Mujtaba Mohamed, A. Alhillan, I. Patel, Arman Mushtaq, E. Zurkovsky, Christian Kaunzinger, Mohammad A. Hossain
Immune thrombocytopenia (previously called idiopathic thrombocytopenic purpura (ITP)) is characterized by an autoimmune destruction and clearance of platelets and megakaryocytes by reticuloendothelial system including liver and spleen. Most of the time, it occurs in the absence of any obvious stimulus. Secondary immune thrombocytopenia coexists with an underlying disease such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), chronic lymphocytic leukemia (CLL), systemic lupus erythematosus (SLE), or can occur following exposure to certain drugs such as heparin or quinidine. Medical treatment includes corticosteroids, intravenous immunoglobulins and rituximab. Splenectomy is reserved for patients who fail medical therapy. Laparoscopic splenectomy is safer than open splenectomy. The main surgical complication of splenectomy is intra-abdominal bleeding. Additional risk factors for post-operative bleeding such as portal hypertension can alter treatment decision in regard to splenectomy. J Curr Surg. 2019;9(4):61-65 doi: https://doi.org/10.14740/jcs399
{"title":"Two Patients With Resistant Immune Thrombocytopenic Purpura and Portal Hypertension Treated Safely With Laparoscopic Splenectomy: A Case Series Report and Literature Review","authors":"Mujtaba Mohamed, A. Alhillan, I. Patel, Arman Mushtaq, E. Zurkovsky, Christian Kaunzinger, Mohammad A. Hossain","doi":"10.14740/jcs399","DOIUrl":"https://doi.org/10.14740/jcs399","url":null,"abstract":"Immune thrombocytopenia (previously called idiopathic thrombocytopenic purpura (ITP)) is characterized by an autoimmune destruction and clearance of platelets and megakaryocytes by reticuloendothelial system including liver and spleen. Most of the time, it occurs in the absence of any obvious stimulus. Secondary immune thrombocytopenia coexists with an underlying disease such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), chronic lymphocytic leukemia (CLL), systemic lupus erythematosus (SLE), or can occur following exposure to certain drugs such as heparin or quinidine. Medical treatment includes corticosteroids, intravenous immunoglobulins and rituximab. Splenectomy is reserved for patients who fail medical therapy. Laparoscopic splenectomy is safer than open splenectomy. The main surgical complication of splenectomy is intra-abdominal bleeding. Additional risk factors for post-operative bleeding such as portal hypertension can alter treatment decision in regard to splenectomy. J Curr Surg. 2019;9(4):61-65 doi: https://doi.org/10.14740/jcs399","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84201208","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}
D. Traficante, D. Galaktionova, Urielle Marseille, Steven M Hochman, Jamshed Zuberi, Robert V. Madlinger
Background: Hypertonic saline (HTS) is an effective treatment for patients with increased intracranial pressure (ICP) secondary to traumatic brain injury (TBI). The ideal concentration for use in these patients is not well defined. The aim of our study was to compare Glasgow coma scale (GCS) and mortality of patients after administration of 3% vs. 23.4% HTS in the initial resuscitation. Methods: We performed a retrospective analysis of patients admitted to the surgical intensive care unit (ICU) under the trauma service with a diagnosis of TBI who received HTS during initial resuscitation. Patient medical records were reviewed to collect data including in-hospital mortality, ICU length of stay, hospital length of stay, GCS at the time of admission and discharge, serum sodium and serum osmolality values at 24, 48 and 72 h after arrival, acute kidney injury and severe hypernatremia. Results: Patients ≥ 18 years of age admitted to trauma ICU with a diagnosis of TBI. Pregnant, incarcerated, or non-traumatic intracranial hemorrhage patients were excluded. Thirty-one patients were included in the study. The 3% arm included 21 patients, and 23.4% arm had 10 patients. All patients received 3% HTS continuous infusion following initial bolus. Median injury severity scores (ISS) were 22 vs. 25 in the 3% vs. 23.4% HTS groups, respectively (P = 0.37). There was no difference in in-hospital mortality between the two groups (52.4% vs. 50.0%, P = 0.45). There was a significant improvement in GCS at