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Revista Espanola de Enfermedades... Aug 2023Pancreatic pseudocysts are mostly located in the peripancreatic region, but extra-abdominal intrathoracic extensions can occur and mimic respiratory and ischemic...
Pancreatic pseudocysts are mostly located in the peripancreatic region, but extra-abdominal intrathoracic extensions can occur and mimic respiratory and ischemic symptoms. Mediastinal location is an example that can present with dyspnea and retrosternal chest pain. Pancreatic-pleural fistulas can form from pseudocysts, often resulting in large and recurrent pleural effusions. In the described case, a 50-year-old man with a previous subdiaphragmatic pseudocyst presented an acute episode of respiratory symptoms and was diagnosed with a newly organized collection located intrathoracically adjacent to the previous one, formed by the fistulization of the abdominal pseudocyst. No similar cases have been described or published in indexed PubMed databases until the year 2023.
PubMed: 37539529
DOI: 10.17235/reed.2023.9819/2023 -
Child's Nervous System : ChNS :... Jun 2024The ventriculoperitoneal shunt placement procedure is common throughout the world, with a prevalence of approximately 30,000 procedures per year in the United States...
The ventriculoperitoneal shunt placement procedure is common throughout the world, with a prevalence of approximately 30,000 procedures per year in the United States (5). However, the rate of complications is still important and must be remembered, with a percentage of 11 to 25% after the first year of implantation. Abdominal complications are described in 5-47% of the cases (6), and the abdominal pseudocyst is one of them. We present the case of a patient colonized by multidrug-resistant bacteria, who underwent exteriorization surgery of a ventriculoperitoneal shunt. Intraoperatively, a blue coloration was observed in the catheter, a phenomenon previously described in urinary infections (1)(2) but not before in pathologies of the central nervous system. Our objective is to present an atypical case of dysfunction of the ventriculoperitoneal shunt, whose diagnosis couldbe evidenced through the coloration of the catheter exteriorized in surgery.
Topics: Humans; Ventriculoperitoneal Shunt; Male; Female; Hydrocephalus
PubMed: 38427107
DOI: 10.1007/s00381-024-06330-x -
Annali Italiani Di Chirurgia 2024The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology... (Review)
Review
OBJECTIVE
The etiology, clinical presentation, diagnosis, and treatment strategies of chronic pancreatitis (CP) vary significantly between countries. Specifically, the etiology and surgical approaches to treating CP differ between China and Western countries. Therefore, this study aims to compare the disparities in CP profiles and management based on our single-center experience and recent data from the West.
METHODS
From January 2007 to December 2017, a total of 130 consecutive patients with histologically confirmed chronic pancreatitis (CP) underwent surgical treatment at the First Affiliated Hospital of Nanjing Medical University. The clinical features, etiology, risk factors, and operative procedures of these CP patients were analyzed and compared with recent data from Western countries.
RESULTS
Our patient cohort was predominantly male (3.19:1), with a median age of 50.2 ± 9.8 years. Upper abdominal pain was the most common symptom, present in 102 patients (78.5%). The most common etiology was obstructive factors (47.7%), followed by alcohol (34.6%). The incidence of genic mutation was 2%, significantly lower than rates reported in Western research. Steatorrhea, weight loss, and jaundice were present in 6.9%, 18.5%, and 17.7% of patients, respectively. Pancreatic cysts or pseudocysts were diagnosed in 7 patients (5.4%). The following procedures were performed: Partington procedure in 33 patients (25.4%), Frey procedure in 17 patients (13.2%), Berne procedure in 5 patients (3.9%), Beger procedure in 1 patient (0.8%), pancreaticoduodenectomy in 17 patients (13.1%), pylorus-preserving pancreaticoduodenectomy in 18 patients (13.9%), middle pancreatectomy in 1 patient (0.8%), and distal pancreatectomy in 9 patients (6.9%). Choledochojejunostomy was performed in 14 patients (10.8%), gastroenterostomy in 2 (1.5%), and 15 patients (11.5%) underwent aspiration biopsy.
CONCLUSION
Our study confirms that, etiologically, obstructive chronic pancreatitis (CP) is more frequent in the Chinese population than in Western populations. Although diagnostic instruments and operative procedures in China and Western countries are roughly comparable, slight differences exist in relation to diagnostic flowcharts/criteria and the indications and optimal timing of surgery.
