Degloving injuries are uncommon serious conditions occurring in high-velocity traumas with high mortality and morbidity. The lack of standard guidelines for the diagnostic and therapeutic management of such injuries provides a challenge to the surgeon. We present a case of a 35-year-old male with an extensive degloving injury who underwent primary closure unsuccessfully. The necrotic area was debrided and negative pressure wound therapy was used for the management of the wound. The patient was managed with split skin grafting and post successful recovery on all fronts has been completely rehabilitated. Though primary suturing is always tried, the viability of the degloved skin remains questionable and might need extensive debridement. Negative Pressure Wound dressing is seen to be accelerating wound healing and improving the treatment outcome.
{"title":"Negative pressure wound therapy: our experience of a polytrauma with degloving injury","authors":"Mangipudi Surya Pratap, Mahak Goel, Janitta Kundaikar, Kusum Meena","doi":"10.18203/2349-2902.isj20240587","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240587","url":null,"abstract":"Degloving injuries are uncommon serious conditions occurring in high-velocity traumas with high mortality and morbidity. The lack of standard guidelines for the diagnostic and therapeutic management of such injuries provides a challenge to the surgeon. We present a case of a 35-year-old male with an extensive degloving injury who underwent primary closure unsuccessfully. The necrotic area was debrided and negative pressure wound therapy was used for the management of the wound. The patient was managed with split skin grafting and post successful recovery on all fronts has been completely rehabilitated. Though primary suturing is always tried, the viability of the degloved skin remains questionable and might need extensive debridement. Negative Pressure Wound dressing is seen to be accelerating wound healing and improving the treatment outcome.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415439","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240578
Benjamin Choo Wee Keat, Salmi Binti Mohamed Sukur
Wound closure is often a challenge in patients with major burns due to the limited amount of healthy skin available for harvesting and grafting. As a result, this often yields severe morbidity and mortality amongst said patients. This case report presents the successful use of the Meek micro-grafting technique on a patient with extensive major deep dermal to full-thickness burn injuries in the Burn Unit of the Kuala Lumpur Hospital of Malaysia. The Meek micro-grafting method, involves the creation of micro-grafts from a small and limited donor site, and proved to be effective in promoting wound healing and minimizing donor site morbidity.
{"title":"Application of Meek micro-grafting technique in severe burn injury: a case report","authors":"Benjamin Choo Wee Keat, Salmi Binti Mohamed Sukur","doi":"10.18203/2349-2902.isj20240578","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240578","url":null,"abstract":"Wound closure is often a challenge in patients with major burns due to the limited amount of healthy skin available for harvesting and grafting. As a result, this often yields severe morbidity and mortality amongst said patients. This case report presents the successful use of the Meek micro-grafting technique on a patient with extensive major deep dermal to full-thickness burn injuries in the Burn Unit of the Kuala Lumpur Hospital of Malaysia. The Meek micro-grafting method, involves the creation of micro-grafts from a small and limited donor site, and proved to be effective in promoting wound healing and minimizing donor site morbidity.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"8 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140410243","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240581
Guillermo A. Macías-González, Alberto Santillán-Arroyo
Ascariasis is one of the most common gastrointestinal parasitic infections in developing countries. In humans, these parasites reside in the jejunum but can lodge in any part of the small intestine and can migrate to the biliary tract. We present the case of a 45-year-old female patient, with no relevant history, from a rural town in Mexico, who presented to the emergency department for abdominal pain in the right hypochondrium, nausea and vomiting of one week's evolution, acute cholecystitis was suspected and an ultrasound of the liver and biliary tract was requested, which reported acute cholecystitis and ascaris was observed in the gallbladder, was evaluated by the general surgery service and cholecystectomy was performed, anthelmintic treatment was started, the patient was cured without complications and was discharged home after 48 hours.