discharge, 8.3% vs. 44.4% in 3% HTS vs. 23.4% HTS arms, respectively (P = 0.029). Patients reaching goal serum sodium and serum osmolality at 24 h was significantly higher in the 23.4% group (33.3% vs. 70.0%; P = 0.028 and 35.7% vs. 77.8%; P = 0.026, respectively). Significant increase in incidence of severe hypernatremia in the 23.4% arm was noted (0.0% vs. 40.0%, P = 0.009). Conclusion: This study demonstrates no significant difference in in-hospital mortality for patients who received 3% vs. 23.4% HTS. Significantly higher percentage of patients receiving 23.4% HTS reached goal serum sodium and osmolality levels at 24 h with a concomitant significantly increased rate of severe hypernatremia. J Curr Surg. 2019;9(4):39-44 doi: https://doi.org/10.14740/jcs389
背景:高渗生理盐水(HTS)是治疗外伤性脑损伤(TBI)继发性颅内压增高的有效方法。在这些患者中使用的理想浓度还没有很好的定义。本研究的目的是比较初始复苏时给予3% HTS和23.4% HTS后患者的格拉斯哥昏迷评分(GCS)和死亡率。方法:我们对创伤科外科重症监护病房(ICU)诊断为TBI并在首次复苏期间接受HTS治疗的患者进行回顾性分析。回顾患者病历，收集住院死亡率、ICU住院时间、住院时间、入院和出院时的GCS、入院后24、48和72 h的血清钠和血清渗透压值、急性肾损伤和重度高钠血症等数据。结果:年龄≥18岁且诊断为TBI的患者入住创伤ICU。排除孕妇、嵌顿或非外伤性颅内出血患者。31名患者参与了这项研究。3%组21例，23.4%组10例。所有患者在初始丸后接受3% HTS持续输注。3%和23.4% HTS组中位损伤严重程度评分(ISS)分别为22和25 (P = 0.37)。两组住院死亡率无差异(52.4% vs 50.0%， P = 0.45)。出院时GCS显著改善，3% HTS组为8.3%，23.4% HTS组为44.4% (P = 0.029)。23.4%组24 h达到目标血清钠和血清渗透压的患者显著高于23.4%组(33.3% vs. 70.0%;P = 0.028, 35.7% vs. 77.8%;P = 0.026)。23.4%组的严重高钠血症发生率显著增加(0.0%比40.0%，P = 0.009)。结论:本研究显示接受3% HTS和23.4% HTS治疗的患者住院死亡率无显著差异。接受23.4% HTS治疗的患者在24小时达到目标血清钠和渗透压水平的比例明显更高，同时严重高钠血症的发生率显著增加。中华外科杂志，2019;9(4):39-44 doi: https://doi.org/10.14740/jcs389
{"title":"Comparison of 3% vs. 23.4% Hypertonic Saline in Traumatic Brain Injury","authors":"D. Traficante, D. Galaktionova, Urielle Marseille, Steven M Hochman, Jamshed Zuberi, Robert V. Madlinger","doi":"10.14740/jcs389","DOIUrl":"https://doi.org/10.14740/jcs389","url":null,"abstract":"Background: Hypertonic saline (HTS) is an effective treatment for patients with increased intracranial pressure (ICP) secondary to traumatic brain injury (TBI). The ideal concentration for use in these patients is not well defined. The aim of our study was to compare Glasgow coma scale (GCS) and mortality of patients after administration of 3% vs. 23.4% HTS in the initial resuscitation. Methods: We performed a retrospective analysis of patients admitted to the surgical intensive care unit (ICU) under the trauma service with a diagnosis of TBI who received HTS during initial resuscitation. Patient medical records were reviewed to collect data including in-hospital mortality, ICU length of stay, hospital length of stay, GCS at the time of admission and discharge, serum sodium and serum osmolality values at 24, 48 and 72 h after arrival, acute kidney injury and severe hypernatremia. Results: Patients ≥ 18 years of age admitted to trauma ICU with a diagnosis of TBI. Pregnant, incarcerated, or non-traumatic intracranial hemorrhage patients were excluded. Thirty-one patients were included in the study. The 3% arm included 21 patients, and 23.4% arm had 10 patients. All patients received 3% HTS continuous infusion following initial bolus. Median injury severity scores (ISS) were 22 vs. 25 in the 3% vs. 23.4% HTS groups, respectively (P = 0.37). There was no difference in in-hospital mortality between the two groups (52.4% vs. 50.0%, P = 0.45). There was a significant improvement in GCS at discharge, 8.3% vs. 44.4% in 3% HTS vs. 23.4% HTS arms, respectively (P = 0.029). Patients reaching goal serum sodium and serum osmolality at 24 h was significantly higher in the 23.4% group (33.3% vs. 70.0%; P = 0.028 and 35.7% vs. 77.8%; P = 0.026, respectively). Significant increase in incidence of severe hypernatremia in the 23.4% arm was noted (0.0% vs. 40.0%, P = 0.009). Conclusion: This study demonstrates no significant difference in in-hospital mortality for patients who received 3% vs. 23.4% HTS. Significantly higher percentage of patients receiving 23.4% HTS reached goal serum sodium and osmolality levels at 24 h with a concomitant significantly increased rate of severe hypernatremia. J Curr Surg. 2019;9(4):39-44 doi: https://doi.org/10.14740/jcs389","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87720245","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}