Topics: Humans; Male; Adult; Middle Aged; Female; Pancreatitis, Chronic; Pancreaticoduodenectomy; Pancreatectomy; Risk Factors; China; Treatment Outcome
PubMed: 38469606
DOI: No ID Found -
Clinical Implant Dentistry and Related... Oct 2023To compare clinical and histological outcomes of sinus augmentation performed immediately or 3 months after pseudocyst removal through a prospective randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To compare clinical and histological outcomes of sinus augmentation performed immediately or 3 months after pseudocyst removal through a prospective randomized controlled study.
MATERIALS AND METHODS
In total, 33 sinus augmentation procedures were performed in 31 patients. Augmentation was performed either immediately after pseudocyst removal (one-stage intervention) or after 3 months (two-stage intervention). Six months postoperatively, bone specimens were harvested, and histomorphometric analysis was performed as primary outcome. Data were recorded and evaluated for implant survival rates, marginal bone resorption, complication rate, and patient-centered outcomes (visual analogue scale [VAS]).
RESULTS
There were no baseline differences between groups or dropouts. Twelve biopsies obtained for histomorphometric analysis showed that delayed sinus augmentation, when compared to immediated led to a 1.1% increased mineralized bone ratio (95% confidence interval [CI]: -15.9 to 13.7). Graft leakage and acute sinusitis occurred in one patient in the one-stage group, none in the two-stage group. No pseudocyst recurrence was observed until the end of 1-year follow-up. Median VAS scores for overall acceptance were significantly increase of 1.4 (95% CI: 0.3-2.56) in immediate group. The degree of post-operative discomfort was not significantly different, although an increase of VAS (0.52, 95% CI: -0.32 to 1.37) was observed in delay group.
CONCLUSIONS
Both procedures of sinus augmentation immediately and 3 months after pseudocyst removal could obtain comparable histological outcomes and had low complication rates. Patients who underwent the one-stage procedure had a short treatment course and high satisfaction rates, but this procedure is technically challenging to perform. This clinical trial was not registered prior to participant recruitment and randomization. The clinical trial registration number is ChiCTR2200063121. The hyperlink is as follows: https://www.chictr.org.cn/showproj.html?proj=172755.
Topics: Humans; Dental Implantation, Endosseous; Sinus Floor Augmentation; Prospective Studies; Maxillary Sinus; Bone Transplantation; Cysts; Bone Substitutes
PubMed: 37218035
DOI: 10.1111/cid.13225 -
International Journal of Gynaecology... Mar 2024Umbilical cord cysts (UCCs)-cysts located in the umbilical cord that are derived from an abnormal embryonic development process-are typically an incidental discovery... (Review)
Review
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.
Topics: Pregnancy; Female; Humans; Prognosis; Cysts; Umbilical Cord; Ultrasonography, Prenatal; Incidental Findings
PubMed: 37489030
DOI: 10.1002/ijgo.15006 -
Archives de Pediatrie : Organe Officiel... Oct 2023Periventricular cysts are one of the most extensively documented antenatal brain lesions found through fetal ultrasound at the University Hospital of Angers. The main... (Review)
Review
BACKGROUND
Periventricular cysts are one of the most extensively documented antenatal brain lesions found through fetal ultrasound at the University Hospital of Angers. The main purpose of our study was to determine the contribution of fetal magnetic resonance imaging (MRI) and postnatal transfontanellar ultrasound (TFU) in the assessment of isolated periventricular cysts found on antenatal ultrasound at the University Hospital of Angers.
METHODS
This retrospective, descriptive study was carried out over a 10-year period. Overall, 82 cases were included, divided into two groups according to the type of cysts found on the ultrasound: 13 cases of subependymal pseudocysts (SEPC) and 69 cases of frontal horn cysts (FHC). In all, 43 children underwent a postnatal TFU: seven in the SEPC group and 36 in the FHC group.
