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Northern Clinics of Istanbul 2022Ovarian tumors are the most common gynecological tumors seen in girls. Approximately 60-70% of them are germ cell tumors. Pseudo-Meigs syndrome is characterized by the...
Ovarian tumors are the most common gynecological tumors seen in girls. Approximately 60-70% of them are germ cell tumors. Pseudo-Meigs syndrome is characterized by the presence of pelvic tumoral mass (benign or malign), pleural effusion, and massive acid. If the tumor is removed, acid and hydrothorax disappear. Endodermal sinus (yolk sac) tumor is a very rare cause in the diagnosis of Pseudo-Meigs syndrome, and only a few cases have been reported. This case is one of the rare cases presenting with Pseudo-Meigs syndrome and pathologically diagnosed as yolk sac tumor.
PubMed: 36530560
DOI: 10.14744/nci.2020.45452 -
Monaldi Archives For Chest Disease =... Sep 2022Thoracic endometriosis is very rare. Usually, the thorax is the most frequent affected site outside the pelvis. Common symptoms include chest pain, dyspnea, and...
Thoracic endometriosis is very rare. Usually, the thorax is the most frequent affected site outside the pelvis. Common symptoms include chest pain, dyspnea, and hemoptysis. Common manifestations include pneumothorax, hemothorax, and pulmonary or pleural nodules. In addition, symptoms and manifestations can be "catamenial" happening a few days after menstruation onset. This disease can be debilitating, causing a significant impact on the quality of life of young women. We present a case of a young female who was referred to our hospital with recurrent right-sided pleural effusions and pneumothoraces. Pleural fluid drainage was consistent with hemothorax. Transvaginal ultrasound showed mild intraperitoneal fluid in the Cul-de-Sac. Due to concerns for thoracic endometriosis, video-assisted thoracoscopic surgery was performed confirming the diagnosis by pathology. Therapeutic pleurectomy with diaphragmatic repair and pleurodesis was performed. The patient was started on medroxyprogesterone acetate injections two weeks after with great clinical response.
Topics: Female; Humans; Endometriosis; Hemothorax; Hemopneumothorax; Quality of Life; Pneumothorax; Thoracic Surgery, Video-Assisted
PubMed: 36172717
DOI: 10.4081/monaldi.2022.2401 -
Surgical Endoscopy Jun 2023There is considerable controversy regarding optimal management of patients with paraesophageal hiatus hernia (pHH). This survey aims at identifying recommended...
AIMS
There is considerable controversy regarding optimal management of patients with paraesophageal hiatus hernia (pHH). This survey aims at identifying recommended strategies for work-up, surgical therapy, and postoperative follow-up using Delphi methodology.
METHODS
We conducted a 2-round, 33-question, web-based Delphi survey on perioperative management (preoperative work-up, surgical procedure and follow-up) of non-revisional, elective pHH among European surgeons with expertise in upper-GI. Responses were graded on a 5-point Likert scale and analyzed using descriptive statistics. Items from the questionnaire were defined as "recommended" or "discouraged" if positive or negative concordance among participants was > 75%. Items with lower concordance levels were labelled "acceptable" (neither recommended nor discouraged).
RESULTS
Seventy-two surgeons with a median (IQR) experience of 23 (14-30) years from 17 European countries participated (response rate 60%). The annual median (IQR) individual and institutional caseload was 25 (15-36) and 40 (28-60) pHH-surgeries, respectively. After Delphi round 2, "recommended" strategies were defined for preoperative work-up (endoscopy), indication for surgery (typical symptoms and/or chronic anemia), surgical dissection (hernia sac dissection and resection, preservation of the vagal nerves, crural fascia and pleura, resection of retrocardial lipoma) and reconstruction (posterior crurorrhaphy with single stitches, lower esophageal sphincter augmentation (Nissen or Toupet), and postoperative follow-up (contrast radiography). In addition, we identified "discouraged" strategies for preoperative work-up (endosonography), and surgical reconstruction (crurorrhaphy with running sutures, tension-free hiatus repair with mesh only). In contrast, many items from the questionnaire including most details of mesh augmentation (indication, material, shape, placement, and fixation technique) were "acceptable".
CONCLUSIONS
This multinational European Delphi survey represents the first expert-led process to identify recommended strategies for the management of pHH. Our work may be useful in clinical practice to guide the diagnostic process, increase procedural consistency and standardization, and to foster collaborative research.
Topics: Humans; Hernia, Hiatal; Delphi Technique; Fundoplication; Laparoscopy; Herniorrhaphy; Surgical Mesh; Treatment Outcome
PubMed: 36849562
DOI: 10.1007/s00464-023-09933-8 -
Journal of Infection in Developing... Sep 2022Sepsis is a serious problem in felines with a mortality rate ranging from 29-79%. Neisseria spp. is considered a commensal microorganism of the oral cavity of dogs and...
INTRODUCTION
Sepsis is a serious problem in felines with a mortality rate ranging from 29-79%. Neisseria spp. is considered a commensal microorganism of the oral cavity of dogs and cats and is usually isolated from human wounds resulting from bites of these animals.
CASE REPORT
The present report describes clinical, imaging and laboratory findings of a feline with sepsis wherein commensal and multidrug-resistant (MDR) Neisseria spp. was isolated. The feline presented a history of four days of anorexia, dyspnea, prostration, and, pericardial, pleural and abdominal effusions. Pericardiocentesis was performed and hemorrhagic exudate was observed. The animal died after 11 days of treatment with gentamicin and amoxicillin combined with clavulanic acid. During necropsy, the abdominal cavity was found to be filled with greenish-yellow content and the pericardial sac was thickened with a large amount of purulent secretion. Histopathology revealed sepsis with necrotizing suppurative pericarditis, diffuse mononuclear pneumonia and necrotic pleuritis, leading to secondary bacterial infection.
CONCLUSIONS
Commensal Neisseria spp. are important zoonotic bacteria, which trigger a serious disease in felines. However, it has not been reported to cause sepsis with pneumonia, suppurative necrotizing pericarditis and pericardial effusion.
Topics: Amoxicillin; Animals; Cat Diseases; Cats; Clavulanic Acid; Dog Diseases; Dogs; Gentamicins; Humans; Neisseria; Pericarditis; Pneumonia; Sepsis
PubMed: 36223630
DOI: 10.3855/jidc.13165