Background: Chest trauma implies trauma to anyone or combination of different thoracic structures. Approximately in one quarter of civilians, trauma deaths are caused by trauma to thorax. Many of these deaths can be avoided by precise clinical diagnosis and immediate management. Most wounds under these situations could be managed conservatively with or without tube thoracostomy. This study aims to assess and analyze the mode of presentation, pattern and management of chest injuries in rural areas. Methods: One hundred consecutive patients within the period of 14 months with thoracic trauma presenting in emergency department were evaluated. Results: Most of the patients (87%) were treated conservatively with minor wound repair and medical treatment and 13% patients had been treated with intercostal chest drain. Among these 13% patients, three were referred to higher centers due to massive initial hemothorax and longstanding pneumothorax. Conclusions: Majority of the chest injury patients can be treated satisfactorily in general surgery unit by conservative management or chest drain. J Curr Surg. 2019;9(2-3):22-25 doi: https://doi.org/10.14740/jcs379
{"title":"Management of Chest Trauma in a Rural Medical College Hospital","authors":"K. Alam, S. Rahman, S. Saad","doi":"10.14740/jcs379","DOIUrl":"https://doi.org/10.14740/jcs379","url":null,"abstract":"Background: Chest trauma implies trauma to anyone or combination of different thoracic structures. Approximately in one quarter of civilians, trauma deaths are caused by trauma to thorax. Many of these deaths can be avoided by precise clinical diagnosis and immediate management. Most wounds under these situations could be managed conservatively with or without tube thoracostomy. This study aims to assess and analyze the mode of presentation, pattern and management of chest injuries in rural areas. Methods: One hundred consecutive patients within the period of 14 months with thoracic trauma presenting in emergency department were evaluated. Results: Most of the patients (87%) were treated conservatively with minor wound repair and medical treatment and 13% patients had been treated with intercostal chest drain. Among these 13% patients, three were referred to higher centers due to massive initial hemothorax and longstanding pneumothorax. Conclusions: Majority of the chest injury patients can be treated satisfactorily in general surgery unit by conservative management or chest drain. J Curr Surg. 2019;9(2-3):22-25 doi: https://doi.org/10.14740/jcs379","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90911158","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}
M. Sridhar, Manrique A. Guerrero, Jacob Miller, P. Hanna, J. Haghshenas, Jamshed Zuberi
Background: The practice of irrigation and/or intraoperative peritoneal drain placement during an appendectomy for complicated appendicitis is currently controversial. This study was aimed at delineating the relationship between the practice of intraoperative drain placement and/or irrigation and patient outcomes for complicated appendicitis cases. Methods: A retrospective study of patients presenting with acute complicated appendicitis, which was defined as perforated or gangrenous, was conducted (n = 225). The primary outcome was defined as the presence of postoperative abscess or sepsis, while the secondary outcome measured was length of hospital stay. Results: Patients who received intraoperative drain placement had an increased risk of postoperative abscess (odds ratio (OR) = 13.33, P < 0.001) and sepsis (OR = 11.37, P = 0.026). There was no significant difference in primary outcomes with irrigation. Patients who received irrigation had a longer length of stay (7.59 vs. 4.69 days, P = 0.001) as did those who received an intraoperative drain (7.61 vs. 5.33 days, P = 0.01). Conclusions: In this study, irrigation did not change the OR of sepsis and postoperative abscess. However, placement of an intraoperative drain increased both the rates of sepsis and postoperative abscesses, indicating possible increase in postoperative complications with intraoperative drains when compared with no drains. J Curr Surg. 2019;9(2-3):17-21 doi: https://doi.org/10.14740/jcs385
背景:在复杂阑尾炎阑尾切除术中进行冲洗和/或术中放置腹膜引流管的做法目前存在争议。本研究旨在描述术中引流管放置和/或冲洗与复杂阑尾炎患者预后之间的关系。方法:对225例急性复杂阑尾炎患者进行回顾性研究，阑尾炎定义为穿孔或坏疽。主要结局被定义为术后脓肿或脓毒症的存在，而次要结局被测量为住院时间。结果:术中放置引流管的患者发生术后脓肿(优势比(OR) = 13.33, P < 0.001)和脓毒症(OR = 11.37, P = 0.026)的风险增加。冲洗组的主要结局无显著差异。接受冲洗的患者住院时间较长(7.59天对4.69天，P = 0.001)，术中引流的患者住院时间较长(7.61天对5.33天，P = 0.01)。结论:在本研究中，冲洗并没有改变脓毒症和术后脓肿的OR。然而，术中引流管的放置增加了脓毒症和术后脓肿的发生率，表明术中引流管与无引流管相比可能增加了术后并发症。中华外科杂志，2019;9(2-3):17-21 doi: https://doi.org/10.14740/jcs385