RESULTS
Our study found excellent agreement between antenatal ultrasound and fetal MRI in the FHC group concerning classification of the cysts (approval rate [TA]: 98.60%; kappa coefficient [κ]: 0.85), their location (TA: 98.80%; κ: 0.91), their number (TA: 78.20%; κ: 0.73), and the detection of FHC (TA: 81.10%; κ: 0.74), as well as a good agreement concerning the detection of SEPC and temporal horn cysts (THC; TA: 99.40% and 95.60%, respectively). Fetal MRI proved to be better in the SEPC group for cyst classification (TA: 66.70%; κ: 0.33), their location (TA: 60%; κ: 0.41), and their number (TA: 53, 30%; κ: 0.45) and the detection of SEPC (TA: 23.10%; κ: 0.14). In both groups, postnatal TFU did not provide additional information compared to MRI.
CONCLUSION
The finding of periventricular cysts in antenatal ultrasound should lead to a reference ultrasound, a key procedure for distinguishing between SEPC and FHC. In our study, no additional benefit from MRI and TFU was established for the evaluation of FHC. These findings should be considered as normal variants, thus limiting pre- and postnatal investigations. The visualization of SEPC, THC, or a parenchymal abnormality on the reference ultrasound should lead to an additional MRI being performed and a personalized follow-up of the child.
Topics: Pregnancy; Child; Female; Humans; Retrospective Studies; Cysts; Anger; Hospitals, University; Magnetic Resonance Imaging; Ultrasonography, Prenatal
PubMed: 37704521
DOI: 10.1016/j.arcped.2023.06.010 -
Journal of Ultrasound in Medicine :... Jan 2024Hidradenitis suppurativa (HS) is a devasting autoimmune cutaneous disease that affects the hair follicles and can clinically present palpable nodules, abscesses, and...
Hidradenitis suppurativa (HS) is a devasting autoimmune cutaneous disease that affects the hair follicles and can clinically present palpable nodules, abscesses, and tunnels (fistulas), usually in the intertriginous regions. It has been widely reported that color Doppler ultrasound can detect subclinical abnormalities and stage the severity of the disease more accurately. Nevertheless, the ultrasound diagnostic criteria were reported with 15 MHz 10 years ago, and now it is possible to detect early anatomical abnormalities in HS using 70 MHz. Thus, an update of the ultrasonographic diagnostic criteria is needed. The most widely used sonographic staging of severity of HS (SOS-HS) includes the number of affected regions, besides counting the number of key lesions like pseudocysts, fluid collections, and tunnels; however, the total number of affected regions may fit better in an activity scoring. Furthermore, a high number of tunnels or communicated tunnels can complicate the management and may indicate an even more urgent treatment, which should be considered in the severity classification. To date, no hidradenitis scoring of activity has been reported in the literature, making it difficult to track the degree of inflammation under treatment objectively. Therefore, two new scorings are proposed. The first is an updated sonographic scoring of severity called modified SOS-HS (mSOS-HS), and the second is an activity ultrasound scoring of HS called US-HSA. Both staging systems can provide better anatomical information for discriminating the categories and, therefore, selecting more appropriate treatments and supporting research and clinical trials by giving more objective anatomical tools in real-world settings.
Topics: Humans; Hidradenitis Suppurativa; Ultrasonography; Fistula; Abscess; Ultrasonography, Doppler, Color; Severity of Illness Index
PubMed: 37846584
DOI: 10.1002/jum.16351 -
Cureus May 2024The main objective was to describe the different types and characteristics of lumbar spine extradural cysts and their optimal treatment options with a focus on... (Review)
Review
The main objective was to describe the different types and characteristics of lumbar spine extradural cysts and their optimal treatment options with a focus on endoscopic technique. We searched Pubmed, EMBASE, Medline, and Google Scholar for articles published between 1967 and 2020 using the keywords "Spinal Cyst," "Extradural Cyst," and "Lumbar Cyst." The various anatomical and histological types of the extradural cysts with their presentations, etiologies, imaging, and optimal treatment with a focus on endoscopic techniques were reviewed from the articles. Lumbar spinal cysts are relatively rare pathologies that might cause radicular symptoms similar to lumbar disc herniation. Spinal extradural cysts are classified either histologically based on the cyst lining tissues (synovial cysts or non-synovial, ganglion cysts) or anatomically based on the structure of origin (epidural cysts, ligamentum flavum cysts, discal cysts, post-discectomy pseudocysts, posterior longitudinal ligament cysts, facet cysts). Surgical excision is the recommended treatment of symptomatic cysts with endoscopic techniques being a viable option. Extradural lumbar cysts can be identified based on their histological structure or depending on their structure of origin. Regardless of their classification, they could all give similar clinical findings, and the optimal treatment would be surgical excision with endoscopic technique being a viable option with a satisfactory outcome.
