructive jaundice and biliary obstruction with rare complications like pseudocyst. We present a case series of two patients of AIP with unusual presentations; one case presented with periorbital swelling, jaundice, and pseudocyst, and the other case presented with abdominal pain and biliary obstruction without jaundice; both showed good response with steroids.
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- 2024
- Full Text
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21. A Comprehensive Clinical Review of Maxillary Sinus Floor Elevation in Patients with Well-Defined Faintly Radiopaque Lesions in the Antrum.
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Nosaka, Yasuhiro, Nosaka, Hitomi, Munakata, Motohiro, and Sanda, Minoru
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MAXILLARY sinus , *HOSPITAL patients , *MAXILLARY sinus diseases , *ASYMPTOMATIC patients , *CONE beam computed tomography , *ODONTOGENIC cysts - Abstract
Well-defined, faintly radiopaque lesions are occasionally observed in the antrum of the maxillary sinus in asymptomatic patients during maxillary sinus floor elevation. These lesions are treated as antral pseudocysts (AP) based on the clinical diagnosis in some cases, and maxillary sinus floor elevation is performed without enucleating these lesions. However, further surgery is required after implant placement if the lesion is a mucocele, odontogenic cyst, or tumour. This comprehensive clinical review aimed to identify an appropriate approach for maxillary sinus floor elevation in patients with well-defined, faintly radiopaque lesions in the antrum based on our clinical experience. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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22. Laparoscopic Approach to Primary Splenic Cyst: Case Report and Review of the Literature.
- Author
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Tiutiuca, Razvan Calin, Nastase Puscasu, Alina Ioana, Stoenescu, Nicoleta, Moscalu, Mihaela, Bradea, Costel, Eva, Iuliana, Lupascu, Cristian Dumitru, Ivan, Luminita, Palaghia, Madalina Maria, Prisecariu, Denisa Ioana, Târcoveanu, Eugen, Vâță, Andrei, Bejan, Valentin, and Vasilescu, Alin Mihai
- Subjects
- *
ARACHNOID cysts , *LITERATURE reviews , *CYSTS (Pathology) , *LAPAROSCOPIC surgery , *POSTOPERATIVE pain , *DIAGNOSTIC imaging , *ECTOPIC pregnancy - Abstract
Splenic cysts are rare benign lesions of the spleen, often asymptomatic and incidentally discovered during imaging studies. While many splenic cysts remain asymptomatic and do not require intervention, surgical management becomes essential in cases of symptomatic cysts, large cysts, or when malignancy cannot be ruled out. Laparoscopic surgery has emerged as a minimally invasive and effective approach for treating splenic cysts, offering advantages such as shorter hospital stays, reduced postoperative pain, and faster recovery. In this case report, we describe our experience with laparoscopic surgery for a symptomatic splenic cyst in a young patient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. Management of Blunt Pancreatic Trauma in Children: A Persistent Controversy—Case Report and Comprehensive Literature Review.
- Author
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Sukhotnik, Igor and Cohen, Neta
- Subjects
ULTRASONIC imaging of the abdomen ,INJURY complications ,PANCREATIC injuries ,DELAYED diagnosis ,CONSERVATIVE treatment ,BLUNT trauma ,PANCREATIC duct ,SURGICAL complications ,PANCREATECTOMY ,TREATMENT effectiveness ,HEALTH care teams ,COMPUTED tomography ,DECISION making in clinical medicine ,EARLY diagnosis ,DISCHARGE planning ,CHILDREN - Abstract
Blunt pancreatic injury (BPI) is relatively uncommon in children, and is associated with relatively high morbidity and mortality, especially if diagnosis is delayed. The aim of this report is to review the literature regarding controversial questions in the early diagnosis and management of pediatric BPI. A representative case of blunt pancreatic trauma in a six-year-old girl with delayed diagnosis and intraoperative and postoperative complications was described. A systematic search of databases and the grey literature in Scopus and Web of Science using relevant keywords was conducted. A total of 26 relevant articles published in last 5 years were found in PubMed. Although early CT performance is considered part of initial pancreatic trauma workup, the sensitivity of CT for detecting main pancreatic duct injuries in children is relatively low. MRCP and ERCP (if available) are useful for assessing ductal injury and should be performed when the status of the pancreatic duct is unclear on the CT. Most patients with low-grade pancreatic damage may be treated conservatively. Although surgery involving distal pancreatectomy remains the preferred approach for most children with high-grade pancreatic injury, there is growing evidence to suggest that non-operative management (NOM) is safe and effective. Most pancreatic pseudo cysts following NOM had relatively mild complications, and most resolved spontaneously. For those children who do require surgery, a conservative operative approach with the least risk is advocated. In conclusion, the optimal management for pediatric pancreatic trauma is controversial. Further clinical trials are required to generate clinical practice guidelines on pancreatic trauma in a child population. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
