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Leber, Magen, Darm Jul 1996Pancreatic pseudocysts with mediastinal extension are a rare clinical entity. The pseudocysts traverse the diaphragma by way of the esophageal hiatus or by erosion...
Pancreatic pseudocysts with mediastinal extension are a rare clinical entity. The pseudocysts traverse the diaphragma by way of the esophageal hiatus or by erosion directly through the diaphragma. Although the predominant clinical manifestations are related to the chest, proper management should include laparotomy and cystenteric anastomoses. In some cases the mediastinal components rapidly disappear without any specifically treatment.
Topics: Adult; Combined Modality Therapy; Critical Care; Diagnosis, Differential; Diaphragm; Humans; Male; Mediastinal Cyst; Pancreas; Pancreatic Function Tests; Pancreatic Pseudocyst; Tomography, X-Ray Computed
PubMed: 8965605
DOI: No ID Found -
The Pan African Medical Journal 2013Cystic tumors of the pancreas are rare and can be confused with pseudocysts.We present a 50 year old woman with a huge mucinous cystadenoma of the pancreas initially...
Cystic tumors of the pancreas are rare and can be confused with pseudocysts.We present a 50 year old woman with a huge mucinous cystadenoma of the pancreas initially diagnosed and managed with a cystojejunostomy and cyst wall biopsy. She required another laparotomy and tumor excision after histological diagnosis. Sensitivity of radiological imaging in differentiating between cystic pancreatic tumors and pseudocysts is limited. Cyst wall histology is diagnostic and biopsy of cyst wall should be done in cases with inconclusive preoperative diagnosis or questionable operative findings.
Topics: Biopsy; Cystadenoma, Mucinous; Diagnostic Errors; Female; Humans; Jejunostomy; Laparotomy; Middle Aged; Pancreatic Neoplasms; Pancreatic Pseudocyst; Sensitivity and Specificity
PubMed: 23847703
DOI: 10.11604/pamj.2013.15.6.2494 -
La Clinica Terapeutica 2012Among adrenal masses only 0.06% to 0.18% are cysts and among them, pseudocysts are the second (39%) most common lesions. Due to the increased use of imaging studies...
Among adrenal masses only 0.06% to 0.18% are cysts and among them, pseudocysts are the second (39%) most common lesions. Due to the increased use of imaging studies their incidence seems to have increased. Most of these lesions are incidentally found during radiologic investigation or at the time of autopsy, and only rarely they are detected in pregnant women. The latter scenario warrants emergency surgery, due to the risk of rupture. We present a case of a 39-years old woman presenting with unrelenting left flank pain due to a large adrenal pseudocyst soon after her first delivery. Four months after, she presented to our surgical division for persistent pain and anemia so underwent an extensive work up that showed a large pseudocystic mass (8 x 8 cm ) of the left adrenal gland. Once the neoplastic and parasitic etiology of the lesion were excluded, she underwent uneventful laparoscopic adrenalectomy. She was discharged home three days postoperatively. This case is the 13th case in the English literature and at the same time is the first case of adrenal pseudocyst occurred four months after delivery.
Topics: Abdominal Pain; Adrenal Gland Diseases; Adult; Cysts; Female; Humans; Postpartum Period
PubMed: 23099983
DOI: No ID Found -
AJR. American Journal of Roentgenology Jan 1983Fifty-four patients were referred to rule out pancreatic pseudocyst. These patients underwent both sonographic and abdominal computed tomographic (CT) examinations for... (Comparative Study)
Comparative Study
Fifty-four patients were referred to rule out pancreatic pseudocyst. These patients underwent both sonographic and abdominal computed tomographic (CT) examinations for the evaluation of suspected pseudocysts. Among the 54 cases were 24 with proven pseudocysts. CT correctly identified 23 of the 24 pseudocysts with one false-negative and two false-positive studies. With sonography, the studies were technically inadequate in 20 of the 54 patients examined. Sonography correctly diagnosed 18 of the 24 pseudocysts; however, in 10 of these 18 cases sonographic findings were incomplete relative to CT findings. There were one false-negative and three false-positive sonographic studies. On the basis of this study, it was concluded that CT is more accurate than sonography in both diagnosing and demonstrating the extent of pseudocysts of the pancreas.