PubMed: 38894794
DOI: 10.7759/cureus.60604 -
Turkish Archives of Pediatrics Mar 2024We aimed to analyze the clinical presentation, imaging, histopathology, and surgical management of pediatric intraabdominal cysts, which are relatively common but...
OBJECTIVE
We aimed to analyze the clinical presentation, imaging, histopathology, and surgical management of pediatric intraabdominal cysts, which are relatively common but diverse lesions that pose diagnostic challenges.
MATERIALS AND METHODS
We conducted a retrospective analysis of pediatric intraabdominal cysts from 2010 to 2021 in a single tertiary center. We collected data on demographics, symptoms, radiological findings, surgical approaches, and histopathological diagnoses and compared them with the current literature.
RESULTS
A total of 36 cases were included. There were 30 females and 6 males, aged 1 to 16 years. Abdominal pain was the most common symptom, followed by tenderness and distention. Diarrhea and vomiting were also reported in some cases. The cysts varied in size, location, and origin and were diagnosed as lymphangioma, mucinous cystadenoma, paratubal cyst, lowgrade mucinous neoplasm, mature cystic teratoma, duplication cyst, mesothelial cyst, pseudocyst, serous cystadenoma, and simple hepatic cyst. The surgical management depended on the type and location of the cysts and involved excision, oophorectomy, appendectomy, or resection.
CONCLUSION
Pediatric intraabdominal cysts are heterogeneous lesions that require timely diagnosis and surgical resection. They may present with various symptoms and complications, depending on their size and location. Radiological and histopathological evaluation is essential for accurate diagnosis and optimal treatment.
PubMed: 38454224
DOI: 10.5152/TurkArchPediatr.2024.23263 -
Medicine Nov 2023Pancreatic pseudocyst (PPC) increases the risk of a poor prognosis in in patients with acute pancreatitis (AP). Currently, an efficient tool is not available for...
Pancreatic pseudocyst (PPC) increases the risk of a poor prognosis in in patients with acute pancreatitis (AP). Currently, an efficient tool is not available for predicting the risk of PPC in patients with AP. Therefore, this research aimed to explore the risk factors associated with PPC secondary to AP and to develop a model based on clinical information for predicting PPC secondary to AP. This study included 400 patients with acute pancreatitis and pancreatic pseudocyst secondary to acute pancreatitis admitted to the emergency department and gastroenterology department of The First Affiliated Hospital of the University of Science and Technology of China from January 2019 to June 2022. Participants were divided into no PPCs (321 cases) and PPCs (79 cases). Independent factors of PPC secondary to AP were analyzed using univariate and multivariate logistic regression. The nomogram model was constructed based on multivariate logistic regression analyses, which included all risk factors, and evaluated using R. We enrolled 400 eligible patients and allocated 280 and 120 to the training and test sets, respectively. Clinical features, including severe pancreatitis history [odds ratio (OR) = 4.757; 95% confidence interval (CI): 1.758-12.871], diabetes mellitus (OR = 6.919; 95% CI: 2.084-22.967), history of biliary surgery (OR = 9.232; 95% CI: 3.022-28.203), hemoglobin (OR = 0.974; 95% CI: 0.955-0.994), albumin (OR = 0.888; 95% CI: 0.825-0.957), and body mass index (OR = 0.851; 95% CI: 0.753-0.962), were significantly associated with the incidence of PPC after AP in the training sets. Additionally, the individualized nomogram demonstrated good discrimination in the training and validation samples with good calibration, The area under the curve and 95% CI of the nomogram were 0.883 (0.839-0.927) in the training dataset and 0.839 (0.752-0.925) in the validation set. We developed a nomogram model of PPC secondary to AP using R Studio. This model has a good predictive value for PPC in patients with AP and can help improve clinical decision-making.
Topics: Humans; Pancreatitis; Acute Disease; Pancreatic Pseudocyst; Risk Factors; Nomograms; Retrospective Studies
PubMed: 38013294
DOI: 10.1097/MD.0000000000036102