24. Surgical and Endoscopic Intervention for Chronic Pancreatitis in Children: The Kings College Hospital Experience.
- Author
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Jeropoulos, Renos M., Joshi, Deepak, Aldeiri, Bashar, and Davenport, Mark
- Subjects
CHRONIC pain treatment ,PANCREATITIS diagnosis ,INJURY complications ,BILIOUS disease diagnosis ,ISLANDS of Langerhans transplantation ,CHRONIC disease diagnosis ,BILE duct abnormalities ,HYPERTENSION ,PANCREAS ,PANCREATIC cysts ,GENETIC mutation ,CHRONIC diseases ,ENDOSCOPIC surgery ,ENDOSCOPIC retrograde cholangiopancreatography ,ENDOSCOPIC ultrasonography ,PANCREATIC duct ,HEALTH outcome assessment ,SURGICAL decompression ,SURGICAL stents ,RISK assessment ,PANCREATIC diseases ,PANCREATECTOMY ,PANCREATITIS ,LITHOTRIPSY ,ENDOSCOPY ,DISEASE complications ,CHILDREN - Abstract
Paediatric chronic pancreatitis (CP) is a rare and debilitating pathology that often requires invasive diagnostics and therapeutic interventions either to address a primary cause such as a pancreaticobiliary malunion or to deal with secondary complications such as chronic pain. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are two endoscopic modalities that have an established diagnostic role in paediatric CP, and their therapeutic utilisation is increasing in popularity. Surgical decompression of the obstructed and dilated pancreatic duct plays a role in alleviating pancreatic duct hypertension, a common association in CP. Surgery equally has a role in certain anatomical abnormalities of the pancreaticobiliary draining system, or occasionally in some CP complications such as drainage of a symptomatic pancreatic pseudocyst. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
25. Return to Vocal Performance Following Microlaryngoscopy in Singers.
- Author
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Rives, Hal, Clark, Christine M., Estes, Christine M., and Sulica, Lucian
- Abstract
Introduction: Although microlaryngoscopy has been recognized to be effective in addressing lesions in vocal performers, no detailed information regarding return to performance (RTP) following surgery exists. We describe our experience and offer proposals to establish standardized criteria for RTP among vocal performers. Methods: Records for adult vocalists who underwent microlaryngoscopy for benign vocal fold (VF) lesions and had a clearly documented RTP date between 2006 and 2022 were reviewed. Patient demographics, diagnoses, interventions, and postsurgical care before and after RTP were described. The need for medical and procedural interventions and rate of reinjury were used to determine the success of RTP. Results: Sixty‐nine vocal performers (average age: 32.8 years, 41 [59.4%] female, 61 [88.4%] musical theater) underwent surgery for 37 (53.6%) pseudocysts, 25 (36.2%) polyps, 5 (7.2%) cysts, 1 (1.4%) varix, and 1 (1.4%) mucosal bridge. Fifty‐seven (82.6%) underwent voice therapy. The average time to RTP was 65.0 ± 29.8 days. Prior to RTP, six (8.7%) experienced VF edema requiring oral steroids and one (1.4%) underwent a VF steroid injection. Within 6 months following RTP, eight (11.6%) received oral steroids for edema and three underwent procedural interventions (two steroid injections for edema/stiffness, one injection augmentation for paresis). One patient experienced pseudocyst recurrence. Conclusions: Return to vocal performance at an average of 2 months following microlaryngoscopy for benign lesions appears overwhelmingly successful, with low rates of need for additional intervention. There is a need for validated instruments to better measure performance fitness to refine and possibly accelerate RTP. Level of Evidence: 4 Laryngoscope, 134:329–334, 2024 [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
26. Persistent Trichomonas vaginalis infections and the pseudocyst form.
- Author
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Shiratori, Mari, Patel, Abhishek, Gerhold, Richard W., Sullivan, Steven A., and Carlton, Jane M.
- Subjects
- *
TRICHOMONAS vaginalis , *TRICHOMONIASIS , *SEXUALLY transmitted diseases , *PAPILLOMAVIRUSES , *CATTLE parasites - Abstract
Trichomonas vaginalis , the most common nonviral sexually transmitted infection in the world, has been reported to establish persistent infections that may be influenced by changes that the vagina undergoes with age. A spherical and immotile form of T. vaginalis , knowns as a pseudocyst, may play a role in persistent infections and has been induced in conditions that parallel those of the premenopausal vagina in vitro. Pseudocysts have been identified in several Trichomonas and Tritrichomonas species and are hypothesized to contribute to persistent infections in several of them. The in vitro study of T. vaginalis will be improved through the use of more physiologically relevant culture conditions and introducing new technologies such as vagina-on-a-chip. Current methods may be resulting in inconsistencies in the biology and pathogenicity of T. vaginalis in vitro compared to in vivo. Recent studies have proposed that Trichomonas vaginalis , the causative agent of trichomoniasis [the most common nonviral sexually transmitted infection (STI) in humans] can establish persistent infections in the vagina. T. vaginalis infections are often asymptomatic but can have adverse consequences such as increased risk of HIV-1 infection and cervical cancer. Despite this, it remains an understudied infection. A potential agent of persistent infections is the 'pseudocyst', a spherical form of T. vaginalis identified by several laboratories and linked to persistence in related species such as the avian parasite Trichomonas gallinae and cattle parasite Tritrichomonas foetus. Additional robust and reproducible research on pseudocysts and persistent T. vaginalis infections is required, which may ultimately shed light on how to better diagnose and treat trichomoniasis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
27. Perforation of pancreatic pseudocyst diagnosed with endoscopy and treated with percutaneous drainage
- Author
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Mako Koseki and Yusuke Hashimoto
- Subjects
fluid collection ,LAMS ,pancreatitis ,perforation ,pseudocyst ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Perforation is a rare but fatal complication of pancreatic pseudocysts. It is generally diagnosed by computed tomography imaging with hemorrhagic ascites and pneumoperitoneum. Traditionally, surgery was the mainstream for treating this critical state. Recently, alternative therapies have also been deemed useful. Herein, we describe the case of a 54‐year‐old with perforation of pancreatic pseudocyst which was confirmed by endoscopy, and managed by endoscopic and percutaneous drainage. The patient was initially referred to our hospital for treatment of a pancreatic pseudocyst with hemorrhagic ascites and underwent endoscopic ultrasonographic‐guided stent placement. The next day, imaging demonstrated pneumoperitoneum and worsening ascites consistent with perforation, and the patient was treated conservatively. One week later, the patient developed severe abdominal pain. Endoscopy showed a large perforation site inside the pseudocyst connected to a large fluid collection and direct visualization inside the pseudocyst and fluid collection. The fluid collection was treated with percutaneous drainage, and the patient was discharged one week later with no complications.