{"title":"Analysis of Outcomes Using Intraoperative Irrigation and Drainage for Complicated Appendicitis","authors":"M. Sridhar, Manrique A. Guerrero, Jacob Miller, P. Hanna, J. Haghshenas, Jamshed Zuberi","doi":"10.14740/jcs385","DOIUrl":"https://doi.org/10.14740/jcs385","url":null,"abstract":"Background: The practice of irrigation and/or intraoperative peritoneal drain placement during an appendectomy for complicated appendicitis is currently controversial. This study was aimed at delineating the relationship between the practice of intraoperative drain placement and/or irrigation and patient outcomes for complicated appendicitis cases. Methods: A retrospective study of patients presenting with acute complicated appendicitis, which was defined as perforated or gangrenous, was conducted (n = 225). The primary outcome was defined as the presence of postoperative abscess or sepsis, while the secondary outcome measured was length of hospital stay. Results: Patients who received intraoperative drain placement had an increased risk of postoperative abscess (odds ratio (OR) = 13.33, P < 0.001) and sepsis (OR = 11.37, P = 0.026). There was no significant difference in primary outcomes with irrigation. Patients who received irrigation had a longer length of stay (7.59 vs. 4.69 days, P = 0.001) as did those who received an intraoperative drain (7.61 vs. 5.33 days, P = 0.01). Conclusions: In this study, irrigation did not change the OR of sepsis and postoperative abscess. However, placement of an intraoperative drain increased both the rates of sepsis and postoperative abscesses, indicating possible increase in postoperative complications with intraoperative drains when compared with no drains. J Curr Surg. 2019;9(2-3):17-21 doi: https://doi.org/10.14740/jcs385","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89112588","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}
O. Abdalla, A. Chitnis, Banan Omer, M. Elhadi, M. O. Karim, S. Sabri
Myofibroblastoma (MFB) is an extremely rare benign tumor that can arise in various organs, but commonly in the breast. Albeit it is a benign tumor, the diagnosis is frequently challenging with insurmountable difficulties as it might be erroneously diagnosed as a malignancy. Herein we are reporting a large-sized MFB presented as a non-tender, firm mass which interestingly was adherent to the skin and was initially thought as cancer. The patient underwent a wide local excision and histology confirmed MFB, and had no evidence of recurrence up to 8 months post-operatively. J Curr Surg. 2019;9(2-3):26-28 doi: https://doi.org/10.14740/jcs340
{"title":"A Case Report of Successful Treatment of Mammary Myofibromyoblastoma in a Male Patient","authors":"O. Abdalla, A. Chitnis, Banan Omer, M. Elhadi, M. O. Karim, S. Sabri","doi":"10.14740/jcs340","DOIUrl":"https://doi.org/10.14740/jcs340","url":null,"abstract":"Myofibroblastoma (MFB) is an extremely rare benign tumor that can arise in various organs, but commonly in the breast. Albeit it is a benign tumor, the diagnosis is frequently challenging with insurmountable difficulties as it might be erroneously diagnosed as a malignancy. Herein we are reporting a large-sized MFB presented as a non-tender, firm mass which interestingly was adherent to the skin and was initially thought as cancer. The patient underwent a wide local excision and histology confirmed MFB, and had no evidence of recurrence up to 8 months post-operatively. J Curr Surg. 2019;9(2-3):26-28 doi: https://doi.org/10.14740/jcs340","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72504138","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}
We present two young patients who developed Ewing’s sarcoma in the proximal radius, managed surgically by resection and no reconstruction with K-wire fixation of the distal radioulnar joint for 6 weeks. Following surgery, both patients developed proximal radius migration with subluxation, which caused the patients to complain about deformation. Proximal radius migration with subluxation is well documented in trauma cases, although they were not described in orthopedic oncology since reconstruction was the classic management for such cases. Our results support the decision of reconstructing the proximal radius after resection in order for better functional outcome and stability. J Curr Surg. 2019;9(2-3):32-37 doi: https://doi.org/10.14740/jcs383
