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Turkish Journal of Surgery Dec 2023Hydatid disease is a zoonotic parasitic disease which rarely involves pancreas primarily. Diagnosis of pancreatic hydatid cyst is a challenge and operative skills are...
Hydatid disease is a zoonotic parasitic disease which rarely involves pancreas primarily. Diagnosis of pancreatic hydatid cyst is a challenge and operative skills are important to avoid spillage of cyst's content. A 19-year-old male patient was admitted to hospital with recurrent abdominal pain which was on epigastrium and left upper quadrant of abdomen. Pain was not associated with nausea, vomiting or fever. An abdominal computed tomography (CT) scan was ordered. As a result of abdominal CT scan, there was a cystic area in tail of pancreas with a diameter of 5.6 cm which includes septa and there was calcification on borders of the cyst. Possible diagnosis were either pancreatic hydatid disease, pancreatic cyst adenoma or cystadenocarcinoma or pseudocyst of autoimmune pancreatitis. Whole body positron emission tomography (PET-CT) scan showed no other cyst or lesion other than pancreatic cyst. Hydatid disease indirect hemagglutination test has been studied and it was positive. Imaging studies and laboratory results were suggested hydatid disease and laparoscopic distal pancreatectomy has been applied. Primary pancreatic hydatid disease should be in differential diagnosis when newly appearing pancreatic cyst has been diagnosed, especially in endemic areas. Appropriate surgical technique has to be applied to avoid dissemination of cyst's content.
PubMed: 38694528
DOI: 10.47717/turkjsurg.2023.4768 -
Clinical Case Reports Sep 2023Abdominal pseudocyst is a rare complication of ventriculoperitoneal (VP) shunt placement. Ventriculopleural shunt (VPL) can be an effective treatment option for the...
KEY CLINICAL MESSAGE
Abdominal pseudocyst is a rare complication of ventriculoperitoneal (VP) shunt placement. Ventriculopleural shunt (VPL) can be an effective treatment option for the recurrent complications of VP shunt failure.
ABSTRACT
Abdominal pseudocyst (APC) is a rare complication of ventriculoperitoneal (VP) shunt placement for the treatment of congenital hydrocephalus. This case report presents a two-and-a-half-year-old male child who underwent VP shunt placement for aqueductal stenosis-related hydrocephalus. The patient subsequently developed recurrent shunt failure and an APC, which was managed initially by surgical excision of the cyst and repositioning of the catheter. However, shunt failure recurred. The patient underwent ventriculopleural (VPL) shunt conversion as a more viable option for recurrent blockage. Postoperatively, the patient developed respiratory distress with massive pleural effusion, which was treated with chest tube insertion. This case highlights the complexity of managing congenital hydrocephalus and its rare complication, APC. Prompt recognition and appropriate management of APC can lead to improved outcomes and minimize the need for invasive procedures. VPL shunt conversion can be considered an alternative treatment option when other treatments have failed. Further research is needed to establish guidelines for the management of APC and determine the long-term effectiveness of VPL shunting.
PubMed: 37692158
DOI: 10.1002/ccr3.7902 -
Journal of Surgical Case Reports Aug 2023In this paper, we describe the case of a 40-year-old patient with an expanding and symptomatic complex liver cyst. Despite comprehensive diagnostics, including labs,...
In this paper, we describe the case of a 40-year-old patient with an expanding and symptomatic complex liver cyst. Despite comprehensive diagnostics, including labs, imaging and biopsy, a clear etiology could not be determined. As a result, a partial liver resection was performed. The histopathological examination revealed evidence of schistosomas. We postulate that the displacement of the portal fields created a pseudocyst and that the resultant ischemia was the root cause of the patient's discomfort. Postoperatively, the patient received an antihelmintic therapy with praziquantel with which she was able to fully recover.
PubMed: 37560609
DOI: 10.1093/jscr/rjad452 -
Cureus May 2024Here, we report a case of tardive peritonitis after endoscopic ultrasound (EUS)-guided transmural pancreatic pseudocyst drainage. A 50-year-old man was diagnosed with...
Here, we report a case of tardive peritonitis after endoscopic ultrasound (EUS)-guided transmural pancreatic pseudocyst drainage. A 50-year-old man was diagnosed with acute pancreatitis and a pancreatic pseudocyst measuring 5 cm. Ten months later, his pancreatic pseudocyst was 10 cm. We performed EUS-guided transmural drainage using a lumen-apposing metal stent. After two months, the stent was replaced with a double-pigtail plastic stent. Two months later, the patient developed fever and abdominal pain, and computed tomography revealed abdominal free air. He was diagnosed with peritonitis due to free air caused by a fistula rupture. The double-pigtail plastic stent was removed, and clipping was performed at the fistula site to achieve closure. The patient's symptoms subsequently improved. Long-term placement of a plastic stent for pancreatic pseudocysts makes recurrence less likely, but late adverse events due to stent placement can occur. Notably, fistula rupture can occur even when the fistula is well-formed several months after the initial drainage.
PubMed: 38868273
DOI: 10.7759/cureus.60179 -
Revista Espanola de Enfermedades... Nov 2023The therapeutic effect of EUS-Guided Pancreatic Pseudocyst Drainage (EUS-PPD) is widely recognized, and intraoperative stent displacement is a rare but potentially...
