scholarly journals Endoscopic Drainage of Giant Pancreatic Pseudocysts Using Both Lumen-Apposing Metal Stent and Plastic Stent: A Report of Two Cases and Review of the Current Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Hussam I. A. Alzeerelhouseini ◽  
Muawiyah Elqadi ◽  
Mohammad N. Elqadi ◽  
Sadi A. Abukhalaf ◽  
Hazem A. Ashhab
Keyword(s):  
Pancreatic Pseudocyst ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Metal Stent ◽  
Case Presentation ◽  
Plastic Stent ◽  
History Of ◽  
Giant Pseudocyst ◽  
The Ideal

Introduction. A pancreatic pseudocyst (PP) with major diameter equal to 10 cm or more is called a giant pseudocyst. The ideal management for giant PPs is controversial. Endoscopic drainage is an alternative nonsurgical approach for PP management. Only a few cases of giant PPs were reported to be managed by endoscopic drainage. Case Presentation. We reported two cases of giant PPs following an episode of acute pancreatitis. Both were resolved following endoscopic cystogastrostomy using metallic and double-pigtail stents with excellent outcomes. There was no history of recurrence or complications on follow-up. In addition, we extensively reviewed all available literature studies of giant pancreatic pseudocyst presentation, management, and complications. We summarized all reported cases and presented them in a comprehensive table. Conclusion. The endoscopic cystogastrostomy approach is cost saving, can avoid surgical complications, and offers an early hospital discharge.

scholarly journals Forgotten metal stent (3 years) presenting with a high burden of intra- and extra-hepatic ducts stones and cholangitis

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Chiapo Lesetedi ◽  
Mpapho Joseph Motsumi
Keyword(s):  
Bile Duct ◽  
Open Cholecystectomy ◽  
Metal Stent ◽  
Endoscopic Retrograde ◽  
Plastic Stent ◽  
High Burden ◽  
Surgical History ◽  
History Of ◽  
Lost To Follow Up

Abstract Forgotten stents may lead to serious complications. We present a case report of a forgotten common bile duct (CBD) fully covered metal stent presenting with recurrent cholangitis. A 79-years-old female patient presented with a history of recurrent cholangitis. Past surgical history was notable for open cholecystectomy for symptomatic cholelithiasis in 2016. Subsequently, she was found to have retained CBD stones in the same year. She had endoscopic retrograde cholangiopancreatography (ERCP), during which a complete clearance of the stone was not achieved and she was stented with a completely covered metal stent. She was lost to follow-up until 2019. A differential diagnosis of cholangitis secondary to a blocked stent was made. At ERCP, she had intra- and extra-hepatic stones, which could not be removed. A plastic stent was deployed. She later had an open bile duct exploration with Roux-en-Y hepaticojejunostomy. Forgotten stents can lead to serious complications. An electronic stent follow-up registry is recommended.

scholarly journals Pancreatic Pseudocysts Transpapillary and Transmural Drainage

HPB Surgery ◽  
2000 ◽  
Vol 11 (5) ◽  
pp. 333-338 ◽  
Author(s):  
E. Della Libera ◽  
E. S. Siqueira ◽  
M. Morais ◽  
M. R. S. Rohr ◽  
C. Q. Brant ◽  
...  
Keyword(s):  
Pancreatic Pseudocyst ◽  
Pain Scale ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Intention To Treat ◽  
Persistent Abdominal Pain ◽  
Serial Ct ◽  
Transmural Drainage ◽  
Good Treatment Option

