Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240757
André A. Silva, Guida C. Pires, Liliana V. Simões, Beatriz R. Lourenço, Catarina C. Rocha, Lília J. Meireles
Malakoplakia is a rare and chronic granulomatous disease, resulting from the accumulation of large granular macrophages containing basophilic inclusion bodies in the cytoplasm named Michaelis-Gutmann bodies. The gastrointestinal tract is the second most common site after the urinary tract, though malakoplakia has the potential to manifest in multiple organs. Rectal malakoplakia is difficult to diagnose due to its unspecific clinical and radiological presentation, usually mimicking a malignancy. Most report cases are associated with immunosuppressive diseases or chronic prolonged illness. We present the case of a 64-year-old male with a history of anal pain. A pelvic magnetic resonance imaging showed a rectal mass with 38 mm invading the mesorectum. Colonoscopy was performed confirming a mass-like lesion and biopsies were taken. Histopathological examination revealed features consistent with malakoplakia. The patient underwent long-term oral antibiotic treatment and during follow-up there was a regression of the lesion and resolution of symptoms.
{"title":"Rectal malakoplakia simulating a locally advanced rectal cancer: a case report","authors":"André A. Silva, Guida C. Pires, Liliana V. Simões, Beatriz R. Lourenço, Catarina C. Rocha, Lília J. Meireles","doi":"10.18203/2349-2902.isj20240757","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240757","url":null,"abstract":"Malakoplakia is a rare and chronic granulomatous disease, resulting from the accumulation of large granular macrophages containing basophilic inclusion bodies in the cytoplasm named Michaelis-Gutmann bodies. The gastrointestinal tract is the second most common site after the urinary tract, though malakoplakia has the potential to manifest in multiple organs. Rectal malakoplakia is difficult to diagnose due to its unspecific clinical and radiological presentation, usually mimicking a malignancy. Most report cases are associated with immunosuppressive diseases or chronic prolonged illness. We present the case of a 64-year-old male with a history of anal pain. A pelvic magnetic resonance imaging showed a rectal mass with 38 mm invading the mesorectum. Colonoscopy was performed confirming a mass-like lesion and biopsies were taken. Histopathological examination revealed features consistent with malakoplakia. The patient underwent long-term oral antibiotic treatment and during follow-up there was a regression of the lesion and resolution of symptoms.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"24 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240754
Sakshi Ramnani, Subhash Chawla, M. S. Utaal, Mrigendra Singh, Dakshita Adlakha, Mrugen Thakor
Extra adrenal retroperitoneal paragangliomas are neuro endocrine neoplasms with extremely rare incidence and a wide plethora of clinical presentations. They originate from the neural crest cells interspersed throughout the body. They can present with vague symptoms of pain abdomen, hypertension, palpitations and in severe cases with renal failure, and shock owing to catecholamine excess. On the other end of the spectrum they can be totally asymptomatic and detected incidentally. The multitude of clinical presentations and lack of specific diagnostic tests hence pose a great difficulty in the pre-operative diagnosis of the disease. We are presenting a case of a 20-year-old female with vague symptoms to highlight the management and clinical diagnosis of extra adrenal retroperitoneal paraganglioma.