- Published
- 2024
- Full Text
- View/download PDF
28. Tracheal pseudocyst: A rare case report
- Author
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Angel George, M P Anoop, P Rajan, and Shalini Kuruvilla
- Subjects
cystectomy ,pseudocyst ,stridor ,Diseases of the respiratory system ,RC705-779 - Abstract
Tracheal pseudocysts are rare benign lesions that can affect individuals of all age groups. In this report, we present a case of tracheal pseudocyst that, to the best of our knowledge, has not been previously reported. A 63-year-old female presented with stridor caused by a cystic mass involving the trachea. The patient underwent cystectomy, and histopathological examination confirmed the presence of a tracheal pseudocyst. Subsequent regular follow-up examinations revealed no recurrence of the lesion.
- Published
- 2024
- Full Text
- View/download PDF
29. An Unexpected Lingual Cortical Erosion in a Solitary Bone Cyst of the Mandible
- Author
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W Maria Priscilla Wincy, R Sankar Narayanan, and P Sri Neeraja
- Subjects
alveolar mucosa ,multilocular ,pseudocyst ,radiolucent ,traumatic bone cyst ,Medicine - Abstract
A 42-year-old woman reported to the outpatient department with the chief complaint of intermittent, sharp, radiating pain in the lower left back tooth region for the past five days which aggravated on mastication and reduced on medication. Medical history was non significant and dental history revealed that the patient underwent extractions five years before. On clinical examination, no extraoral abnormalities were detected [Table/Fig-1]. Intraoral examination revealed decayed 27, 36, 47 teeth, missing 46,31,32, and tenderness on percussion in relation to 37,38. There was generalised gingival attachment loss and mobility in relation to 37,22,16,41,42 [Table/ Fig-2]. On further examination, a localised swelling was evident on the alveolar mucosa in relation to 37 and 38, measuring approximately 1×2 mm with a smooth surface and irregular margins. No discharge was present. On palpation, the swelling was tender with no pus discharge. No bony expansion was appreciated [Table/Fig-3]. A provisional diagnosis of dental caries with a periapical abscess in relation to 37, 38 was given.
- Published
- 2024
- Full Text
- View/download PDF
30. Giant Pancreatic Pseudocyst after Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report
- Author
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Ming-Jen Chan, Chun-Yih Hsieh, Yi-Jiun Su, Chien-Chang Huang, Wen-Hung Huang, Cheng-Hao Weng, Tzung-Hai Yen, and Ching-Wei Hsu
- Subjects
cardiopulmonary bypass ,coronary artery bypass graft ,end-stage renal disease ,hemodialysis ,pancreatitis ,pseudocyst ,Medicine (General) ,R5-920 - Abstract
End-stage renal disease (ESRD) patients have a high prevalence of coronary artery disease, and coronary artery bypass graft (CABG) is one of the essential treatments. ESRD patients undergoing CABG surgery have an increased risk of postoperative complications, including acute pancreatitis. Here, we present the unique case of an exceptionally large pancreatic pseudocyst caused by pancreatitis in an ESRD patient after CABG surgery. A 45-year-old male with ESRD under maintenance hemodialysis received CABG surgery for significant coronary artery disease. Two weeks later, he experienced worsening abdominal pain and a palpable mass was noticed in the epigastric region. Computer tomography revealed an unusually large pseudocyst measuring 21 × 17 cm in the retroperitoneum due to necrotizing pancreatitis. The patient underwent percutaneous cystic drainage, and the symptoms were significantly improved without surgical intervention. Factors such as prolonged cardiopulmonary bypass time, postoperative hypotension, and intradialytic hypotension appeared to have contributed to the development of severe pancreatitis in this case. This report highlights the rarity of a giant pancreatic pseudocyst in an ESRD patient after CABG surgery and emphasizes the importance of vigilant postoperative care.
- Published
- 2023
- Full Text
- View/download PDF
31. MODERN ASPECTS OF NONPARASITIC LIVER CYSTS
- Author
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I.A. KOPYTIN, V.V. IVANOV, V.B. FILIMONOV, G.Y. ZHURAVLYOV, V.S. FOMIN, and I.V. ABRAMOV
- Subjects
liver ,cyst ,nonparasitic cyst ,pseudocyst ,laparoscopic fenestration. ,Public aspects of medicine ,RA1-1270 - Abstract
Objective: The relevance of nonparasitic cysts of the liver (NPCL) is related to their steadily increasing incidence, high recurrence rates, delayed diagnosis, and potential complications. In general, hepatic cysts (HCs) are classified into several types, including simple and complex, false and true. Simple cysts are mainly congenital but also occur in polycystic liver disease. Complex cysts include mucinous neoplasms, echinococcal cysts, hemorrhagic cysts, cystic hepatocellular carcinoma, and other rare lesions. Nonparasitic cystic liver lesions do not usually cause symptoms, and their characteristics are not specific. In 15% of cases, nonspecific signs (flatulence, nausea, dyspepsia) accompany pain. Diagnosis of NPCL is based on data from ultrasound, CT, or MRI of the abdominal organs. There still needs to be a consensus on surgical treatment indications or the effectiveness and feasibility of its various methods. Many surgical interventions for NPCL treatment include puncture drainage, multiple minimally invasive (laparoscopic) surgery options, and open methods. In clinical practice, laparoscopic fenestration, associated with fewer complications and faster recovery, has become widespread. However, significant progress has yet to be achieved in reducing NPCL recurrence rates despite advances in surgical treatment. Therefore, multiple studies are underway to improve treatment options for this medical condition.