{"title":"Biliary ascariasis: an unusual cause of acute cholecystitis","authors":"Guillermo A. Macías-González, Alberto Santillán-Arroyo","doi":"10.18203/2349-2902.isj20240581","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240581","url":null,"abstract":"Ascariasis is one of the most common gastrointestinal parasitic infections in developing countries. In humans, these parasites reside in the jejunum but can lodge in any part of the small intestine and can migrate to the biliary tract. We present the case of a 45-year-old female patient, with no relevant history, from a rural town in Mexico, who presented to the emergency department for abdominal pain in the right hypochondrium, nausea and vomiting of one week's evolution, acute cholecystitis was suspected and an ultrasound of the liver and biliary tract was requested, which reported acute cholecystitis and ascaris was observed in the gallbladder, was evaluated by the general surgery service and cholecystectomy was performed, anthelmintic treatment was started, the patient was cured without complications and was discharged home after 48 hours.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140411837","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240577
Jesús A. Montero-Puga, Francisco J. Pat-Cruz, Guillermo Padrón Arredondo
Internal hernias are classified in congenital or acquired. Congenital arises from abnormalities during embryonic development, whereas acquired result from trauma, surgical procedures, or another. Gastric surgical procedures can increase susceptibility to internal hernias. A 85-year-old female, denies previous surgeries. Went to the emergency department due to vomiting, adding colicky abdominal pain. Was discharged with a diagnosis of acute gastroenteritis. Came back 12 hours after discharge due to mesogastric pain accompanied by general malaise, abdominal distention and hyporexia, reporting a lack of evacuation. She was algid, pale, abdomen globose, distended, tympanic colonic frame, peristalsis increased. An evaluation was requested from general surgery for probable appendicitis in the elderly vs. secondary ileus. Went to operation room, finding an internal hernia. Transomental herniations are rare conditions. An abnormal omental opening can be either acquired following abdominal surgery, trauma, inflammatory conditions, low body mass index (BMI) and be associated with a long mesentery, intestinal malrotation, or abnormal peritoneal attachments. Although internal hernias are extremely rare (between 1 and 4% of acute or intermittent intestinal obstructions) it is essential not to miss this diagnosis, even in patient whit no previous surgeries. Management of omental hernias are critical as the postoperative mortality rate is over 30% and even 50% if strangulation is present. The lack of current literature on this rare condition, particularly for lesser omental hernias (because can present with nonspecific signs and symptoms) makes diagnosis and management difficult.
{"title":"Internal hernia a preoperative diagnostic challenge in virgin abdomen: case report","authors":"Jesús A. Montero-Puga, Francisco J. Pat-Cruz, Guillermo Padrón Arredondo","doi":"10.18203/2349-2902.isj20240577","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240577","url":null,"abstract":"Internal hernias are classified in congenital or acquired. Congenital arises from abnormalities during embryonic development, whereas acquired result from trauma, surgical procedures, or another. Gastric surgical procedures can increase susceptibility to internal hernias. A 85-year-old female, denies previous surgeries. Went to the emergency department due to vomiting, adding colicky abdominal pain. Was discharged with a diagnosis of acute gastroenteritis. Came back 12 hours after discharge due to mesogastric pain accompanied by general malaise, abdominal distention and hyporexia, reporting a lack of evacuation. She was algid, pale, abdomen globose, distended, tympanic colonic frame, peristalsis increased. An evaluation was requested from general surgery for probable appendicitis in the elderly vs. secondary ileus. Went to operation room, finding an internal hernia. Transomental herniations are rare conditions. An abnormal omental opening can be either acquired following abdominal surgery, trauma, inflammatory conditions, low body mass index (BMI) and be associated with a long mesentery, intestinal malrotation, or abnormal peritoneal attachments. Although internal hernias are extremely rare (between 1 and 4% of acute or intermittent intestinal obstructions) it is essential not to miss this diagnosis, even in patient whit no previous surgeries. Management of omental hernias are critical as the postoperative mortality rate is over 30% and even 50% if strangulation is present. The lack of current literature on this rare condition, particularly for lesser omental hernias (because can present with nonspecific signs and symptoms) makes diagnosis and management difficult.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140414751","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240569
Someswara Rao Meegada, K. Alapati, Mathai Varughese