{"title":"A rare case of extra adrenal retroperitoneal paraganglioma: case report","authors":"Sakshi Ramnani, Subhash Chawla, M. S. Utaal, Mrigendra Singh, Dakshita Adlakha, Mrugen Thakor","doi":"10.18203/2349-2902.isj20240754","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240754","url":null,"abstract":"Extra adrenal retroperitoneal paragangliomas are neuro endocrine neoplasms with extremely rare incidence and a wide plethora of clinical presentations. They originate from the neural crest cells interspersed throughout the body. They can present with vague symptoms of pain abdomen, hypertension, palpitations and in severe cases with renal failure, and shock owing to catecholamine excess. On the other end of the spectrum they can be totally asymptomatic and detected incidentally. The multitude of clinical presentations and lack of specific diagnostic tests hence pose a great difficulty in the pre-operative diagnosis of the disease. We are presenting a case of a 20-year-old female with vague symptoms to highlight the management and clinical diagnosis of extra adrenal retroperitoneal paraganglioma.\u0000 ","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"04 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240752
Tan Ying An, K. Nagandla, Krishna Kumar, Akshatha Daniel
Cesarean scar pregnancy is a rare type of ectopic pregnancy but potentially life threatening. The incidence of this ectopic pregnancy continues to rise due to global increase in cesarean sections rates as well as the diagnosis with wide use of transvaginal ultrasound. Delay or wrong diagnosis may result to uterine rupture and life-threatening bleeding with potential maternal morbidity and mortality. Endo-vaginal ultrasound has a reported sensitivity of 85-90% for detection. In difficult cases, magnetic resonance imaging is often useful as second line imaging. Treatment may be ranging from conservative to medical therapy or surgery. We present a series of three illustrative cases successfully managed with medical management and sequential treatment of medical and surgical management. We discuss diagnostic challenges and review of literature on updates on management strategies.
{"title":"Caesarean section scar pregnancy: a case series","authors":"Tan Ying An, K. Nagandla, Krishna Kumar, Akshatha Daniel","doi":"10.18203/2349-2902.isj20240752","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240752","url":null,"abstract":"Cesarean scar pregnancy is a rare type of ectopic pregnancy but potentially life threatening. The incidence of this ectopic pregnancy continues to rise due to global increase in cesarean sections rates as well as the diagnosis with wide use of transvaginal ultrasound. Delay or wrong diagnosis may result to uterine rupture and life-threatening bleeding with potential maternal morbidity and mortality. Endo-vaginal ultrasound has a reported sensitivity of 85-90% for detection. In difficult cases, magnetic resonance imaging is often useful as second line imaging. Treatment may be ranging from conservative to medical therapy or surgery. We present a series of three illustrative cases successfully managed with medical management and sequential treatment of medical and surgical management. We discuss diagnostic challenges and review of literature on updates on management strategies.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240749
Mehmet G. Sönmez, Eren Erol, Leyla Ö. Sönmez, Arif Aydın
Background: The aim of this study was to evaluate the efficacy of intracavernosal alprostadil treatment for erectile dysfunction and the evaluation of factors such as ease of drug use, duration of use, and difficulties in habituation. Methods: The data of 40 patients who were treated for erectile dysfunction, had inadequate response from first-line treatment modalities, received intracavernosal alprostadil in second-line treatment and continued treatment for more than 12 weeks without interruption were analyzed. Sexual function status was evaluated by 15-question international ındex of erectile function (IIEF-15) form and degree of erection (1-10 points). In addition, duration of use, self-administered dose, reasons for difficulty, and reasons for treatment interruption were investigated. Results: The mean duration of use was 21.38 months. Patients switched to self-administration after an average minimum dose of 2.23 doses. After 12 weeks, 50% of the patients discontinued self-administration, 10% because of difficulty in administration, 55% because of inadequate erection response, 25% because of time, and 10% because of additional health problems. IIEF-15 parameters and the degree of erection were found to improve significantly after administration (p<0.05 for all parameters). Conclusions: Intracavernosal alprostadil provides significant improvement in sexual function, but since it is an invasive application, patients have difficulty in getting used to it, self-administration is started after a minimum of 2 doses, and the reason for discontinuation is mostly due to inadequate erectile response.
