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Lisfranc injury in a 14-year-old patient. A case report and literature review 14岁患者Lisfranc损伤。病例报告及文献复习
Pub Date : 2019-01-01 DOI: 10.5455/ACES.20190115064521
A. Benjumea-Carrasco, C. Sánchez-Pérez, Francisco de Borja Sobrón-Caminero
We report the case of a 14-year-old girl who experienced a Lisfranc fracture-dislocation while playing sport. The lesion was treated with surgery, consisting of open reduction and internal fixation using cannulated screws and Kirschner wires. After one year of follow-up, the patient has no symptoms and no X-ray evidence of degenerative changes in the midfoot. In our view, the surgical procedure, using rigid fixation for the medial column and the second ray, and a provisional fixation to all other rays, allowed for a satisfactory short-term result in this patient. We have used this case to review the management of this lesion in the pediatric population.
我们报告的情况下,14岁的女孩谁经历了Lisfranc骨折脱位,而进行运动。病变采用手术治疗,包括切开复位和使用空心螺钉和克氏针内固定。经过一年的随访,患者没有任何症状,也没有足中部退行性改变的x线证据。在我们看来,手术过程中,对内侧柱和第二线进行刚性固定,并对所有其他射线进行临时固定,可以使该患者获得满意的短期结果。我们用这个病例来回顾在儿科人群中这种病变的处理。
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引用次数: 0
Predictors for locoregional recurrent breast cancer in Egyptian females 埃及女性局部区域复发性乳腺癌的预测因素
Pub Date : 2018-01-01 DOI: 10.5455/ACES.20171227020905
A. Abdelkader, A. Darwish
Introduction: Locoregional recurrence (LRR) after proper therapy for breast cancer is not uncommon; it represents around 13%. LRR is classified into true recurrence (TR) or new primary (NP) breast cancer. In true recurrence (TR), some cells may survive and multiply to be detected after mastectomy or breast conservative surgery (BCS). However, in new primary (NP) breast cancer, de novo cancer cells arising from preserved breast tissue after BCS in spite of proper treatment to eliminate all cancer cells. Aim: The aim of the study was to assess and identify the predictors for locoregional recurrent breast cancer in Egyptian females as there is a lack of studying these factors among them. Patients and methods: The study was conducted retrospectively on 60 female patients with locoregional recurrent breast cancer presented to Alexandria Main University Hospital, Surgical Oncology Unit with exclusion criteria of bilateral breast cancer and male breast cancer. Results: 30 cases had a recurrence after BCS while the other 30 cases had a recurrence after modified radical mastectomy (MRM), the mean age of the patients was 36.67 years. 40 cases harvested less than ten lymph nodes with 42 cases have ≥ 4 lymph nodes affected. Regarding the 30 cases that had undergone BCS; 16 cases had negative margin in the frozen section, 12 cases had close margin, and 2 cases were negative in frozen section while positive in paraffin. Pathologically, 34 cases were grade II, 38 cases had a lymphovascular invasion, 24 cases had an extracapsular extension, 28 cases were ER-positive, and 54 cases were negative for Her 2neo. Conclusion: Predictive factors of significance for local failure are young age, positive resection margins, lymphovascular invasion, and heavy affection of axillary lymph nodes, extracapsular extension, extensive intraductal component, and high histologic grade. Some of these predictive factors proved to be significant in this study.