- Published
- 2023
- Full Text
- View/download PDF
32. A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report
- Author
-
Tokuro Baba, Toru Yamazaki, Masato Sakai, Koichiro Matshuda, Koji Amaya, Mitsuhisa Takatsuki, and Yasuhiro Okada
- Subjects
Pancreas divisum ,Pancreatitis ,Pseudocyst ,Endoscopic retrograde cholangiopancreatography (ERCP) ,Surgery ,RD1-811 - Abstract
Abstract Background Pancreas divisum (PD), the most common pancreatic anomaly, is caused by the failure of pancreatic bud fusion in the embryo. Although most cases are asymptomatic, it can cause pancreatitis or epigastric pain. We report an unusual case of PD in an infant. Case presentation The patient was a 9-month-old girl with no pertinent medical history. She had suffered vomiting and diarrhea for 1 week before transfer to our hospital. Her general condition was poor, and abdominal distention was noted. Blood tests revealed microcytic anemia with normal chemical markers. The parents reported no episode of pancreatitis. Ultrasonography revealed massive ascites, which was later found to be bloody. Enhanced computed tomography and magnetic resonance imaging depicted a cystic lesion, approximately 2 cm in size, anterior to the second portion of the duodenum. During exploratory laparotomy, a pinhole was identified on the cyst wall, which was mistakenly identified as a duodenal perforation, and direct closure was performed. Postoperative levels of serum amylase and inflammation markers were elevated, and the amount of ascites increased, impairing oral feeding. The level of pancreatic enzymes in the ascites was high. Imaging studies were repeated, but the cause of pancreatic fistula was not identified. Conservative therapy, including administration of total parenteral nutrition, antibiotics, and octreotide, was initiated, but the situation did not improve. Three months after admission, endoscopic retrograde cholangiopancreatography showed a thick dorsal pancreatic duct communicating with a hypoplastic ventral duct, which was indicative of PD. Contrast medium leaking from the dorsal duct near the minor ampulla revealed the presence of a pseudocyst. Stenting via the minor papilla was impossible because the minor papilla was obstructed. Instead, a stent was inserted into the ventral pancreatic duct. Endoscopic transgastric drainage of the cyst was effective, and the patient was discharged, 7 months after admission. The patient is healthy, but the gastric stent needs to be replaced regularly. Conclusion In children, PD can manifest with pancreatic pseudocyst that causes pancreatic ascites, even in the absence of pancreatitis. This may be a previously unrecognized manifestation of PD in children, and clinicians need to be aware of it.
- Published
- 2023
- Full Text
- View/download PDF
33. Pancreas Signs
- Author
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Yale, Steven H., Tekiner, Halil, Yale, Eileen S., Yale, Ryan C., Yale, Steven H., Tekiner, Halil, Yale, Eileen S., and Yale, Ryan C.
- Published
- 2023
- Full Text
- View/download PDF
34. Medical, Nutritional and Surgical Management of Chronic Pancreatitis
- Author
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Leeds, John S. and Nightingale, Jeremy M.D., editor
- Published
- 2023
- Full Text
- View/download PDF
35. Radiological Signs of Benign and Malignant Disease and Their Appearance on CBCT
- Author
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Ng, Suk Y. and Ng, Suk Y.
- Published
- 2023
- Full Text
- View/download PDF
36. Large or multiple pseudocysts can impede or complicate the nonsurgical treatment of pancreatolithiasis
- Author
-
Satoshi Yamamoto, Kazuo Inui, Yoshiaki Katano, Hironao Miyoshi, Takashi Kobayashi, and Yoshihiko Tachi
- Subjects
chronic pancreatitis ,pancreatolithiasis ,pseudocyst ,extracorporeal shock wave lithotripsy ,Medicine (General) ,R5-920 - Abstract
Objectives: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis. Methods: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter. Pseudocysts in the other nine patients had diameters of at least 60 mm or were multiple. The locations of pseudocysts along the length of the pancreas varied from the area with stone involvement to the pancreatic tail. We compared the outcomes in these groups. Results: We found no significant differences in pain relief, stone clearance, stone recurrence, or the likelihood of adverse events between pseudocyst groups or between patients with vs without pseudocysts. However, 4 of 9 patients with large or multiple pseudocysts required transition to surgical treatment (44%) compared with 13 of 144 patients with pancreatolithiasis and no pseudocyst (9.0%) (P=0.006). Conclusions: Patients with smaller pseudocysts typically underwent nonsurgical stone clearance successfully with few adverse events, similar to findings in patients with pancreatolithiasis and no pseudocysts. Pancreatolithiasis complicated by large or multiple pseudocysts did not cause more adverse events but was more likely to require transition to surgery compared with pancreatolithiasis without pseudocysts. In patients with large or multiple pseudocysts, early transition to surgery should be considered when nonsurgical treatment is ineffective.
- Published
- 2023
- Full Text
- View/download PDF
37. Acute pancreatitis revealing an isolated hydatid pancreatic cyst simulating a pseudocyst: A case report
- Author
-
Ihssane Afilal, MD, Widad Abbou, MD, Khaoula Oukrid, MD, Narjisse Aichouni, MD, Siham Nasri, MD, Imane Kamaoui, MD, and Imane Skiker, MD
- Subjects
Pancreatitis ,Pseudocyst ,Hydatid cyst ,Echinococcus ,MRI ,Diagnosis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Hydatid disease is a worldwide public health problem, especially in endemic countries, caused by the larval stage of Echinococcus granulosis. The pancreatic location of this disease is exceptional, representing only 1% of all possible locations, making this a widely misdiagnosed entity. We report a case of a 42-year-old man with a history of alcoholism and recurring abdominal pain, who presented to the emergency department with acute pancreatitis revealing a hydatid pancreatic cyst mimicking as a pseudocyst of the pancreas. The diagnosis was established using computed tomography and magnetic resonance imaging.