{"title":"Assessing the use habits and efficacy of intracavernosal alprostadil: is it tolerable and sustainable?","authors":"Mehmet G. Sönmez, Eren Erol, Leyla Ö. Sönmez, Arif Aydın","doi":"10.18203/2349-2902.isj20240749","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240749","url":null,"abstract":"Background: The aim of this study was to evaluate the efficacy of intracavernosal alprostadil treatment for erectile dysfunction and the evaluation of factors such as ease of drug use, duration of use, and difficulties in habituation.\u0000Methods: The data of 40 patients who were treated for erectile dysfunction, had inadequate response from first-line treatment modalities, received intracavernosal alprostadil in second-line treatment and continued treatment for more than 12 weeks without interruption were analyzed. Sexual function status was evaluated by 15-question international ındex of erectile function (IIEF-15) form and degree of erection (1-10 points). In addition, duration of use, self-administered dose, reasons for difficulty, and reasons for treatment interruption were investigated.\u0000Results: The mean duration of use was 21.38 months. Patients switched to self-administration after an average minimum dose of 2.23 doses. After 12 weeks, 50% of the patients discontinued self-administration, 10% because of difficulty in administration, 55% because of inadequate erection response, 25% because of time, and 10% because of additional health problems. IIEF-15 parameters and the degree of erection were found to improve significantly after administration (p<0.05 for all parameters).\u0000Conclusions: Intracavernosal alprostadil provides significant improvement in sexual function, but since it is an invasive application, patients have difficulty in getting used to it, self-administration is started after a minimum of 2 doses, and the reason for discontinuation is mostly due to inadequate erectile response.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"8 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240763
Arijit Rumu Baruah, Darpana Kalita
Fournier’s gangrene is a rare and rapidly progressive necrotising fasciitis of the external genitalia and perineum. It is characterised by obliterative endarteritis of the subcutaneous arteries resulting in gangrene of the subcutaneous tissue and the overlying skin. Rural surgery refers to the practice of surgery serving people in rural communities and geographically remote areas. Rural surgery faces multiple challenges like limitation of resources and manpower, poverty, multiple co-morbidities and superstitions. We present such a case of Fournier’s gangrene treated in a secondary care centre of rural Assam. A 45 year old male presented with pain and discharge from the scrotum since two weeks. No other co-morbidities were present. Initially, wound debridement and dressing with hydrogen peroxide and povidone iodine is done. Necrosed tissue is sent for microbial culture and sensitivity. Initially, empirical antibiotics was started and was converted to fluoroquinolones as it showed sensitivity. Serial dressing and debridement were continued till healthy granulation tissue appeared. Then, the wound was closed by loose approximation method. Wound was successfully apposed and viability of both the testis was also found to be intact. Thus, the age-old principle of dressing and debridement still serves as the background of wound care in modern rural surgery.
{"title":"Principles of dressing and debridement in modern rural surgery: experience of a case of Fournier’s gangrene","authors":"Arijit Rumu Baruah, Darpana Kalita","doi":"10.18203/2349-2902.isj20240763","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240763","url":null,"abstract":"Fournier’s gangrene is a rare and rapidly progressive necrotising fasciitis of the external genitalia and perineum. It is characterised by obliterative endarteritis of the subcutaneous arteries resulting in gangrene of the subcutaneous tissue and the overlying skin. Rural surgery refers to the practice of surgery serving people in rural communities and geographically remote areas. Rural surgery faces multiple challenges like limitation of resources and manpower, poverty, multiple co-morbidities and superstitions. We present such a case of Fournier’s gangrene treated in a secondary care centre of rural Assam. A 45 year old male presented with pain and discharge from the scrotum since two weeks. No other co-morbidities were present. Initially, wound debridement and dressing with hydrogen peroxide and povidone iodine is done. Necrosed tissue is sent for microbial culture and sensitivity. Initially, empirical antibiotics was started and was converted to fluoroquinolones as it showed sensitivity. Serial dressing and debridement were continued till healthy granulation tissue appeared. Then, the wound was closed by loose approximation method. Wound was successfully apposed and viability of both the testis was also found to be intact. Thus, the age-old principle of dressing and debridement still serves as the background of wound care in modern rural surgery.