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BMC Surgery Mar 2021Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported...
BACKGROUND
Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far.
CASE PRESENTATION
This article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up.
CONCLUSION
To the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).
Topics: Abdomen; Aged; Cerebrospinal Fluid; Cysts; Drainage; Female; Hemorrhage; Humans; Hydrocephalus; Laparoscopy; Postoperative Complications; Tomography, X-Ray Computed; Ventriculoperitoneal Shunt
PubMed: 33743657
DOI: 10.1186/s12893-021-01161-y -
Oman Medical Journal Jul 2023Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary...
Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary pseudocyst in a seven-year-old boy who presented with a chest injury from a traffic accident. He had a scapula fracture, multiple abrasions on his body, and decreased respiratory sounds in the left hemithorax. His Glasgow Coma Scale score was 15. Chest X-ray suggested a 3 × 3.5 cm cavitary lesion. Computed tomography scan revealed a pulmonary pseudocyst in addition to parenchymal contusion and pneumothorax. A Velpeau bandage was applied to the scapula fracture. After five days of in-hospital observation without any thoracic intervention, the patient was discharged free of complications.
PubMed: 37724321
DOI: 10.5001/omj.2023.34 -
Frontiers in Surgery 2022Pancreatic pseudocysts are characterized by the leakage of pancreatic juice caused by various reasons, which leads to pancreatic juice accumulates around the pancreas,...
BACKGROUND
Pancreatic pseudocysts are characterized by the leakage of pancreatic juice caused by various reasons, which leads to pancreatic juice accumulates around the pancreas, and stimulates the greater omentum and other tissues to form an area of fibrotic loculated effusion with an integrated capsule. Approximately, one-third of patients experienced recurrent pancreatic juice leakage, compression symptoms, infection, and bleeding, which requires surgical intervention, but spontaneous rupture cases are extremely rare.
CASE PRESENTATION
We here present the case of 40-year-old male who presented with abdominal pain and vomiting for two days and 10 h, respectively. He had a history of chronic pancreatitis and pseudocysts. The symptoms of abdominal pain worsened in the second day. Laboratory tests showed a progressive decrease in hemoglobin. Then, emergency pancreatoduodenectomy was performed. Intraoperative exploration found a small blood clot in the abdominal cavity and a hematoma that had formed in the intestinal cavity and retroperitoneum.
CONCLUSION
This case showed that pseudocysts of the pancreas can rupture under certain circumstances, leading to intraperitoneal bleeding and hematoma formation, which can endanger the life of the patient. And surgical treatment can be the first choice for hemorrhagic pseudocysts.
PubMed: 35846954
DOI: 10.3389/fsurg.2022.906520 -
Case Reports in Gastroenterology 2018The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here...
The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here we report the rare case of a patient suffering from chronic pancreatitis with an arterial pseudoaneurysm within a pancreatic pseudocyst and present its successful therapeutic management by angioembolization to prevent critical bleeding. A 67-year-old male with a history of chronic pancreatitis presented with severe acute abdominal pain and vomiting to the emergency department. Seven weeks prior to the present admission, a CT scan had displayed a pancreatic pseudocyst with a maximum diameter of 53 mm. A laboratory examination revealed an elevated white blood cell count (15.40 × 10/μL), as well as elevated serum lipase (191 U/L), bilirubin (1.48 mg/dL), and blood glucose (353 mg/dL) levels. Sonographically, the previously described pancreatic pseudocyst revealed a slightly increased maximum diameter of 65 mm and an inhomogeneous echo of the cystic content. A contrast-enhanced CT scan showed a further increase in maximum diameter to 70 mm of the known pseudocyst. Inside the pseudocyst, a pseudoaneurysm originating from the splenic artery with a maximum diameter of 41 mm was visualized. After interdisciplinary consultation, prophylactic coil embolization of the splenic artery was immediately performed. The pseudoaneurysm was shut off from blood supply by back-door/front-door occlusion employing 27 coils, resulting in complete exclusion of the pseudoaneurysm from the circulation. Pseudoaneurysms are a rare complication of acute and chronic pancreatitis which has been shown to be efficiently treated by coil embolization.
PubMed: 30283285
DOI: 10.1159/000492459 -
Journal of Indian Association of... 2023Pancreatic cysts can be true or pseudocysts. True pancreatic cysts in children are rare clinical entities. We present a 23-month-old boy with a cystic lesion in the...
Pancreatic cysts can be true or pseudocysts. True pancreatic cysts in children are rare clinical entities. We present a 23-month-old boy with a cystic lesion in the distal body and tail of the pancreas which on histopathology was found to be a rare true congenital simple cyst of the pancreas.
PubMed: 37389382
DOI: 10.4103/jiaps.jiaps_150_22 -
The Pan African Medical Journal 2019Pancreatic pseudocyst is a rare benign condition, in particular among children. It is an intra or extra pancreatic juice collection lacking of an epithelial lining. We...
Pancreatic pseudocyst is a rare benign condition, in particular among children. It is an intra or extra pancreatic juice collection lacking of an epithelial lining. We conducted a retrospective study of 7 children whose medical record data were collected in the Department of Paediatric Surgery at the University Hospital Hassan II in Fez, over a period of 11 years, from 1 January 2005 to 31 December 2016. All children were male, their average age was 6.6 years (15 months - 12 years). An history of abdominal trauma was found in 4 cases, abdominal bloating, pain, vomiting and transit disorders were the primary reason for consultation. Clinical examination showed epigastric tenderness and an alteration of the general state in all cases. Abdominal ultrasound as well as abdominal CT scan helped to diagnose pancreatic pseudocyst before surgery. Six patients, out of a total of seven, underwent surgery; we opted for internal bypass (gastro-cystic anastomosis) in 4 cases, external bypass in 2 cases and therapeutic abstention in one case. Pancreatic pseudocysts are rare. Nevertheless, they are the most frequent (80% of pancreatic cystic lesions are pseudocysts and due to acute and/or chronic pancreatitis, pancreatic trauma or pancreatic ductal obstruction).