Background: Pancreatic pseudocyst endoscopic drainage has been described as a good treatment option, with morbidity and mortality rates that are lower than surgery. The aim of our study is to describe the efficacy of different forms of endoscopic drainage and estimate pseudocyst recurrence rate after short follow up period.Patients and Methods: We studied 30 patients with pancreatic pseudocyst that presented some indication for treatment: persistent abdominal pain, infection or cholestasis. Clinical evaluation was performed with a pain scale, 0 meaning absence of pain and 4 meaning continuous pain. Pseudocysts were first evaluated by abdominal CT scan, and after endoscopic retrograde pancreatography the patients were treated by transpapillary or transmural (cystduodenostomy or cystgastrostomy) drainage. Pseudocyst resolution was documented by serial CT scans.Results: 25/30 patients could be treated. Drainage was successful in 21 (70% in an ‘intention to treat’ basis). After a mean follow-up of 42±35.82 weeks, there was only 1 (4.2%) recurrence. A total of 6 complications occurred in 37 procedures (16.2%), and all but 2 were managed clinically and/or endoscopically: there was no mortality related to the procedure. Patients submitted to combined drainage needed more procedures than the other groups. There was no difference in the efficacy when we compared the three different drainage methods.Conclusions: We concluded that pancreatic pseudocyst endoscopic drainage is possible in most patients, with high success rate and low morbidity.

scholarly journals Transduodenal drainage of hard-to-reach pancreatic pseudocyst under endosonography control

2021 ◽  
Vol 1 (5) ◽  
pp. 97-100
Author(s):  
S. V. Dzhantukhanova ◽  
Yu. G. Starkov ◽  
R. D. Zamolodchikov ◽  
A. A. Zvereva ◽  
V. S. Shirokov ◽  
...  
Keyword(s):  
Pancreatic Pseudocyst ◽  
Clinical Observation ◽  
Abdominal Cavity ◽  
Modern Technology ◽  
Complex Configuration ◽  
Endoscopic Drainage ◽  
Anatomical Location ◽  
History Of ◽  
The Moment

The aim of the investigation was to demonstrate the possibility of modern technology of endoscopic drainage of difficultly accessible pancreatic pseudocyst of complex configuration using endosonography.Material and methods: a patient with a long history of recurrent chronic pancreatitis and a pseudocyst of complex configuration and anatomical location formed on this background was subjected to internal drainage of postnecrotic cyst under the control of endosonography in November 2020.Result: The surgical intervention and postoperative period were without complications. Control CT scan of the abdominal cavity organs after 3 months showed complete reduction and disappearance of the cyst. The follow-up period up to the present time is 5 months. The patient had no complaints at the moment.Conclusion: this clinical observation demonstrates the advantages of minimally invasive intraluminal transduodenal access. The used access permitted to perform surgery in maximum organ preserving variant with the best functional result.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals The spontaneous resolution of a vortex vein varix: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara L Weidmayer ◽  
Hakan Demirci
Keyword(s):  
Case Report ◽  
Natural History ◽  
Extended Period ◽  
Spontaneous Resolution ◽  
Case Presentation ◽  
Clinical Resolution ◽  
History Of ◽  
Vortex Vein ◽  
Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

Abdominopelvic Pain in Patient with Uterus Didelphys and Unilateral Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome)

2021 ◽  
Author(s):  
Zahra Tavoli ◽  
Ali Montazeri
Keyword(s):  
Renal Agenesis ◽  
Primary Diagnosis ◽  
Case Presentation ◽  
Uterus Didelphys ◽  
Future Fertility ◽  
History Of ◽  
Ohvira Syndrome ◽  
Obstructed Hemivagina ◽  
Magnetic Resonance Imaging Mri

Introduction: Uterus didelphys with obstructed hemivagina associated with ipsilateral renal agenesis (OHVIRA syndrome) is a rare female urogenital malformation and delay in its diagnosis could lead to several complications. Case presentation: A 21-year-old virgin woman was admitted to the emergency department (ED) with severe abdominal pain, without fever and vaginal discharge. She reported a history of cyclic abdominopelvic pain and dysmenorrhea for 5 years. The primary diagnosis (OHVIRA syndrome) was made using ultrasonography, spiral computed tomography (CT) and magnetic resonance imaging (MRI). In addition, laparoscopy was performed to confirm diagnosis and drain hematosalpinx. Then, hysteroscopy was carried out for septum resection and catheter insertion. At one-month follow-up the ultrasonography showed normal left hemicavity of uterus associated with significant decrease in dysmenorrhea. Conclusion: Being aware of OHVIRA syndrome and clinical suspicion of this rare anomaly are essential for making a timely diagnosis, preventing complications, relieving symptoms, and preserving future fertility.