导读:乳腺癌经适当治疗后局部复发(LRR)并不罕见;约占13%。LRR分为真复发(TR)和新发原发性(NP)乳腺癌。在真正的复发(TR)中,一些细胞可以存活并繁殖,以便在乳房切除术或乳房保守手术(BCS)后被检测到。然而,在新发原发性(NP)乳腺癌中,尽管进行了适当的治疗以消除所有癌细胞,但BCS后保存的乳腺组织中仍会出现新生癌细胞。目的:该研究的目的是评估和确定埃及女性局部区域复发性乳腺癌的预测因素,因为缺乏对这些因素的研究。患者和方法:回顾性分析亚历山大美因大学医院外科肿瘤科收治的60例局部区域性复发性乳腺癌女性患者,排除双侧乳腺癌和男性乳腺癌。结果:BCS术后复发30例,改良根治术(MRM)术后复发30例,患者平均年龄36.67岁。40例淋巴结少于10个,42例淋巴结≥4个。30例行BCS;冷冻切片16例为阴性,近缘12例,冷冻切片2例为阴性,石蜡切片2例为阳性。病理分级为ⅱ级34例,淋巴血管侵犯38例,囊外延伸24例,er阳性28例,Her 2neo阴性54例。结论:年轻、切除边缘阳性、淋巴血管浸润、腋窝淋巴结严重影响、囊外延伸、导管内成分广泛、组织学分级高是局部失败的重要预测因素。其中一些预测因素在本研究中被证明是重要的。
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引用次数: 0
Isolated splenic tuberculosis in immunocompetent patient: A rare occurrence 孤立性脾结核在免疫正常的病人:罕见的发生
Pub Date : 2018-01-01 DOI: 10.5455/ACES.20170913072832
V. Tyagi, Snigdha Goyal, S. Goyal
Globally millions of people are affected by tuberculosis (TB) each year and India has the largest number of TB cases both pulmonary and extrapulmonary. Extrapulmonary TB affecting spleen is quite rare and occurs mostly as a part of miliary tuberculosis in immunocompromised patients. In the Immunocompetent patients, isolated splenic tuberculosis is extremely rare. Herein, we present the case of an immunocompetent female with isolated splenic tuberculosis.
全球每年有数百万人受到结核病的影响,印度的肺结核和肺外肺结核病例数量最多。影响脾脏的肺外结核是相当罕见的,主要发生在免疫功能低下患者的军旅结核的一部分。在免疫功能正常的病人中,孤立性脾结核极为罕见。在此,我们提出的情况下,免疫功能正常的女性与孤立的脾结核。
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引用次数: 0
Using latex film sheet in the fresh cadaveric cow brain for the evaluating brain protection 用乳胶膜片对新鲜死牛脑进行脑保护评价
Pub Date : 2018-01-01 DOI: 10.5455/aces.20171209030732
A. Gokyar, C. Çokluk
Objective: Assessment of latex film sheet usage to protect the brain tissue against the harmful mechanical effects of metal microsurgical instruments while doing neurosurgical interventions has been the aim of this experimental study. Methods: For this experimental study, brains of cows were grouped as ones for which the latex film sheet was used (Group I) and the others the latex film sheet was not used for (Group II). The latex film sheet was sprawled over the left lateral side of the interhemispheric sulcus in Group I. Additionally, three groups of mechanical traumatic effects were created for the effects of metallic surgical instruments as “minor, moderate and severe”. Results: The results showed that there were 11 minor injured brains in Group I (n=15), with the percentage of 73. 34%. This percentage was 26. 67% with four brains in Group II (n=15) with regard to the minor injuries. When it comes to the moderately injured brain parenchyma, the numbers and percentages were 2 and 13. 33% for Group I, and 8 and 53. 33% for Group II. Severe injury numbers and percentages were 2 and 13. 33% for Group I, and 3 and 20% for Group II. Conclusions: According to the findings of this study, it can be said that the protection of brain tissue from the mechanical injury using the latex film sheet seems to be favorable. The heating effect of the operating microscope’s light is also thought to be prevented to some extent with latex film sheet implementation. On the whole, latex film sheet may have favorable effects for the practical microneurosurgery in protecting the brain tissue.
