scholarly journals Unique Surgical Issues in the Management of a Giant Retroperitoneal Schwannoma and Brief Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Santhosh Kuriakose ◽  
Syam Vikram ◽  
Surij Salih ◽  
Satheesan Balasubramanian ◽  
Nizamudeen Mangalasseri Pareekutty ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Foot Drop ◽  
Neurological Deficits ◽  
Sensory Loss ◽  
Uneventful Recovery ◽  
Iliopsoas Muscle ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Internal Iliac ◽  
Retroperitoneal Schwannoma

Ancient Schwannoma, though benign, can cause diagnostic dilemma because of its clinical presentation and imaging features. We report the management of a giant retroperitoneal schwannoma in a 19-year-old young lady who presented with lower abdominal distension. CT scan reported a large heterogenous lesion in the abdominopelvic retroperitoneum (42 cm × 16 cm × 16 cm) as a malignant tumor. The unique problems we encountered were the enormous size, the location of major part of the tumor in the pelvis, the need for fertility preservation, the external iliac vessels stretching over the tumor making mobilization surgically demanding, and the prospects of neurological deficits. An en bloc resection of schwannoma with common iliac, external iliac and internal iliac veins, internal iliac artery, femoral and obturator nerves, and iliopsoas muscle was done maintaining oncological principles. External iliac artery that was cut to facilitate tumor mobilization was reanastomosed at the end of the procedure. Postoperatively patient had uneventful recovery with patchy sensory loss, foot drop, and quadriceps weakness which was rehabilitated with a foot drop splint and active physiotherapy.

scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  
Keyword(s):  
Low Frequency ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Complete Surgical Excision ◽  
Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

Internal Iliac Aneurysm Rupture into the Rectum following Endovascular Exclusion: An Unusual Cause of Massive Lower Gastrointestinal Bleeding

2002 ◽  
Vol 9 (6) ◽  
pp. 907-911 ◽  
Author(s):  
Christos D. Karkos ◽  
Taohid O. Oshodi ◽  
Dale Vimalachandran ◽  
John S. Abraham ◽  
Mohan Adiseshiah
Keyword(s):  
Gastrointestinal Bleeding ◽  
Iliac Artery ◽  
Aneurysm Rupture ◽  
Lower Gastrointestinal Bleeding ◽  
Uneventful Recovery ◽  
Intestinal Bleeding ◽  
Iliac Aneurysm ◽  
Stent Grafting ◽  
Internal Iliac ◽  
Internal Iliac Aneurysm

Purpose: To report a rare iliorectal fistula following endovascular treatment of an internal iliac aneurysm. Case Report: A 76-year-old man developed lower gastrointestinal bleeding 3 months after successful endovascular exclusion of a left internal iliac aneurysm with coil embolization, attempted stent-grafting, ligation of the distal external iliac artery, and a femorofemoral crossover bypass. Aortography showed no clear intestinal bleeding point, but demonstrated recanalization and continued perfusion of the aneurysm. At laparotomy, an iliorectal fistula was detected. The common iliac artery was ligated proximally, the aneurysm sac was opened, and the back-bleeding internal iliac artery branches were oversewn. The rectum was closed primarily. He made an uneventful recovery. Conclusions: An iliorectal fistula is an extremely rare and unlikely complication of coil occlusion of an iliac aneurysm. A high index of suspicion for the diagnosis is of paramount importance. Periodic imaging in these patients is required to detect recanalization and continuing aneurysm expansion.

scholarly journals A Case of Giant Aortoiliac Aneurysm Rupture when Open Repair Seems a One-Way Street

Aorta ◽  
2021 ◽  
Author(s):  
Georgios Galanopoulos ◽  
Vassilios Papavassiliou
Keyword(s):  
Iliac Artery ◽  
Surgical Repair ◽  
Open Repair ◽  
Internal Iliac Artery ◽  
Aneurysm Rupture ◽  
Uneventful Recovery ◽  
Aortoiliac Aneurysm ◽  
Risk Of Rupture ◽  
Internal Iliac ◽  
Nosological Entity