Topics: Abdominal Injuries; Abdominal Pain; Child; Child, Preschool; Hospitals, University; Humans; Infant; Male; Pancreatic Pseudocyst; Retrospective Studies; Tomography, X-Ray Computed; Vomiting
PubMed: 31223368
DOI: 10.11604/pamj.2019.32.77.14688 -
Journal of Medical Case Reports Apr 2024Non-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...
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.
Topics: Humans; Male; Adult; Tomography, X-Ray Computed; Cysts; Peritoneal Diseases; Treatment Outcome
PubMed: 38679699
DOI: 10.1186/s13256-024-04503-5 -
Caspian Journal of Internal Medicine 2016Splenic cysts are known as rare clinical encounter. Classifying into primary (true) and secondary cysts (pseudocysts), true cysts contain cellular epithelial lining and...
BACKGROUND
Splenic cysts are known as rare clinical encounter. Classifying into primary (true) and secondary cysts (pseudocysts), true cysts contain cellular epithelial lining and subdivided into parasitic and non-parasitic cysts. This study aimed to determine the outcome of treatment in patients with splenic cyst.
METHODS
All patients with splenic cyst who had been treated in Department of General Surgery of Ghaem and Omid teaching hospitals over a 24-year period were identified. The medical records of these 16 patients were reviewed.
RESULTS
The study patients included 11 females (68.75%) and 5 males (31.25%) with average age of 39.8 years. Fifteen cases had true cyst including 11 parasitic cysts (hydatid) and only one pseudocyst. 37.5% of the splenic cysts had coexistent cysts in liver, pelvis, omentum and paracolic regions. Nine patients underwent total splenectomy and 5 cases partial splenectomy and 2 remaining cases received conservative medical treatment. The size of the cysts varied from 6 to 25 centimeter with average size of 14.3 centimeter. All patients with hydatid cysts received albendazole postoperative medical treatment with albendazole for 6 months. All patients recovered after treatment.
CONCLUSION
Open splenectomy whether total or partial is effective and safe in patients with splenec cysts with or without hydatidosis. The outcome of treatment is good without recurrences.
PubMed: 27757209
DOI: No ID Found -
Chirurgia (Bucharest, Romania : 1990) 2021The surgical treatment of pancreatic pseudocysts (PPs) in patients who fail nonoperative management has evolved from aggressive open to a minimally invasive approach....
The surgical treatment of pancreatic pseudocysts (PPs) in patients who fail nonoperative management has evolved from aggressive open to a minimally invasive approach. The application of robotic surgery in this setting is scarcely reported. The aim of this study is to analyze the safety and feasibility of the robotic approach to pancreatic pseudocyst drainage. A single centre retrospective review of consecutive patients undergoing robotic-assisted pancreatic pseudocyst surgeries in an academic tertiary institution was performed. There were 14 patients studied, of whom 10 underwent cystogastrostomy and 4 Roux-En- Y cystojejunostomy. Eight patients had gallstone pancreatitis and 3 patients alcoholic pancreatitis. The mean size of cyst was 8.9 +-1cm and 57.1% located at the pancreatic body. The overall operative time of the procedure was 135 +-34 minutes. There were no open conversions. The overall success rate was 92.8%, while the primary success rate 85.7%. The major morbidity rate was 14.3% and there was no 30-day mortality. The mean post-operative hospital stay was 7 +-3 days with one recurrence of the pancreatic pseudocyst on follow-up requiring endoscopic drainage without further recurrence. The robotic approach for the drainage of symptomatic pancreatic pseudocyst is safe and feasible and can be considered as a viable modality for operative intervention in well-selected patients.
Topics: Drainage; Feasibility Studies; Humans; Neoplasm Recurrence, Local; Pancreatic Pseudocyst; Retrospective Studies; Robotic Surgical Procedures; Treatment Outcome
PubMed: 34191707
DOI: 10.21614/chirurgia.116.3.261 -
The Journal of International Medical... May 2021Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an...
Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an understanding of the disease, which is usually asymptomatic. Some patients with PD may experience recurrent pancreatitis and progress to chronic pancreatitis. Recently, a 13-year-old boy presented with pancreatic pseudocyst, recurrent pancreatitis, and incomplete PD, and we report this patient's clinical data regarding the diagnosis, medical imagining, and treatment. The patient had a history of recurrent pancreatitis and abdominal pain. Magnetic resonance cholangiopancreatography was chosen for diagnosis of PD, pancreatitis, and pancreatic pseudocyst, followed by endoscopic retrograde cholangiopancreatography, minor papillotomy, pancreatic pseudocyst drainage, and stent implantation. In the follow-up, the pseudocyst lesions were completely resolved, and no recurrent pancreatitis has been observed.
Topics: Acute Disease; Adolescent; Child; Cholangiopancreatography, Endoscopic Retrograde; Humans; Male; Pancreas; Pancreatic Ducts; Pancreatic Pseudocyst; Pancreatitis
PubMed: 34038204
DOI: 10.1177/03000605211014395