- Published
- 2023
- Full Text
- View/download PDF
38. Giant Pancreatic Pseudocyst after Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report.
- Author
-
Chan, Ming-Jen, Hsieh, Chun-Yih, Su, Yi-Jiun, Huang, Chien-Chang, Huang, Wen-Hung, Weng, Cheng-Hao, Yen, Tzung-Hai, and Hsu, Ching-Wei
- Subjects
- *
CORONARY artery bypass , *CORONARY artery surgery , *HEMODIALYSIS patients , *CARDIOPULMONARY bypass , *CHRONIC kidney failure , *NECROTIZING pancreatitis - Abstract
End-stage renal disease (ESRD) patients have a high prevalence of coronary artery disease, and coronary artery bypass graft (CABG) is one of the essential treatments. ESRD patients undergoing CABG surgery have an increased risk of postoperative complications, including acute pancreatitis. Here, we present the unique case of an exceptionally large pancreatic pseudocyst caused by pancreatitis in an ESRD patient after CABG surgery. A 45-year-old male with ESRD under maintenance hemodialysis received CABG surgery for significant coronary artery disease. Two weeks later, he experienced worsening abdominal pain and a palpable mass was noticed in the epigastric region. Computer tomography revealed an unusually large pseudocyst measuring 21 × 17 cm in the retroperitoneum due to necrotizing pancreatitis. The patient underwent percutaneous cystic drainage, and the symptoms were significantly improved without surgical intervention. Factors such as prolonged cardiopulmonary bypass time, postoperative hypotension, and intradialytic hypotension appeared to have contributed to the development of severe pancreatitis in this case. This report highlights the rarity of a giant pancreatic pseudocyst in an ESRD patient after CABG surgery and emphasizes the importance of vigilant postoperative care. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. A Combined DNA/RNA-based Next-Generation Sequencing Platform to Improve the Classification of Pancreatic Cysts and Early Detection of Pancreatic Cancer Arising From Pancreatic Cysts.
- Author
-
Nikiforova, Marina N., Wald, Abigail I., Spagnolo, Daniel M., Melan, Melissa A., Grupillo, Maria, Yi-Tak Lai, Brand, Randall E., O'Broin-Lennon, Anne Marie, McGrath, Kevin, Park, Walter G., Pfau, Patrick R., Polanco, Patricio M., Kubiliun, Nisa, DeWitt, John, Easler, Jeffrey J., Dam, Aamir, Mok, Shaffer R., Wallace, Michael B., Kumbhari, Vivek, and Boone, Brian A.
- Abstract
Objective: We report the development and validation of a combined DNA/RNA next-generation sequencing (NGS) platform to improve the evaluation of pancreatic cysts. Background and Aims: Despite a multidisciplinary approach, pancreatic cyst classification, such as a cystic precursor neoplasm, and the detection of high-grade dysplasia and early adenocarcinoma (advanced neoplasia) can be challenging. NGS of preoperative pancreatic cyst fluid improves the clinical evaluation of pancreatic cysts, but the recent identification of novel genomic alterations necessitates the creation of a comprehensive panel and the development of a genomic classifier to integrate the complex molecular results. Methods: An updated and unique 74-gene DNA/RNA-targeted NGS panel (PancreaSeq Genomic Classifier) was created to evaluate 5 classes of genomic alterations to include gene mutations (e.g., KRAS, GNAS, etc.), gene fusions and gene expression. Further, CEA mRNA (CEACAM5) was integrated into the assay using RT-qPCR. Separate multi-institutional cohorts for training (n = 108) and validation (n = 77) were tested, and diagnostic performance was compared to clinical, imaging, cytopathologic, and guideline data. Results: Upon creation of a genomic classifier system, PancreaSeq GC yielded a 95% sensitivity and 100% specificity for a cystic precursor neoplasm, and the sensitivity and specificity for advanced neoplasia were 82% and 100%, respectively. Associated symptoms, cyst size, duct dilatation, a mural nodule, increasing cyst size, and malignant cytopathology had lower sensitivities (41--59%) and lower specificities (56--96%) for advanced neoplasia. This test also increased the sensitivity of current pancreatic cyst guidelines (IAP/Fukuoka and AGA) by >10% and maintained their inherent specificity. Conclusions: PancreaSeqGCwas not only accurate in predicting pancreatic cyst type and advanced neoplasia but also improved the sensitivity of current pancreatic cyst guidelines. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