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"97 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240750
Hepi V. Patel, Dharmesh P. Vasavada
Background: Hydatid cyst disease, caused by the larval stage of the parasite Echinococcus granulosus, commonly affects the liver and lungs but can also manifest in various extrahepatic and extrapulmonary locations. Splenic hydatid disease, despite being rare, is the third most common location. This paper presents a case series highlighting the clinical presentation, diagnostic challenges, and management strategies for patients with extrahepatic and extrapulmonary hydatid cysts. Several studies already postulated on sites of hydatid cysts which have statistically significant results. Methods: Patients who were operated on for hydatid disease or cystic lesions, which were later diagnosed as hydatid disease, between September 2022-August 2023 were retrieved retrospectively. Patients with lesions localized outside the liver and the lung as well as in liver and lung were enrolled in the study. Fifty-Two patients with extra-hepatic primary hydatid disease were treated surgically at our clinic. The cysts were located in different part of body. Results has undergone statistical methods like Z-test and Mann-Whitney U test. Any patient of any gender admitted with diagnosis of hydatid cyst in any part of body with age >18 but less than 70 years irrespective of any comorbidities. Results: Surgical techniques like partial or total cystectomy with or without tube drainage are good option for management of extrahepatic and extrapulmonary primary hydatid cysts. There were no complications or mortality in the postoperative period. Hydatid cyst is considered in the differential diagnosis of cystic lesions, especially in endemic areas. Surgical technique planned according to the location of the cyst. Conclusions: Cystectomy is a surgical option in extrahepatic and extrapulmonary hydatid cyst which is evaluate better in this study.
背景：由棘球蚴幼虫阶段引起的包虫囊肿病通常会影响肝脏和肺部，但也可表现为肝外和肺外的各种部位。脾包虫病虽然罕见，但却是第三大常见病发部位。本文通过一系列病例着重介绍了肝外和肺外包虫囊肿患者的临床表现、诊断难题和治疗策略。已有多项研究推测了水瘤囊肿的发病部位，并得出了具有统计学意义的结果：方法：回顾性检索 2022 年 9 月至 2023 年 8 月期间因包虫病或囊性病变接受手术的患者，这些患者后来被诊断为包虫病。病变位于肝脏和肺脏以外以及肝脏和肺脏内的患者均被纳入研究。52 名肝外原发性包虫病患者在本诊所接受了手术治疗。囊肿位于身体的不同部位。研究结果采用 Z 检验和 Mann-Whitney U 检验等统计方法。任何性别、年龄大于 18 岁但小于 70 岁、被诊断为身体任何部位的包虫囊肿患者，无论是否有任何合并症：肝外和肺外原发性包虫囊肿的治疗方法中，部分或全部囊肿切除术（带或不带管道引流）是不错的选择。术后无并发症或死亡率。在囊性病变的鉴别诊断中应考虑包虫囊肿，尤其是在地方病流行地区。根据囊肿的位置规划手术技术：囊肿切除术是肝外和肺外包虫囊肿的一种手术选择，在本研究中得到了较好的评价。
{"title":"Extrahepatic and extrapulmonary hydatid cysts as primary lesions","authors":"Hepi V. Patel, Dharmesh P. Vasavada","doi":"10.18203/2349-2902.isj20240750","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240750","url":null,"abstract":"Background: Hydatid cyst disease, caused by the larval stage of the parasite Echinococcus granulosus, commonly affects the liver and lungs but can also manifest in various extrahepatic and extrapulmonary locations. Splenic hydatid disease, despite being rare, is the third most common location. This paper presents a case series highlighting the clinical presentation, diagnostic challenges, and management strategies for patients with extrahepatic and extrapulmonary hydatid cysts. Several studies already postulated on sites of hydatid cysts which have statistically significant results.\u0000Methods: Patients who were operated on for hydatid disease or cystic lesions, which were later diagnosed as hydatid disease, between September 2022-August 2023 were retrieved retrospectively. Patients with lesions localized outside the liver and the lung as well as in liver and lung were enrolled in the study. Fifty-Two patients with extra-hepatic primary hydatid disease were treated surgically at our clinic. The cysts were located in different part of body. Results has undergone statistical methods like Z-test and Mann-Whitney U test. Any patient of any gender admitted with diagnosis of hydatid cyst in any part of body with age >18 but less than 70 years irrespective of any comorbidities.