Background: Perianal sepsis which includes perianal fistula and abscess is a common clinical condition that requires thorough preoperative evaluation to decrease the recurrence rate and to plan relevant surgery according to the anatomy of the fistula. MRI and 3D EAUS are two important preoperative investigations that delineate the anatomy of simple and complex fistula tracts. Due to lower cost and easier use 3D EAUS is a safe and reliable first-line investigation in evaluating perianal abscess. Methods: This is a retrospective and prospective analysis of patients with perianal sepsis who underwent pre-operative unenhanced 3D-EAUS in the departments of Colorectal surgery, Gastrointestinal surgery, and General surgery in our hospital. A B-K medical 2052 transducer was used for the study and the surgical assessment was done by multiple surgeons from multiple departments. Results: A total of 255 patients were assessed. The accuracy for primary fistula tracts and internal opening was 83.53% and 88.62% respectively. The kappa coefficient of correlation was k=0.70 (substantial agreement) for the fistula tract and k=0.81 (near perfect agreement) for the internal opening. The sensitivity, and specificity of primary tracts and internal openings were calculated. Transphincteric fistulas were 57% in our study. Conclusions: Unenhanced 3D EAUS is a reliable first-line investigation in preoperative evaluation of perianal fistula and abscess. Transphincteric fistula is the most common type of fistula. There is a high chance of correlation for the primary tract if a non-colorectal specialist performs the fistula surgery after 3D-EAUS without blinding.
{"title":"Evaluation of unenhanced three-dimensional endoanal ultrasound scan in preoperative assessment of perianal sepsis","authors":"Someswara Rao Meegada, K. Alapati, Mathai Varughese","doi":"10.18203/2349-2902.isj20240569","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240569","url":null,"abstract":"Background: Perianal sepsis which includes perianal fistula and abscess is a common clinical condition that requires thorough preoperative evaluation to decrease the recurrence rate and to plan relevant surgery according to the anatomy of the fistula. MRI and 3D EAUS are two important preoperative investigations that delineate the anatomy of simple and complex fistula tracts. Due to lower cost and easier use 3D EAUS is a safe and reliable first-line investigation in evaluating perianal abscess.\u0000Methods: This is a retrospective and prospective analysis of patients with perianal sepsis who underwent pre-operative unenhanced 3D-EAUS in the departments of Colorectal surgery, Gastrointestinal surgery, and General surgery in our hospital. A B-K medical 2052 transducer was used for the study and the surgical assessment was done by multiple surgeons from multiple departments.\u0000Results: A total of 255 patients were assessed. The accuracy for primary fistula tracts and internal opening was 83.53% and 88.62% respectively. The kappa coefficient of correlation was k=0.70 (substantial agreement) for the fistula tract and k=0.81 (near perfect agreement) for the internal opening. The sensitivity, and specificity of primary tracts and internal openings were calculated. Transphincteric fistulas were 57% in our study.\u0000Conclusions: Unenhanced 3D EAUS is a reliable first-line investigation in preoperative evaluation of perianal fistula and abscess. Transphincteric fistula is the most common type of fistula. There is a high chance of correlation for the primary tract if a non-colorectal specialist performs the fistula surgery after 3D-EAUS without blinding.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415729","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240570
Mir Fazil Illahi, Mubashir Gani, Sameer H. Naqash, Mubashir A. Shah
Background: Gastric cancer remains the second leading cause of cancer-related deaths worldwide. Various dietary and environmental factors have been implicated in the pathogenesis of gastric cancer. Helicobacter pylori has strong association with peptic ulcer disease and gastric cancer. Methods: This study was conducted in department of general and minimal invasive surgery SKIMS Srinagar, from May 2019 to April 2022 comprising of 50 patients. All the patients were studied prospectively using set of questionnaires about the quantity and quality of salted tea. Final inferences were drawn after analysing the data using various statistical tools. Results: The most common age group was >60 years of age with male preponderance. Majority of patients had no comorbidity. About 50% of the patients were smokers. The most common histology found was intestinal type. 20% patients had proximal (cardia) tumor and 80% had distal location. Only 14% of the patients came positive for intra-operative H. pylori testing. Among the H. pylori positive patients, 14.3% were <40 years of age and 85.7% were >40 years of age. The most common histological grade found in H. pylori positive patients was poorly differentiated with signet ring cell type. About 88% of all the patients had a history of Noon chai intake with 14% positive and 86% negative for H. Pylori. Conclusions: There is a positive relation between Noon chai and gastric carcinoma and an inverse relation between ca stomach and presence of H. pylori intraoperatively at the time of surgical intervention.