目的:评价在神经外科手术中使用乳胶膜片保护脑组织免受金属显微手术器械的有害机械效应。方法:本实验研究将牛脑分为使用乳胶膜片组(ⅰ组)和未使用乳胶膜片组(ⅱ组),将乳胶膜片铺在左半球间沟外侧,并将金属手术器械的机械创伤效应分为“轻度、中度和重度”三组。结果:结果显示,ⅰ组小脑损伤11例(n=15),占73%;34%。这个比例是26%。II组(n=15)轻伤发生率为67%(4脑)。中度脑实质损伤的发生率分别为2和13。1组33%,8组和53组。第二组33%。重伤人数和百分比分别为2和13。第一组为33%第二组为3%和20%结论:根据本研究结果,可以说乳胶膜片对脑组织机械损伤的保护似乎是有利的。操作显微镜的光的热效应也被认为是防止在一定程度上与乳胶薄膜片的实施。综上所述,乳胶膜片在实际的微神经外科手术中对脑组织的保护可能具有良好的效果。
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引用次数: 0
A rare presentation of right adrenal angiomyolipoma with accelerated hypertension: A case report 罕见的右肾上腺血管平滑肌脂肪瘤伴高血压加速:1例报告
Pub Date : 2018-01-01 DOI: 10.5455/ACES.20180213091543
H. Chunchu, Ramya Kalva, M. Vattipelli, S. Bag, B. Kunduru
Right adrenal angiomyolipoma with accelerated hypertension is usually an incidentaloma and infrequent finding, and only adrenal angiomyolipomas are reported but not with tumor-associated accelerated hypertension. In this case, a 45-year-old male patient presented with the typical symptoms of a headache, neck pain and also giddiness in the last four days. Right adrenal angiomyolipoma diagnosed by using CT and USG scans of the abdomen, and majorly by histopathology. Mostly the management of this case requires surgery, but the preoperative and postoperative management and monitoring of high blood pressure is the utmost importance due to accelerated hypertension. Laparoscopic excision of adrenal tumor and adrenalectomy was done under general anesthesia. Postoperative recovery was uneventful, and patient blood pressure became normal.
右肾上腺血管平滑肌脂肪瘤伴加速高血压通常是一种偶发瘤和罕见的发现,只有肾上腺血管平滑肌脂肪瘤被报道,但没有肿瘤相关的加速高血压。本例患者为45岁男性,过去4天出现头痛、颈部疼痛、头晕等典型症状。右肾上腺血管平滑肌脂肪瘤通过腹部CT和USG扫描诊断,主要通过组织病理学。大多数情况下,这种情况的处理需要手术,但由于高血压加速,术前和术后管理和监测高血压是最重要的。全麻下行腹腔镜肾上腺肿瘤切除及肾上腺切除术。术后恢复顺利,患者血压恢复正常。
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引用次数: 1
Surgical outcome and survival analysis of pancreaticogastrostomy after pancreaticoduodenectomy: A prospective study in a single institution 胰十二指肠切除术后胰胃造口术的手术结果和生存分析:一项单一机构的前瞻性研究
Pub Date : 2018-01-01 DOI: 10.5455/ACES.20180309084000
M. Kassem, H. El-Haddad, Mohamed Elriwini, Adel AbuNasr, G. Shehata
Background: The definitive reconstructive technique of the pancreatic stump after pancreaticoduodenectomy (PD) differs among centers. Purpose: The purpose of this study was to evaluate the surgical outcome of stented pancreaticogastrostomy (PG) and the long-term survival after PD in a single center. Patients and Methods: A prospective study of stented PG was performed on 152 patients by the same surgical team over a 7-year period from January 2010 to January 2017. In the early postoperative period, patients were examined for morbidity and mortality related to the procedure. After that, patients were followed up for long-term survival. Results: There were 88 men (57.9%) and 64 women (42.1%); with a mean age of 62.6 (35-87) years. Early postoperative complications occurred in 47 patients (30.9%) including five patients with the pancreatic leak. The survival rate at the end of 1 year, 3 and five years were 80%, 58%, and 42% respectively. Univariate and multivariate analysis revealed that longer survival was found in patients with lower tumor grades and stages, CA 19.9 level less than 100 ng/ml, negative R status and in patients not receiving chemotherapy. Conclusion: The present technique with its low morbidity rate approaches the parameters of an ideal pancreatic anastomotic technique after PD. Factors associated with better survival should be considered for the sake of obtaining the best prognosis.