40. Endoscopic And Surgical Approaches To Pancreas Pseudocyst: A Single Centre Experience.
- Author
-
Şansal, Müfit and Üstüner, Mehmet Akif
- Subjects
PANCREATITIS ,ENDOSCOPY ,CYSTS (Pathology) ,LAPAROSTOMY ,SURGICAL stents - Abstract
Objective: Pseudocyst is the most frequently observed cystic lesion of the pancreas and generally develops on the basis of pancreatitis. The aim of this study was to present cases of pancreas pseudocyst treated with endoscopic or surgical cystogastrostomy. Material and Method: A retrospective evaluation was made of patients who underwent an invasive procedure because of pancreas pseudocyst between January 2021 and June 2023. Results: The patients comprised 5 (55.5%) females and 4 (44.5%) males with a mean age of 50 years. The etiology of pseudocyst was observed to be biliary pancreatitis in 6 (66.6%) patients, postpartum pancreatitis in 2 (22.2%) patients, and pancreas head cancer in 1 (11.1%) patient. Cystogastrostomy was performed with placement of an endoscopic stent in 4 (44.5%) patients, laparotomy was performed in 3 (33.3%) patients when the endoscopic intervention failed, and direct surgical cystogastrostomy was performed in 2 (22.2%) patients. The mean time between pancreatitis and the invasive intervention was 115 days. The procedure was repeated in 4 (44.5%) patients applied with a stent and in 1 (11.1%) patient who underwent laparotomy. Change of stent was made in 2 patients applied with a stent. According to the Pan pancreas pseudocyst classification, all the patients were type 4. During a mean 7-month follow-up period, wound site infection was observed in 2 patients, and intra-abdominal abscess in 1. Conclusion: Cystogastrostomy with minimally invasive endoscopic drainage+stent can be used as the first option in the treatment of pancreas pseudocysts. When endoscopic interventions are not appropriate or not successful, conventional surgery can be safely selected. [ABSTRACT FROM AUTHOR]
- Published
- 2023
41. A possible manifestation of pancreas divisum–pancreatic pseudocyst in an infant with no apparent history of pancreatitis: a case report.
- Author
-
Baba, Tokuro, Yamazaki, Toru, Sakai, Masato, Matshuda, Koichiro, Amaya, Koji, Takatsuki, Mitsuhisa, and Okada, Yasuhiro
- Subjects
PANCREAS divisum ,PANCREATITIS ,MAGNETIC resonance imaging ,ENDOSCOPIC retrograde cholangiopancreatography ,PANCREATIC duct ,PANCREATIC fistula ,GASTRIC outlet obstruction - Abstract
Background: Pancreas divisum (PD), the most common pancreatic anomaly, is caused by the failure of pancreatic bud fusion in the embryo. Although most cases are asymptomatic, it can cause pancreatitis or epigastric pain. We report an unusual case of PD in an infant. Case presentation: The patient was a 9-month-old girl with no pertinent medical history. She had suffered vomiting and diarrhea for 1 week before transfer to our hospital. Her general condition was poor, and abdominal distention was noted. Blood tests revealed microcytic anemia with normal chemical markers. The parents reported no episode of pancreatitis. Ultrasonography revealed massive ascites, which was later found to be bloody. Enhanced computed tomography and magnetic resonance imaging depicted a cystic lesion, approximately 2 cm in size, anterior to the second portion of the duodenum. During exploratory laparotomy, a pinhole was identified on the cyst wall, which was mistakenly identified as a duodenal perforation, and direct closure was performed. Postoperative levels of serum amylase and inflammation markers were elevated, and the amount of ascites increased, impairing oral feeding. The level of pancreatic enzymes in the ascites was high. Imaging studies were repeated, but the cause of pancreatic fistula was not identified. Conservative therapy, including administration of total parenteral nutrition, antibiotics, and octreotide, was initiated, but the situation did not improve. Three months after admission, endoscopic retrograde cholangiopancreatography showed a thick dorsal pancreatic duct communicating with a hypoplastic ventral duct, which was indicative of PD. Contrast medium leaking from the dorsal duct near the minor ampulla revealed the presence of a pseudocyst. Stenting via the minor papilla was impossible because the minor papilla was obstructed. Instead, a stent was inserted into the ventral pancreatic duct. Endoscopic transgastric drainage of the cyst was effective, and the patient was discharged, 7 months after admission. The patient is healthy, but the gastric stent needs to be replaced regularly. Conclusion: In children, PD can manifest with pancreatic pseudocyst that causes pancreatic ascites, even in the absence of pancreatitis. This may be a previously unrecognized manifestation of PD in children, and clinicians need to be aware of it. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
42. Pseudoquiste mesentérico: reporte de un caso.
- Author
-
Salada-Morales, Rocío, Castelli, Fernando, and Barberousse, Carlos
- Abstract
Introduction: Mesenteric cysts can be found throughout the entire intestine mesentery. Mesenteric pseudocysts are characterized by lack of endothelial lining. They are generally asymptomatic and the diagnosis can be made by imaging studies. Material and Method: Report of a clinical case Results: We present the case of a healthy 50-year-old woman consulted for a painless tumor on the left flank. She requested a CT and MRI where a thin-walled, homogeneous cystic tumor of 88mm in greatest diameter with septa and partitions was visualized. A laparoscopic approach was performed identifying a 12cm mass that protruded at the level of the mesentery of the second jejunal loop, it was resected without incident. The pathological anatomy reported a mesenteric pseudocyst, without elements of malignancy. Good subsequent evolution. Conclusions: Mesenteric cysts are extremely rare. They are generally located in the mesentery of the small intestine, as in the case presented. Taking into account the histopathological characteristics, they are classified into six groups. Although its malignant transformation is exceptional, the treatment always consists of its surgical resection. Laparoscopy is preferred for its well-known benefits. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