{"title":"Association of salted tea (noon chai), Helicobacter pylori infection and gastric carcinoma","authors":"Mir Fazil Illahi, Mubashir Gani, Sameer H. Naqash, Mubashir A. Shah","doi":"10.18203/2349-2902.isj20240570","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240570","url":null,"abstract":"Background: Gastric cancer remains the second leading cause of cancer-related deaths worldwide. Various dietary and environmental factors have been implicated in the pathogenesis of gastric cancer. Helicobacter pylori has strong association with peptic ulcer disease and gastric cancer.\u0000Methods: This study was conducted in department of general and minimal invasive surgery SKIMS Srinagar, from May 2019 to April 2022 comprising of 50 patients. All the patients were studied prospectively using set of questionnaires about the quantity and quality of salted tea. Final inferences were drawn after analysing the data using various statistical tools.\u0000Results: The most common age group was >60 years of age with male preponderance. Majority of patients had no comorbidity. About 50% of the patients were smokers. The most common histology found was intestinal type. 20% patients had proximal (cardia) tumor and 80% had distal location. Only 14% of the patients came positive for intra-operative H. pylori testing. Among the H. pylori positive patients, 14.3% were <40 years of age and 85.7% were >40 years of age. The most common histological grade found in H. pylori positive patients was poorly differentiated with signet ring cell type. About 88% of all the patients had a history of Noon chai intake with 14% positive and 86% negative for H. Pylori.\u0000Conclusions: There is a positive relation between Noon chai and gastric carcinoma and an inverse relation between ca stomach and presence of H. pylori intraoperatively at the time of surgical intervention.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415778","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240588
Birbal Kumar, Balkishan Gupta, D. Mitra
This case report described a rare and unusual lesion found in a 68-year-old male, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, large firm mass, about 2 cm in diameter, characterized by slow growth. Complete excision was performed and the histopathologic analysis showed pleomorphic adenoma.
{"title":"A rare ectopic localization of pleomorphic adenoma of lip","authors":"Birbal Kumar, Balkishan Gupta, D. Mitra","doi":"10.18203/2349-2902.isj20240588","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240588","url":null,"abstract":"This case report described a rare and unusual lesion found in a 68-year-old male, which was diagnosed as pleomorphic adenoma of the minor salivary glands in the upper lip. The tumor was a circumscribed, large firm mass, about 2 cm in diameter, characterized by slow growth. Complete excision was performed and the histopathologic analysis showed pleomorphic adenoma.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"1982 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416784","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240586
Supreet Kumar, Rigved Gupta, Neerav Goyal, A. Pandey, Vivek Tandon
Neuroendocrine tumors (NETs) of the extrahepatic bile ducts are extremely rare. They are heterogeneous entities of varied histopathological features. The pathological types vary greatly with regards to biological behavior and prognosis. We presented such a case of silent tumor of the biliary tract of neuroendocrine origin in a middle-aged female with nonspecific abdominal pain without any clinically obvious signs which on radiological imaging revealed a tumor of hepatic confluence with metastatic deposits in liver for which she underwent left trisectionectomy with segment 7 metastatectomy. As per the literature reviews regarding extrahepatic bile duct NET these tumors are more common in the middle age population with a female preponderance. The tumors were symptomatic in majority of patients and the symptoms are mostly related to tumor mass and its invasion of adjacent structures or metastases rather than hormone and vasoactive peptide secretions. The low incidence and uncommon modes of presentation makes the diagnosis tough and management challenging.