AbstractGiant aortoiliac aneurysm is a rare nosological entity. Owing to the increased diameter, the risk of rupture is extremely high and, similarly, the repair is extremely challenging. In this article, open surgical repair of a ruptured giant aortoiliac aneurysm in a 72-year-old male is described. A bifurcated Dacron graft was used with left internal iliac artery revascularization, while the contralateral internal iliac artery was ligated. The patient had an uneventful recovery.

scholarly journals Ruptured internal iliac artery aneurysm masquerading as an inguinal hernia

2021 ◽  
Vol 11 (2) ◽  
pp. 39-41
Author(s):  
Jia Ying Isaac Tay
Keyword(s):  
Inguinal Hernia ◽  
Organ Dysfunction ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Pelvic Organ ◽  
Careful Examination ◽  
Uneventful Recovery ◽  
Hernia Sac ◽  
Abdominal Masses ◽  
Internal Iliac

Internal iliac artery aneurysms are rare, representing less than 2% of all aneurysms. Nonetheless, the mortality is high at up to 60% when ruptured. Ruptured internal iliac artery aneurysms commonly present with overt abdominal pain and systemic instability. They can also present with symptoms of pelvic organ dysfunction, such as urinary retention or obstipation. This report describes the first case of a ruptured internal iliac artery (IIA) aneurysm masquerading as a reducible inguinal hernia. It was diagnosed on a Computed Tomography scan, which showed a large contained ruptured right IIA aneurysm with extension of haemorrhage through the hernia sac. He underwent an endovascular procedure to exclude the aneurysm that was uncomplicated, and he had an uneventful recovery. It highlights the importance of considering IIA aneurysms as differentials for abdominal masses, groin lumps or vague symptoms of pelvic organ dysfunction. Thorough exploration of the history and careful examination will help flag these diagnoses in our clinical assessment.

scholarly journals Internal iliac artery pseudoaneurysm: a rare presentation with foot drop and sciatica

2018 ◽  
Vol 35 (2) ◽  
pp. 222-225
Author(s):  
Pradeep Ramakrishnan ◽  
Milind Padmakar Hote ◽  
Nanditha Sreedhar ◽  
Sanjeev Kumar ◽  
Vishwas Malik ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Foot Drop ◽  
Rare Presentation ◽  
Artery Pseudoaneurysm ◽  
Internal Iliac ◽  
Iliac Artery Pseudoaneurysm

Preoperative evaluation of iliac blood vessels for first kidney transplant recipients: Combination of conventional and contrast-enhanced ultrasonography

2021 ◽  
pp. 1-11
Author(s):  
Wen-qi Yang ◽  
Xiao-lan Cui ◽  
Ming Zhang ◽  
Xiao-dong Yuan ◽  
Liang Ying ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Operative Strategy ◽  
Post Transplant ◽  
Transplant Outcomes ◽  
Contrast Enhanced ◽  
Internal Iliac ◽  
Contrast Enhanced Ultrasonography ◽  
Us Findings

OBJECTIVE: To assess iliac blood vessels using conventional ultrasound (US) and contrast-enhanced ultrasonography (CEUS) before kidney transplantation (KT) and determine whether US findings related to post-transplant outcomes. METHODS: A total of 119 patients received US and CEUS before KT waiting-list acceptance. The preoperative iliac blood hemodynamics and vascular conditions were evaluated. The operative strategy and follow-up outcomes were recorded. Logistic regression and correlation analysis were used. The accuracy in determining the patency of iliac blood vessels was calculated before and after the injection of contrast materials. RESULTS: CEUS can help to significantly improve the visualization of the internal iliac artery, but there was no significant correlation with post-transplant outcomes. In terms of accuracy, there were significant differences in determining the patency of internal iliac arteries between conventional US and CEUS (60.5% and 100%, p <  0.001). The surgical strategy of one patient was regulated and two patients were excluded from KT according to US findings. CONCLUSIONS: Compared with conventional US, CEUS helps to improve the visualization of the internal iliac artery. Conventional US and CEUS have the potential to serve as effective methods to evaluate anatomy and hemodynamics of iliac vessels and have a potential value while defining clinical algorithms in surgery decision-making.

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