43. Detailed Characteristics of Post-discharge Mortality in Acute Pancreatitis.
- Author
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Czapári, Dóra, Váradi, Alex, Farkas, Nelli, Nyári, Gergely, Márta, Katalin, Váncsa, Szilárd, Nagy, Rita, Teutsch, Brigitta, Bunduc, Stefania, Erőss, Bálint, Czakó, László, Vincze, Áron, Izbéki, Ferenc, Papp, Mária, Merkely, Béla, Szentesi, Andrea, and Hegyi, Péter
- Abstract
The in-hospital survival of patients suffering from acute pancreatitis (AP) is 95% to 98%. However, there is growing evidence that patients discharged after AP may be at risk of serious morbidity and mortality. Here, we aimed to investigate the risk, causes, and predictors of the most severe consequence of the post-AP period: mortality. A total of 2613 well-characterized patients from 25 centers were included and followed by the Hungarian Pancreatic Study Group between 2012 and 2021. A general and a hospital-based population was used as the control group. After an AP episode, patients have an approximately threefold higher incidence rate of mortality than the general population (0.0404 vs 0.0130 person-years). First-year mortality after discharge was almost double than in-hospital mortality (5.5% vs 3.5%), with 3.0% occurring in the first 90-day period. Age, comorbidities, and severity were the most significant independent risk factors for death following AP. Furthermore, multivariate analysis identified creatinine, glucose, and pleural fluid on admission as independent risk factors associated with post-discharge mortality. In the first 90-day period, cardiac failure and AP-related sepsis were among the main causes of death following discharge, and cancer-related cachexia and non–AP-related infection were the key causes in the later phase. Almost as many patients in our cohort died in the first 90-day period after discharge as during their hospital stay. Evaluation of cardiovascular status, follow-up of local complications, and cachexia-preventing oncological care should be an essential part of post-AP patient care. Future study protocols in AP must include at least a 90-day follow-up period after discharge. [Display omitted] Post-discharge mortality in acute pancreatitis is as important as in-hospital mortality. A follow-up plan and a screening program are recommended for patients with acute pancreatitis. [ABSTRACT FROM AUTHOR]
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- 2023
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44. Clinical spectrum and outcome of pancreatic disorders in children.
- Author
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Shaikh, Uzma, Parakash, Arit, Merchant, Aisha, and Shaikh, Mehmood
- Subjects
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PANCREAS divisum , *PEDIATRICS , *PANCREATIC duct , *ABDOMINAL pain , *COMPUTED tomography , *EXOCRINE pancreatic insufficiency , *CHRONIC pancreatitis - Abstract
Objective: To determine the clinical spectrum and immediate outcome of pancreatic disorders in children attending National Institute of Child Health, Karachi, Pakistan. Study Design: Cross Sectional study. Setting: Inpatient and Outpatient Department of Pediatric Medicine, National Institute of Child Health, Karachi. Period: January 2022 to December 2022. Material & Methods: A total of 49 children of either gender aged between 2 to 15 years presenting with clinical features of pancreatic disorders were analyzed. At the time of enrollment, data about demographic and clinical characteristics were noted. Important laboratory investigations were sent to local institutional laboratory. Ultrasound and/or CT scan of abdomen of each child was performed and reported by consultant radiologist having 3 years of experience for confirmation of the diagnosis. Immediate outcome was noted after 15 days of treatment among all children. Outcomes were labeled in terms of improved, not improved or expired. Results: In a total of 49 children, 30 (61.2%) were male while the mean age was 8.46±3.40 years. Epigastric pain, vomiting and whole abdominal pain were the most frequent presenting complaints noted in 40 (81.6%), 35 (71.4%) and 32 (65.3%) children respectively. Atrophy, inflammation and edema, calcifications, pancreatic duct dilation and pancreatic divisum were the commonest radiological findings noted in 10 (20.4%), 21 (42.9%), 18 (36.7%), 13 (26.5%) and 2 (4.1%) children respectively. Chronic pancreatitis was found to be the most frequent pancreatic disorder in 29 (59.2%) patients and they were associated with low fecal elastase level while acute pancreatitis was noted in 20 (40.8%) cases. Improved outcomes were observed in 44 (89.8%) children while no mortality was reported. Conclusion: Majority of the children with pancreatic disorders were male and aged between 6 to 12 years. Chronic pancreatitis was the most common type of pancreatic disorder. Epigastric pain, vomiting and whole abdominal pain were the most frequent presenting complaints. Outcome was generally good and no mortality was noted. [ABSTRACT FROM AUTHOR]
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- 2023
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45. Safety and Efficacy of Long-Term Transmural Plastic Stent Placement After Removal of Lumen Apposing Metal Stent in Resolved Pancreatic Fluid Collections with Duct Disconnection at Head/Neck of Pancreas.
- Author
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Rana, Surinder S., Sharma, Ravi, Sharma, Gaurav, and Gupta, Rajesh
- Subjects
- *
PANCREATIC duct , *PANCREAS , *NECK , *PLASTICS , *HEAD , *ENDOSCOPIC retrograde cholangiopancreatography - Abstract
Background and Aims: Replacing lumen apposing metal stents (LAMS) with permanent indwelling plastic stents after the resolution of pancreatic fluid collections (PFC) in patients with disconnected pancreatic duct (DPD) is a debatable issue. We retrospectively evaluated the safety and efficacy of replacing LAMS with long-term indwelling transmural plastic stents in patients with DPD at head/neck of pancreas. Methods: The database of patients with PFC who underwent endoscopic transmural drainage with LAMS over the last three years was retrospectively analyzed to identify patients with DPD at the level of the head/neck of the pancreas. The patients were divided into two groups: Group A where LAMS could be replaced with plastic stents and Group B, where LAMS could not be replaced with plastic stents. The two groups were compared for recurrence of symptoms/PFC and complications. Results: Out of 53 patients studied, 39 patients (34 males; mean age: 35.7 ± 6.6 years) were included in Group A and 14 patients in Group B (11 males; mean age: 33.4 ± 5.9 years). The demographic profile as well as indwelling time of LAMS was comparable between two groups. PFC recurrence was observed in 2/39 (5.1%) patients in group A and 6/14 (42.8%) patients in group B (p = 0.0001) with one patient in group A and 5 patients in group B requiring repeat intervention for recurrent PFC. Conclusions: Long-term transmural plastic stent placement after removal of LAMS in pancreatic duct disconnection at head/neck of the pancreas is safe and effective strategy to prevent the recurrence of PFC. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Rupture of Splenic Artery Pseudoaneurysm with Pancreatitis: A Rare Case Report
- Author
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Taekyung Kang and Mi-Jin Kang
- Subjects
pseudoaneurysm ,pseudocyst ,splenic artery ,transcatheter arterial embolization ,Surgery ,RD1-811 - Abstract
Vascular involvement of pancreatic pseudocyst is a rare complication that can potentially result in a fatal outcome. If there is vascular involvement, the splenic artery is most often involved; its rupture and massive bleeding into the peritoneal cavity or retroperitoneal space can lead to hypovolemic shock. We report on a 66-year-old-male patient, who initially presented with atypical chest pain and was diagnosed with a rupture of the splenic artery pseudoaneurysm resulting from chronic pancreatitis. The patient was successfully treated by transcatheter arterial embolization (TAE). The patient’s condition improved and he was finally discharged without complications 22 days after admission. The splenic arterial involvement in the patient with pancreatic pseudocyst is an uncommon complication. Chest pain with pleuritic symptom is often misdiagnosed as cardiovascular or pulmonary disease. Proper management depending on hemodynamic stability can prevent a life-threatening event.