\u0000Results: Surgical techniques like partial or total cystectomy with or without tube drainage are good option for management of extrahepatic and extrapulmonary primary hydatid cysts. There were no complications or mortality in the postoperative period. Hydatid cyst is considered in the differential diagnosis of cystic lesions, especially in endemic areas. Surgical technique planned according to the location of the cyst.\u0000Conclusions: Cystectomy is a surgical option in extrahepatic and extrapulmonary hydatid cyst which is evaluate better in this study.\u0000 ","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"93 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240748
Mia Shepherdson, Daniel Kilburn, Matthew Marshall-Webb, Shahid Ullah, John Chen, M. Brooke-Smith
Background: Despite advances in surgical techniques and chemotherapy, poor outcomes persist in pancreatic malignancy. This study aimed to investigate clinical outcomes and describe the impact of factors like the closest resection margin on overall survival following open pancreatoduodenectomy at a tertiary referral centre over a ten-year period. Methods: Patients who underwent a pancreaticoduodenectomy at a tertiary hospital in South Australia between 2009-2019 were included in this retrospective study. Patient demographics, systemic treatments, complications, and histological features were analysed for their role in overall survival. Kaplan-Meier survival curves were used to assess patient survival and estimate median survival time. Results: There were 134 open pancreaticoduodenectomy procedures during 2009-2019. Majority of patients were male (54.7%) between 65-75 years of age (41%) with an ASA physical status classification grade of 3 (63.3%). 56.7% of patients experienced a complication with 5 in-hospital deaths recorded and 12 ISPGF grade B or C pancreatic anastomotic leaks (n=5, n=7 respectively). 88% of resected specimens were malignant with an overall 5-year survival of 32%. A resection margin of >2 mm had a significantly improved overall survival compared to 0 mm (p=0.01). There was no survival benefit for a resection margin of <1 mm or 1-2 mm compared 0mm margin (p=0.6 and p=0.2 respectively). 65 patients (54.6%) experienced either local or distal disease recurrence by the end of the study period. Conclusions: There has been no improvement in overall survival post pancreatoduodenectomy for pancreatic malignancy. Further research into the clinical significance of the R status classification is required.
{"title":"Need for a paradigm shift? Survival post-pancreatoduodenectomy remains poor despite surgical and oncological advances","authors":"Mia Shepherdson, Daniel Kilburn, Matthew Marshall-Webb, Shahid Ullah, John Chen, M. Brooke-Smith","doi":"10.18203/2349-2902.isj20240748","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240748","url":null,"abstract":"Background: Despite advances in surgical techniques and chemotherapy, poor outcomes persist in pancreatic malignancy. This study aimed to investigate clinical outcomes and describe the impact of factors like the closest resection margin on overall survival following open pancreatoduodenectomy at a tertiary referral centre over a ten-year period.\u0000Methods: Patients who underwent a pancreaticoduodenectomy at a tertiary hospital in South Australia between 2009-2019 were included in this retrospective study. Patient demographics, systemic treatments, complications, and histological features were analysed for their role in overall survival. Kaplan-Meier survival curves were used to assess patient survival and estimate median survival time.\u0000Results: There were 134 open pancreaticoduodenectomy procedures during 2009-2019. Majority of patients were male (54.7%) between 65-75 years of age (41%) with an ASA physical status classification grade of 3 (63.3%). 56.7% of patients experienced a complication with 5 in-hospital deaths recorded and 12 ISPGF grade B or C pancreatic anastomotic leaks (n=5, n=7 respectively). 88% of resected specimens were malignant with an overall 5-year survival of 32%. A resection margin of >2 mm had a significantly improved overall survival compared to 0 mm (p=0.01). There was no survival benefit for a resection margin of <1 mm or 1-2 mm compared 0mm margin (p=0.6 and p=0.2 respectively). 65 patients (54.6%) experienced either local or distal disease recurrence by the end of the study period.\u0000Conclusions: There has been no improvement in overall survival post pancreatoduodenectomy for pancreatic malignancy. Further research into the clinical significance of the R status classification is required.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"46 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140376912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240753