背景:不同的中心对胰十二指肠切除术(PD)后胰残端重建的确定技术有所不同。目的:本研究的目的是评估单中心胰胃支架造口术(PG)的手术效果和PD后的长期生存率。患者和方法:同一外科团队在2010年1月至2017年1月的7年期间对152例患者进行了支架PG的前瞻性研究。术后早期,检查患者与手术相关的发病率和死亡率。之后,对患者进行长期随访。结果:男性88例(57.9%),女性64例(42.1%);平均年龄62.6岁(35-87岁)。术后早期并发症47例(30.9%),其中胰漏5例。1年、3年、5年末生存率分别为80%、58%、42%。单因素和多因素分析显示,肿瘤分级和分期较低、CA 19.9水平低于100 ng/ml、R状态为阴性和未接受化疗的患者生存期较长。结论:该技术具有低发病率,接近PD后理想的胰腺吻合技术参数。为了获得最佳预后,应考虑与较好生存率相关的因素。
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引用次数: 0
Gestational ovarian choriocarcinoma: A case report 妊娠期卵巢绒毛膜癌1例报告
Pub Date : 2018-01-01 DOI: 10.5455/aces.20180314041954
Hemalata Mahantappa, S. Belur, A. Agarwal
Ovarian choriocarcinoma is an extremely rare trophoblastic disease of either gestational or non-gestational origin. It can arise due to metastasis from uterine choriocarcinoma or from an ovarian ectopic pregnancy. Here we present a case of gestational ovarian choriocarcinoma in a 27-year-old female clinically diagnosed as ectopic ovarian pregnancy. Histopathologically, the tumor showed characteristic features of choriocarcinoma. The presence of corpus luteum adjacent to the tumor, high serum β-HCG levels and reproductive age of the patient favored the diagnosis of gestational choriocarcinoma.
卵巢绒毛膜癌是一种极其罕见的滋养细胞疾病,无论是妊娠还是非妊娠起源。它可由子宫绒毛膜癌转移或卵巢异位妊娠引起。我们在此报告一位27岁女性临床诊断为卵巢异位妊娠的妊娠期卵巢绒毛膜癌病例。组织病理学表现为绒毛膜癌的特征。肿瘤附近存在黄体,血清β-HCG水平高,患者的生育年龄有利于妊娠绒毛膜癌的诊断。
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引用次数: 1
Thoracoscopic resection of a bronchogenic cyst in intradiaphragmatic position: A case report 胸腔镜切除支气管源性囊肿1例
Pub Date : 2018-01-01 DOI: 10.5455/aces.20180209054222
Wen-Wang Chang, Chi-Hsuan Chen, Kunmin Wu
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引用次数: 0
Diagnostic value of free-to-total PSA proportion and PSA density in prostate cancer detection for prostate volumes and #8805;100 cc 游离总PSA比例和PSA密度在前列腺体积和#8805;100cc前列腺癌检测中的诊断价值
Pub Date : 2018-01-01 DOI: 10.5455/aces.20180315071327
M. Zor, E. Kaya
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引用次数: 0
Especial internal herniation through mesentery of Meckel's diverticulum 尤其是经由梅克尔憩室肠系膜的内疝
Pub Date : 2018-01-01 DOI: 10.5455/aces.20171002045204
Ankit Shukla, Roshni Shukla, V. Verma, R. Chaudhary, Bhanu Gupta
Acute intestinal obstruction is a common surgical emergency worldwide, and it is a result of different causes. Meckel’s diverticulum is a well - established cause of intestinal obstruction in adults. However, cases of intestinal obstruction arising from internal herniation of bowel through the mesentery of Meckel’s diverticulum is a very atypical entity. Precise diagnosis of internal herniation of bowel through the mesentery of Meckel’s diverticulum is not possible preoperatively owing to its rarity. We reported a very rare and especial case of a young gentleman with intestinal obstruction as a complication of herniation through mesentery of Meckel’s diverticulum diagnosed intraoperatively and managed successfully by timely and immediate surgical interventio
急性肠梗阻是世界范围内常见的外科急症,其原因多种多样。梅克尔憩室是成人肠梗阻的一种公认的病因。然而,肠内疝通过梅克尔憩室肠系膜引起肠梗阻的病例是一个非常不典型的实体。通过梅克尔憩室肠系膜的肠内疝的精确诊断是不可能的,因为它的罕见,术前。我们报告了一个非常罕见和特殊的病例,一位年轻的先生,肠梗阻作为梅克尔憩室肠系膜疝的并发症,术中诊断并通过及时和立即的手术干预成功地处理
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引用次数: 0
期刊
Archives of Clinical and Experimental Surgery
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