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- 2023
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47. Pseudocyst of Pinna: Recurrence free Approach with drain placement - A Tertiary care Experience
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Varunkumar J and Priyanka Kumar Arora
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seroma ,pinna ,recurrence ,pseudocyst ,chondromalacia ,Medicine - Abstract
Background: Pseudocyst (seroma) of pinna is a clinical condition where there occurs accumulation of serous fluid between the skin and perichondrium layer either due to trivial trauma or degeneration. Treatment of this condition is challenging as there are high chances of recurrence and cosmetic disfigurement. Methodology: 20 clinically diagnosed auricular seroma patients were studied and compared with needle aspiration technique & Incision and drainage with drain in situ technique and results were compiled. Results: All patients tolerated procedure well. Patients who underwent needle aspiration and pressure dressing had 40% recurrence when compared to drain in situ technique with no recurrence and disfigurement of pinna on follow up of 6 months. Conclusion: Incision and drainage with drain in situ of Pinna seroma is cost effective & simple method with almost nil recurrence rate when compared to needle aspiration technique with good results.
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- 2023
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48. Discal Cysts
- Author
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Akhaddar, Ali and Akhaddar, Ali
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- 2023
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49. Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions
- Author
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Miruna Patricia Olar, Maria Iacobescu, Sorana D. Bolboacă, Cristina Pojoga, Ofelia Moșteanu, Radu Seicean, Ioana Rusu, Oana Banc, Cristina Adela Iuga, and Andrada Seicean
- Subjects
cystic pancreatic lesions ,endoscopic ultrasound ,neutrophil gelatinase-associated lipocalin (Ngal) ,pancreas ,pseudocyst ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Undetermined pancreatic cystic lesion (PCL) differentiation benefits from endoscopic ultrasound (EUS) based on morphology and cyst fluid analysis, but room for new biomarkers exists. Our aim was to assess the intracystic and serum diagnostic value of neutrophil gelatinase-associated lipocalin (Ngal) and interleukin 1 beta (IL-1β) for differentiation of PCLs. This prospective study included patients from one tertiary hospital, evaluated between April 2018 and May 2020. EUS fine-needle aspiration or pancreatic pseudocysts drainage was the source of PCL intracystic liquid. The final diagnosis was based on surgery or EUS results (morphology, cytology, glucose, and CEA—carcinoembryogenic antigen). The intracystic samples were tested for Ngal, IL-1β, glucose, and CEA, and serum for Ngal and IL-1β. We evaluated 63 cysts, 33 pseudocysts, and 30 non-inflammatory cysts. The diagnostic sensitivity and specificity for mucinous PCL was 70.8% and 92.3% for intracystic Ngal (cut-off: 500–800 ng/dL), without correlation with serum Ngal, no matter the inclusion of infected pseudocysts. After exclusion of infected pseudocysts, the sensitivity and specificity for glucose were 87% and 75%, respectively, and for CEA, they were 87.1%, and 96.8%, respectively. Intracystic Ngal shows promise in differentiating mucinous PCLs, but researchers need to conduct further studies to confirm its effectiveness. Intracystic IL-1β and serum Ngal made no diagnostic contribution.
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- 2024
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50. Minimally Invasive Open Cystogastrostomy for Giant Pancreatic Pseudocyst in Pediatric Patients.
- Author
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Gupta, Rahul, Singh, Ratendra, and Bhandari, Anu
- Subjects
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STOMACH surgery , *PANCREATIC cysts , *MINIMALLY invasive procedures , *TREATMENT effectiveness , *PREOPERATIVE care , *ULTRASONIC imaging , *PEDIATRICS , *GASTROSTOMY , *SUTURING , *SURGICAL site , *PATIENT aftercare - Abstract
Open cystogastrostomy is the standard treatment for the operative management of pancreatic pseudocysts. We describe our technique of minimally invasive open cystogastrostomy for giant pediatric pancreatic pseudocyst. Preoperative incision marking on the most prominent part of the pseudocyst was done by ultrasound guidance. A transverse incision of approximately 3-4 cm was made, and a minilaparotomy was performed. Stay sutures were applied on the anterior wall of the stomach. The anterior wall was exteriorized; transverse gastrotomy was performed, and superior and inferior flaps were made. Deaver's retractor was placed inside the lumen, and cystogastrostomy was completed. We employed this technique in five male patients without any complications. All patients were allowed clear liquids on postoperative day 4 or 5; and gradually shifted to a soft diet. The mean duration of postoperative stay was 7 days. The size of the scar ranged from 3 to 5 cm. All patients were doing well on follow up. Our technique of minimally invasive open cystogastrostomy is a viable option for pancreatic pseudocyst in pediatric patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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