Topics: False Negative Reactions; False Positive Reactions; Humans; Pancreatic Cyst; Pancreatic Pseudocyst; Tomography, X-Ray Computed; Ultrasonography
PubMed: 6600325
DOI: 10.2214/ajr.140.1.53 -
Journal of Hepato-biliary-pancreatic... 2000Internal drainage of acute pancreatic pseudocysts is indicated 6 weeks after the first documentation of pseudocyst. It is also indicated for symptomatic chronic... (Review)
Review
Internal drainage of acute pancreatic pseudocysts is indicated 6 weeks after the first documentation of pseudocyst. It is also indicated for symptomatic chronic pseudocysts 6 cm or more in diameter. When pseudocysts are located in close contact with the posterior wall of the stomach, they are best drained by pseudocyst-gastrostomy. This procedure can also be completed making use of intragastric surgical techniques. Under standard laparoscopic observation, three intragastric ports are placed through the abdominal and anterior gastric walls, establishing working channels for a telescope and hand instruments. After the presence of pseudocysts is confirmed, the posterior wall of the stomach and the cyst wall can be incised by electrocautery. After a sufficient drainage orifice is made and the cyst contents are thoroughly debrided, the intragastric ports are removed and defects in the gastric wall are closed with sutures placed via the standard laparoscopic approach. This approach is much less invasive than the conventional approach, which entails a large gastrotomy in the anterior wall of the stomach. This procedure should be the method of choice when interventional radiology or endoscopic intervention fails to effectively drain retrogastric pseudocysts.
Topics: Drainage; Equipment Design; Female; Gastrostomy; Humans; Laparoscopes; Laparoscopy; Male; Pancreatic Pseudocyst; Prognosis; Sensitivity and Specificity; Surgical Instruments; Treatment Outcome
PubMed: 10982588
DOI: 10.1007/s005340050150 -
The Australian and New Zealand Journal... Dec 1998A rational algorithm for the management of symptomatic pancreatic pseudocysts is necessary with the increasing availability of radiological, surgical and endoscopic...
BACKGROUND
A rational algorithm for the management of symptomatic pancreatic pseudocysts is necessary with the increasing availability of radiological, surgical and endoscopic methods of treatment.
METHODS
A retrospective audit of the management and outcome of all patients who presented with symptomatic pancreatic pseudocysts to the Auckland Hospital over a 9-year period (1988-96) was made.
RESULTS
There were 44 patients (28 men, 16 women; median age 50; range 18-81) in this series. Initial management was not based on pseudocyst size, duration, location, wall thickness, the patients' symptoms and comorbidity, or the aetiology of pancreatitis. Of the 27 patients who had initial conservative management, 15 pseudocysts (56%) completely resolved. Of the 17 patients who were initially or subsequently treated with percutaneous catheter drainage (PCD), 10 pseudocysts (59%) completely resolved without additional treatment. Of the 13 patients initially or subsequently treated by surgery, all but one completely resolved after the first procedure. Two patients were successfully treated with endoscopic pancreatic stent placement. Complications arose in eight patients treated with PCD (47%) and four patients treated with surgery (31%). There was no mortality. The decision for active treatment was not preceded by delineation of the pancreatic duct by ERCP (endoscopic retrograde cholangiopancreatography) in 60% of patients.
CONCLUSIONS
More than one-third of all patients with symptomatic pancreatic pseudocysts can be managed conservatively. Surgery yields excellent results but PCD has a high failure rate in patients with an underlying pancreatic duct stricture. A rational management algorithm is presented, based on pre-intervention ERCP, which should improve patient selection and outcome.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Catheterization; Cholangiopancreatography, Endoscopic Retrograde; Cholelithiasis; Constriction, Pathologic; Drainage; Female; Humans; Male; Medical Audit; Middle Aged; Pancreatic Diseases; Pancreatic Ducts; Pancreatic Pseudocyst; Pancreatitis; Pancreatitis, Alcoholic; Patient Selection; Radiology, Interventional; Reoperation; Retrospective Studies; Rupture, Spontaneous; Stents; Treatment Outcome
PubMed: 9885866
DOI: 10.1046/j.1440-1622.1998.01465.x -
Micron (Oxford, England : 1993) Jun 2015Tritrichomonas foetus is a parasite that causes bovine trichomonosis, a major sexually transmitted disease in cattle. It grows in axenic media as a trophozoite with a...
Tritrichomonas foetus is a parasite that causes bovine trichomonosis, a major sexually transmitted disease in cattle. It grows in axenic media as a trophozoite with a pear-shaped body, three anterior flagella, and one recurrent flagellum. However, under some well-controlled experimental conditions in vitro, as well as in vivo in infected bulls, the parasite acquires a spherical or elliptical shape, and the flagella are internalized but the cells do not display a cyst wall. This form, known as the endoflagellar or pseudocystic form, is viable, and can be transformed back to trophozoites with pear-shaped body. We used confocal laser scanning microscopy, and high resolution scanning electron microscopy to examine the changes that take place in the protozoan cytoskeleton during trophozoite-pseudocyst transformation. Results confirmed previous studies and added new structural information to the organization of cytoskeletal structures during the transformation process. We observed that changes take place in the pseudocysts' axostyle and costa, which acquired a curved shape. In addition, the costa of multinucleated/polymastigont pseudocysts took variable conformations while curved. The costa accessory structure, as well as a network of filaments connecting this structure to the region where the recurrent flagellum associates to the protozoan body, was not seen in pseudocysts. In addition, the axostyle was fragmented during trophozoite-pseudocyst transformation.