肝外胆管神经内分泌肿瘤（NET）极为罕见。它们是具有不同组织病理学特征的异质性实体。这些病理类型在生物学行为和预后方面差异很大。我们接诊了这样一例神经内分泌源性胆道沉默肿瘤患者，患者为一名中年女性，无特异性腹痛，无任何临床明显体征，放射影像学检查显示为肝汇合部肿瘤，肝内有转移性沉积物，为此她接受了左侧三段胆管切除术和第7段转移灶切除术。根据有关肝外胆管 NET 的文献综述，这些肿瘤在中年人群中更为常见，且女性居多。大多数患者无症状，症状主要与肿瘤肿块及其对邻近结构的侵犯或转移有关，而不是与激素和血管活性肽分泌有关。由于发病率低且表现方式不常见，因此诊断和治疗都很困难。
{"title":"Silent neuroendocrine tumor of biliary confluence","authors":"Supreet Kumar, Rigved Gupta, Neerav Goyal, A. Pandey, Vivek Tandon","doi":"10.18203/2349-2902.isj20240586","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240586","url":null,"abstract":"Neuroendocrine tumors (NETs) of the extrahepatic bile ducts are extremely rare. They are heterogeneous entities of varied histopathological features. The pathological types vary greatly with regards to biological behavior and prognosis. We presented such a case of silent tumor of the biliary tract of neuroendocrine origin in a middle-aged female with nonspecific abdominal pain without any clinically obvious signs which on radiological imaging revealed a tumor of hepatic confluence with metastatic deposits in liver for which she underwent left trisectionectomy with segment 7 metastatectomy. As per the literature reviews regarding extrahepatic bile duct NET these tumors are more common in the middle age population with a female preponderance. The tumors were symptomatic in majority of patients and the symptoms are mostly related to tumor mass and its invasion of adjacent structures or metastases rather than hormone and vasoactive peptide secretions. The low incidence and uncommon modes of presentation makes the diagnosis tough and management challenging.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"83 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140408349","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}
Crossed renal ectopia is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital, and bone malformations. To best of our knowledge, there aren't many cases of inferior crossed fused renal ectopia of the right kidney documented in the literature at this time. A case of crossed-fused renal ectopia is presented here. A 32-year-old man arrived at our hospital complaining of pain in the right flank. Diagnosis: We suspected a single right kidney based on abdominal ultrasonography. An inferior left to right crossed-fused ectopic kidney with calculus in the right (normal) renal pelvis was the patient's diagnosis when combined with 3D computed tomography. Interventions: percutaneous nephrolithotomy with DJ stenting. Because the management of renal stone in this uncommon malformation is complicated, a preoperative assessment with contrast computed tomography is required before moving forward with surgery in order to explore a single kidney with calculi and avoid missing the diagnosis of crossed fused renal ectopia.