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty
Keyword(s):  
Frontal Sinus ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
High Rate ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

scholarly journals Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

2021 ◽  
Author(s):  
Tao Sun ◽  
Wentao Wang ◽  
Longshuang He ◽  
Yu Su ◽  
Ning Li ◽  
...  
Keyword(s):  
Nervous System ◽  
Trigeminal Neuralgia ◽  
Hemifacial Spasm ◽  
Treatment Strategies ◽  
Glossopharyngeal Neuralgia ◽  
Case Presentation ◽  
Involuntary Contraction ◽  
History Of ◽  
Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

Coeliac crisis mimicking nephrotic syndrome in a post-partum patient

2019 ◽  
Vol 64 (3) ◽  
pp. 116-118
Author(s):  
Özant Helvacı ◽  
Seyma Yıldız ◽  
Berfu Korucu ◽  
Ulver Derici ◽  
Turgay Arinsoy
Keyword(s):  
Nephrotic Syndrome ◽  
Coeliac Disease ◽  
Post Partum ◽  
Lower Extremity Weakness ◽  
Case Presentation ◽  
Multisystem Involvement ◽  
Life Threatening ◽  
History Of ◽  
Rare Occasion

Background Coeliac crisis is a life-threatening presentation of coeliac disease. Severe diarrhoea, weight loss, electrolyte imbalances and malnutrition are prominent features. Although mainly a disease of childhood, it can on the rare occasion be diagnosed in adults. Case presentation A 25-year-old female with severe generalised oedema, lower extremity weakness, hypokalemia and profound hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. Three months previously she had given birth to a healthy child following an uneventful pregnancy. She did not have proteinuria. She had a history of diarrhoea with gluten-containing food since childhood but lacked a formal diagnosis of coeliac disease. A duodenal biopsy confirmed the suspected diagnosis. Coeliac crisis was diagnosed with life-threatening multisystem involvement. Introduction of a gluten-free diet abolished all disease symptoms and ameliorated laboratory parameters at six months’ follow-up. Conclusion Coeliac crisis is a rare, yet dangerous presentation of coeliac disease in adults. As this case suggests, it can present with generalised oedema and hypoalbuminemia mimicking nephrotic syndrome. Rapid diagnosis is the key to successful treatment.

scholarly journals A case of hypokalemia-induced bidirectional ventricular tachycardia

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097144
Author(s):  
Yanan Xie ◽  
Jingzhe Han ◽  
Jinming Liu ◽  
Jie Hao ◽  
Xiuguang Zu ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Electrical Storm ◽  
Case Presentation ◽  
Cardioverter Defibrillator ◽  
Long Term Follow Up ◽  
History Of

Background Bidirectional ventricular tachycardia (BVT) is a rare, but serious, arrhythmia. Hypokalemia is commonly found in clinical practice, but hypokalemia-induced BVT has rarely been reported. Case presentation A 74-year-old male patient with the symptoms of chest distress and palpitations was admitted owing to frequent discharge of his implantable cardioverter defibrillator (ICD) for 4 days. Before admission, the patient experienced diarrhea after intake of crabs, and felt frequent discharge of his ICD with a total of approximately 17 discharges in 4 days. He had no history of digitalis use. The serum potassium level after admission was 3.1 mmol/L and an electrocardiogram was consistent with BVT. The diagnosis was ventricular tachycardia, electrical storm, and hypokalemia. His ventricular tachycardia was completely relieved after correction of hypokalemia. Conclusions After correction of hypokalemia in this patient, the episode of BVT was terminated and no recurrence of BVT was observed during long-term follow-up. Our findings suggest the diagnosis of hypokalemia-induced BVT.

Sign in / Sign up

Export Citation Format

Share Document