Topics: Animals; Cattle; Cytoskeleton; Flagella; Microscopy, Electron, Scanning; Microtubules; Tritrichomonas foetus; Trophozoites
PubMed: 25880467
DOI: 10.1016/j.micron.2015.03.008 -
Zhonghua Wai Ke Za Zhi [Chinese Journal... Apr 2018Pancreatic pseudocyst is the most common pancreatic cystic disease in clinical practice.In the surgical treatment of pancreatic pseudocysts, most surgeons preferred...
Pancreatic pseudocyst is the most common pancreatic cystic disease in clinical practice.In the surgical treatment of pancreatic pseudocysts, most surgeons preferred laparoscopic surgery in recent years.The options and the timing of laparoscopic surgery for pancreatic pseudocysts in different situations are explored in the paper.Pancreatic pseudocysts during the observation period, the imaging examination to detect whether the cyst has disappeared or increased, such as cysts found to be enlarged or still can not dissipate after 6 months, the largest diameter greater than 6 cm, and clinical symptoms, surgical drainage should be considered treatment.Surgery based on the location of the cyst and surgical experience of surgical options.Pancreatic cyst often choose laparoscopic cyst-gastric anastomosis, far from the stomach cyst should choose laparoscopic cyst-jejunal anastomosis.Laparoscopic surgery for the treatment of pancreatic pseudocyst has a unique advantage, short operation time, less bleeding, less trauma, less postoperative complications, rapid recovery, is a safe and effective treatment options.
Topics: Anastomosis, Surgical; Drainage; Humans; Laparoscopy; Pancreatic Pseudocyst
PubMed: 29562410
DOI: 10.3760/cma.j.issn.0529-5815.2018.E004 -
ACG Case Reports Journal Feb 2019Pancreatic pseudocysts and peripancreatic fluid collections extending into the mediastinum are unusual. Endoscopically, intra-abdominal pseudocysts can be drained...
Pancreatic pseudocysts and peripancreatic fluid collections extending into the mediastinum are unusual. Endoscopically, intra-abdominal pseudocysts can be drained transmurally through the stomach or duodenum depending on the location. An endoscopic ultrasound-guided esophageal approach for mediastinal pseudocysts has not been reported commonly in the literature. We report a rare case of a large mediastinal pseudocyst that was drained through the distal esophagus with eventual complete resolution of symptoms and pseudocyst.
PubMed: 31616718
DOI: 10.14309/crj.0000000000000016 -
Journal of Hepato-biliary-pancreatic... 2002Internal drainage of acute pancreatic pseudocysts is indicated after the first 6 weeks of pseudocyst documentation. It is also indicated for symptomatic chronic...
BACKGROUND/PURPOSE
Internal drainage of acute pancreatic pseudocysts is indicated after the first 6 weeks of pseudocyst documentation. It is also indicated for symptomatic chronic pseudocysts 6 cm or more in diameter. When a pseudocyst is in close contact with the posterior wall of the stomach, it is best drained by pseudocyst gastrostomy.
METHODS
Intragastric surgical techniques were used in 18 patients with retrogastric pseudocysts. Intragastric ports were successfully placed in all patients, and the presence of pseudocysts was confirmed by needle aspiration in 17.
RESULTS
The intragastric approach was successful in 14 patients. In three cases a small abdominal would 8 cm in length was needed. The reasons for such conversion included uncontrollable bleeding from the cystic wall in two cases and a cystic wall in contact with, but not adherent to, the posterior gastric wall in one. Bleeding was controlled through a gastrotomy, and cystgastrostomy was performed. The wound required for conversion was much smaller than that needed for planned open surgery. These procedures are called laparoscopy-assisted cystgastrostomy. Good short- and long-term results were obtained. One patient, in whom the cystgastrostomy was too small, developed a cyst infection and underwent reoperation. Except for this case, no recurrence was observed, and no further treatment was needed.
CONCLUSIONS
This experience demonstrates that cystgastrostomy with the intragastric surgical technique is a safe, less invasive procedure for effectively draining a retrogastric pseudocyst.
Topics: Adult; Aged; Drainage; Female; Gastrostomy; Humans; Laparoscopy; Male; Middle Aged; Pancreatic Pseudocyst; Treatment Outcome
PubMed: 12541038
DOI: 10.1007/s005340200072