{"title":"Percutaneous nephrolithotomy in case of crossed fused renal ectopia: a case report","authors":"Ankit Anand, Prakriti Gupta, Sumit Gupta, Arpit Tripathi, Shailja Mishra","doi":"10.18203/2349-2902.isj20240596","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240596","url":null,"abstract":"Crossed renal ectopia is a rare congenital anomaly that is frequently associated with gastrointestinal, cardiovascular, genital, and bone malformations. To best of our knowledge, there aren't many cases of inferior crossed fused renal ectopia of the right kidney documented in the literature at this time. A case of crossed-fused renal ectopia is presented here. A 32-year-old man arrived at our hospital complaining of pain in the right flank. Diagnosis: We suspected a single right kidney based on abdominal ultrasonography. An inferior left to right crossed-fused ectopic kidney with calculus in the right (normal) renal pelvis was the patient's diagnosis when combined with 3D computed tomography. Interventions: percutaneous nephrolithotomy with DJ stenting. Because the management of renal stone in this uncommon malformation is complicated, a preoperative assessment with contrast computed tomography is required before moving forward with surgery in order to explore a single kidney with calculi and avoid missing the diagnosis of crossed fused renal ectopia.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415225","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 : 2024-02-29DOI: 10.18203/2349-2902.isj20240574
Tushar L. Agrawal, Brielle E. Williams, Bryan M. Tran, Ramesh Damodaran Prabha, Sooraj Pillai, Craig Sommerville
Liver flukes, endemic in East Asia, are parasites that can infect humans and cause liver and bile duct disease. While most infected individuals are asymptomatic, chronic infection can lead to structural hepatobiliary manifestations including hepatomegaly, intrahepatic bile duct dilatation, epithelial hyperplasia, periductal fibrosis, and potentially cholangiocarcinoma. There are no reports of human cases of liver fluke infection presenting as a hepatic cystic lesion. We present the case of a 52-year-old asymptomatic Chinese immigrant presenting with a suspected mucinous cystic neoplasm of the liver. CT and Ultrasound examinations demonstrated an enlarging complex cyst involving segments II and III. Liver function tests, hydatid serology and tumour markers were normal. He underwent elective laparoscopic left hemi-hepatectomy with liver fluke discovered on histology. Subsequent genetic testing confirmed Clonorchis sinensis infection. The patient made an uneventful recovery from surgery and was treated with anthelminthic therapy. This case highlights the importance of considering liver fluke as a differential diagnosis for hepatic cystic lesions in patients from endemic regions. Appropriate diagnosis could avoid surgery, whilst targeted anthelminthic therapy minimises the risk of chronic infection and associated complications, including cholangiocarcinoma.
{"title":"Clonorchis sinensis: a mimic of hepatic mucinous cystic neoplasm or just a fluke?","authors":"Tushar L. Agrawal, Brielle E. Williams, Bryan M. Tran, Ramesh Damodaran Prabha, Sooraj Pillai, Craig Sommerville","doi":"10.18203/2349-2902.isj20240574","DOIUrl":"https://doi.org/10.18203/2349-2902.isj20240574","url":null,"abstract":"Liver flukes, endemic in East Asia, are parasites that can infect humans and cause liver and bile duct disease. While most infected individuals are asymptomatic, chronic infection can lead to structural hepatobiliary manifestations including hepatomegaly, intrahepatic bile duct dilatation, epithelial hyperplasia, periductal fibrosis, and potentially cholangiocarcinoma. There are no reports of human cases of liver fluke infection presenting as a hepatic cystic lesion. We present the case of a 52-year-old asymptomatic Chinese immigrant presenting with a suspected mucinous cystic neoplasm of the liver. CT and Ultrasound examinations demonstrated an enlarging complex cyst involving segments II and III. Liver function tests, hydatid serology and tumour markers were normal. He underwent elective laparoscopic left hemi-hepatectomy with liver fluke discovered on histology. Subsequent genetic testing confirmed Clonorchis sinensis infection. The patient made an uneventful recovery from surgery and was treated with anthelminthic therapy. This case highlights the importance of considering liver fluke as a differential diagnosis for hepatic cystic lesions in patients from endemic regions. Appropriate diagnosis could avoid surgery, whilst targeted anthelminthic therapy minimises the risk of chronic infection and associated complications, including cholangiocarcinoma.","PeriodicalId":14372,"journal":{"name":"International Surgery Journal","volume":"2020 37","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140416174","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：