Dakshita Adlakha, Subhash Chawla, M. S. Utaal, Shivam Sharma, Ankita Khurana, Mrugen Thakor, Sakshi Ramnani
Hydatid cyst (HD) disease is a parasitic infection caused by Echinococcus granulosus. It occurs worldwide, but its prevalence is higher in the rural communities where sheep and cattle raising constitute a crucial component of the agricultural industry. This is a zoonotic disease which spreads via close contact of humans with sheep and dogs. The most common organs involved in hydatid cyst are the liver and lungs. However, other organs may also foster it, such as the spleen which is a rare clinical condition, with an incidence rate of between 0.5% and 4%. In this study, a 46-year-old male with a primary splenic HC is reported with chief complaint of pain and non-tender palpable mass in left hypochondrium. A 9.7×10.6×11 cm splenic cystic mass was detected on ultrasonography (US) and confirmed by abdominal computed tomography (CT) scan, without involvement of other organs. Splenectomy was done along with excision of intact hydatid cyst. Pathological examinations revealed cystic hydatidosis. We describe this case of an isolated splenic HC, which was successfully treated with total splenectomy, focusing on the management and outcome of this disease.
{"title":"Splenic hydatid cyst: a case report","authors":"Dakshita Adlakha, Subhash Chawla, M. S. Utaal, Shivam Sharma, Ankita Khurana, Mrugen Thakor, Sakshi Ramnani","doi":"10.18203/2349-2902.isj20240753","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240753","url":null,"abstract":"Hydatid cyst (HD) disease is a parasitic infection caused by Echinococcus granulosus. It occurs worldwide, but its prevalence is higher in the rural communities where sheep and cattle raising constitute a crucial component of the agricultural industry. This is a zoonotic disease which spreads via close contact of humans with sheep and dogs. The most common organs involved in hydatid cyst are the liver and lungs. However, other organs may also foster it, such as the spleen which is a rare clinical condition, with an incidence rate of between 0.5% and 4%. In this study, a 46-year-old male with a primary splenic HC is reported with chief complaint of pain and non-tender palpable mass in left hypochondrium. A 9.7×10.6×11 cm splenic cystic mass was detected on ultrasonography (US) and confirmed by abdominal computed tomography (CT) scan, without involvement of other organs. Splenectomy was done along with excision of intact hydatid cyst. Pathological examinations revealed cystic hydatidosis. We describe this case of an isolated splenic HC, which was successfully treated with total splenectomy, focusing on the management and outcome of this disease.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"43 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cholelithiasis (gallstones), crystalline formations in the gallbladder, presents a common yet intricate medical concern. These stones can vary in size and composition, ranging from cholesterol to pigment-based stones. Treatment often involves surgical intervention, with laparoscopic procedures being a minimally invasive and effective option. However, complications arise when multiple stones are present, leading to heightened inflammation and recurrent symptoms. In this study, we present a case of a 34-year-old, male who came with complaints of abdominal pain and bloating, intermittent nausea, vomiting, and jaundice for more than 5 days. He was diagnosed with multiple calculi in the gallbladder (acute cholecystitis with cholelithiasis) based on ultrasonography. Since the patient had jaundice, he was suggested to get a magnetic resonance cholangiopancreatography (MRCP) to rule out any pathoanatomy. He received treatment by laparoscopic cholecystectomy and showed improvement within 5 days of surgery.