The therapeutic effect of EUS-Guided Pancreatic Pseudocyst Drainage (EUS-PPD) is widely recognized, and intraoperative stent displacement is a rare but potentially serious condition. We report a case of the cyst stent displace into the cyst cavity during EUS-PPD, we successfully reduced the stent in time under the guidance of EUS and fluoroscopy in the final.
PubMed: 37929969
DOI: 10.17235/reed.2023.10014/2023 -
BioRxiv : the Preprint Server For... Oct 2023Commensal protists and gut bacterial communities exhibit complex relationships, mediated at least in part through host immunity. To improve our understanding of this...
Commensal protists and gut bacterial communities exhibit complex relationships, mediated at least in part through host immunity. To improve our understanding of this tripartite interplay, we investigated community and functional dynamics between the murine protist ( ) and intestinal bacteria in healthy and B cell-deficient mice. We identified dramatic, protist-driven remodeling of resident microbiome growth and activities, in parallel with functional changes, accelerated in the absence of B cells. Metatranscriptomic data revealed nutrient-based competition between bacteria and the protist. Single cell transcriptomics identified distinct life stages, providing new evidence for trichomonad sexual replication and the formation of pseudocysts. Unique cell states were validated through microscopy and flow cytometry. Our results reveal complex microbial dynamics during the establishment of a commensal protist in the gut, and provide valuable datasets to drive future mechanistic studies.
PubMed: 37090671
DOI: 10.1101/2023.03.06.528774 -
Cureus Dec 2023Splenic abscess is a rare condition that generally results from hematogenous spread and affects individuals with hemoglobinopathies or immunocompromising conditions....
Splenic abscess is a rare condition that generally results from hematogenous spread and affects individuals with hemoglobinopathies or immunocompromising conditions. Although optimal management has recently been under contention, this condition was traditionally managed with splenectomy. We present a rare case of a 58-year-old male with chronic pancreatitis that developed a splenic abscess via a contiguous spread of a pancreatic pseudocyst. His condition was complicated by septic shock. The splenic abscess was managed with antibiotics, image-guided percutaneous drainage, and notably without surgical intervention.
PubMed: 38239539
DOI: 10.7759/cureus.50747 -
Internal Medicine (Tokyo, Japan) Feb 2024A 70-year-old woman presented with stage III pancreatic head cancer. After endoscopic sphincterotomy, a fully covered self-expandable metallic stent (FCSEMS) was placed...
A 70-year-old woman presented with stage III pancreatic head cancer. After endoscopic sphincterotomy, a fully covered self-expandable metallic stent (FCSEMS) was placed in the common bile duct to manage jaundice. The patient developed a fever and abdominal pain 40 days after stent placement, with a suspected diagnosis of infected pancreatic pseudocyst. Purulent discharge from the papilla was observed during FCSEMS removal, and pancreatography revealed a pseudocyst connected to the main pancreatic duct. The pancreatic pseudocyst resolved after transpapillary drainage. Pancreatic pseudocysts should be suspected after biliary FCSEMS placement, and prompt removal and endoscopic drainage of the FCSEMS should be considered.
PubMed: 38403761
DOI: 10.2169/internalmedicine.3178-23 -
World Journal of Gastroenterology Jan 2024The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma, diffuse autoimmune pancreatitis and groove located mass lesions that...
The radiological differential diagnosis of acute pancreatitis includes diffuse pancreatic lymphoma, diffuse autoimmune pancreatitis and groove located mass lesions that may mimic groove pancreatitis. Dual energy computed tomography and diffusion weighted magnetic resonance imaging are useful in the early diagnosis of acute pancreatitis, and dual energy computed tomography is also useful in severity assessment and prognosis prediction. Walled off necrosis is an important complication in terms of prognosis, and it is important to know its radiological findings and distinguish it from pseudocyst.
Topics: Humans; Pancreatitis; Acute Disease; Prognosis; Pancreas; Tomography, X-Ray Computed; Diagnosis, Differential
PubMed: 38293323
DOI: 10.3748/wjg.v30.i1.108 -
Imaging Science in Dentistry Mar 2024This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography.
PURPOSE
This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography.
MATERIALS AND METHODS
In total, 210 joints from 183 patients (144 females, 39 males, ranging from 12 to 88 years old with a mean age of 44.75±19.97 years) diagnosed with temporomandibular joint osteoarthritis were stratified by age. Mandibular condyle position and bony changes (flattening, erosion, osteophytes, subchondral sclerosis, and subchondral pseudocysts in both the condyle and articular eminence, thickening of the glenoid fossa, joint space narrowing, and joint loose bodies) were evaluated through cone-beam computed tomography. After adjusting for sex, the association between age groups and radiographic findings was analyzed using both a multiple regression model and a multinomial logistic regression model (α=0.05).
RESULTS
The prevalence of joint space narrowing and protruded condyle position in the glenoid fossa significantly increased with age (<0.05). The risks of bony changes, including osteophytes and subchondral pseudocysts in the condyle; flattening, erosion, osteophyte, and subchondral sclerosis in the articular eminence; joint loose bodies; and thickening of the glenoid fossa, also significantly rose with increasing age (<0.05). The number of radiographic findings increased with age; in particular, the increase was more pronounced in the temporal bone than in the mandibular condyle (<0.05).
CONCLUSION
Increasing age was associated with a higher frequency and greater diversity of bony changes in the temporal bone, as well as a protruded condyle position in the glenoid fossa, resulting in noticeable joint space narrowing in temporomandibular joint osteoarthritis.
PubMed: 38571783
DOI: 10.5624/isd.20230229