{"title":"A comprehensive case study of cholecystectomy in a patient with a gallbladder laden with 442 stones","authors":"Prashant Kedari, Milind Joshi, Vaibhav Kapoor, Sushant Khurana","doi":"10.18203/2349-2902.isj20240761","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240761","url":null,"abstract":"Cholelithiasis (gallstones), crystalline formations in the gallbladder, presents a common yet intricate medical concern. These stones can vary in size and composition, ranging from cholesterol to pigment-based stones. Treatment often involves surgical intervention, with laparoscopic procedures being a minimally invasive and effective option. However, complications arise when multiple stones are present, leading to heightened inflammation and recurrent symptoms. In this study, we present a case of a 34-year-old, male who came with complaints of abdominal pain and bloating, intermittent nausea, vomiting, and jaundice for more than 5 days. He was diagnosed with multiple calculi in the gallbladder (acute cholecystitis with cholelithiasis) based on ultrasonography. Since the patient had jaundice, he was suggested to get a magnetic resonance cholangiopancreatography (MRCP) to rule out any pathoanatomy. He received treatment by laparoscopic cholecystectomy and showed improvement within 5 days of surgery.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"17 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-27DOI: 10.18203/2349-2902.isj20240755
Omar S. Fattel-Servin, Osvaldo I. Guevara-Valmaña, Sebastian Trigueiros-Guzmán, Valentina Prieto-Vargas, Ximena I. Ramirez-Morales, Armando Apellaniz-campo
Animal bites represent a significant source of morbidity in the pediatric population, with dogs being the primary cause. Highlighting the need for innovative solutions to effectively tackle the issue and enhance both functional and aesthetic outcomes. Dog bites, marked by a heightened morbidity rate, present an inherent infection risk owing to the considerable bacterial load present in saliva. The fundamental approach to treatment revolves around preventing infection through meticulous washing, debridement, and the timely implementation of early primary closure. We detail the management of a pediatric patient with a dog bite on the pelvic limb, resulting in a challenging-to-manage wound. This case was successfully treated with a skin graft on a bed of collagen matrix, secured with negative pressure therapy. The choice of the appropriate technique for reconstructing skin defects depends on their depth and size. Consequently, combining these three techniques yielded a favorable functional and aesthetic outcome for the patient. This case report emphasizes the relevance of employing different techniques in managing complicated dog bites.
{"title":"Skin graft on a collagen and elastin matrix fixed with negative pressure in a complicated pediatric dog bite: case report","authors":"Omar S. Fattel-Servin, Osvaldo I. Guevara-Valmaña, Sebastian Trigueiros-Guzmán, Valentina Prieto-Vargas, Ximena I. Ramirez-Morales, Armando Apellaniz-campo","doi":"10.18203/2349-2902.isj20240755","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240755","url":null,"abstract":"Animal bites represent a significant source of morbidity in the pediatric population, with dogs being the primary cause. Highlighting the need for innovative solutions to effectively tackle the issue and enhance both functional and aesthetic outcomes. Dog bites, marked by a heightened morbidity rate, present an inherent infection risk owing to the considerable bacterial load present in saliva. The fundamental approach to treatment revolves around preventing infection through meticulous washing, debridement, and the timely implementation of early primary closure. We detail the management of a pediatric patient with a dog bite on the pelvic limb, resulting in a challenging-to-manage wound. This case was successfully treated with a skin graft on a bed of collagen matrix, secured with negative pressure therapy. The choice of the appropriate technique for reconstructing skin defects depends on their depth and size. Consequently, combining these three techniques yielded a favorable functional and aesthetic outcome for the patient. This case report emphasizes the relevance of employing different techniques in managing complicated dog bites.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"2 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140374132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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