{"title":"Proximal Radius Ewing’s Sarcoma Resection Followed by Migration of the Proximal Radius: Report of Two Cases","authors":"W. Al-Juhani, Mohammed Benmeakel","doi":"10.14740/jcs383","DOIUrl":"https://doi.org/10.14740/jcs383","url":null,"abstract":"We present two young patients who developed Ewing’s sarcoma in the proximal radius, managed surgically by resection and no reconstruction with K-wire fixation of the distal radioulnar joint for 6 weeks. Following surgery, both patients developed proximal radius migration with subluxation, which caused the patients to complain about deformation. Proximal radius migration with subluxation is well documented in trauma cases, although they were not described in orthopedic oncology since reconstruction was the classic management for such cases. Our results support the decision of reconstructing the proximal radius after resection in order for better functional outcome and stability. J Curr Surg. 2019;9(2-3):32-37 doi: https://doi.org/10.14740/jcs383","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73026043","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}
A. Hillan, Mujtaba Mohamed, Kadhim Al-Banaa, Diana Curras-Martin, S. Gorcey, Mohammad A. Hossain
Laparoscopic sleeve gastrectomy is a restrictive procedure without the malabsorptive component of gastric bypass or duodenal switch. Reported common complications include bleeding, stenosis, misalignment, staple line leaks, and severe regurgitate symptoms. This case represents an uncommon complication characterized by gastroesophageal junction outflow obstruction due to redundant tissue from post-surgical change in the fundus. Repair with complete resolution of symptoms was achieved by performing endoscopy gastroplasty with the Apollo overstitch suturing system. J Curr Surg. 2019;9(2-3):29-31 doi: https://doi.org/10.14740/jcs380
{"title":"Realignment of a Surgical Gastric Sleeve Using the Apollo Endoscopic Suturing Platform in a Patient With Postoperative Persistent Nausea and Vomiting","authors":"A. Hillan, Mujtaba Mohamed, Kadhim Al-Banaa, Diana Curras-Martin, S. Gorcey, Mohammad A. Hossain","doi":"10.14740/jcs380","DOIUrl":"https://doi.org/10.14740/jcs380","url":null,"abstract":"Laparoscopic sleeve gastrectomy is a restrictive procedure without the malabsorptive component of gastric bypass or duodenal switch. Reported common complications include bleeding, stenosis, misalignment, staple line leaks, and severe regurgitate symptoms. This case represents an uncommon complication characterized by gastroesophageal junction outflow obstruction due to redundant tissue from post-surgical change in the fundus. Repair with complete resolution of symptoms was achieved by performing endoscopy gastroplasty with the Apollo overstitch suturing system. J Curr Surg. 2019;9(2-3):29-31 doi: https://doi.org/10.14740/jcs380","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78379794","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}
Manrique A. Guerrero, Mariam Selevany, M. Sridhar, P. Hanna, Jamshed Zuberi
Cecal diverticulitis (CD) is a rarely seen and studied condition in American medicine. CD presents in a manner that is almost clinically indistinguishable from acute appendicitis. Both CD and acute appendicitis present with exceedingly similar symptoms including, but not limited to, right lower quadrant (RLQ) pain, fever, and vomiting. The diagnosis of CD is usually made during an operation and is seldom caught preoperatively. Although a fair number of CD cases have been reported since its discovery, only a handful of patients concurrently had a history of cystic fibrosis (CF). We report a rare case of CD that was initially believed to be appendicitis in a male patient with CF. Intraoperatively, a diagnosis of CD was reached due to identification of a single diverticulum in the cecal region with inflammatory changes consistent with microperforation. A partial cecectomy was performed and the patient was discharged 4 days later with resolution of symptoms. J Curr Surg. 2019;9(1):13-16 doi: https://doi.org/10.14740/jcs374
{"title":"A Rare Presentation of Cecal Diverticulitis in a Patient With Cystic Fibrosis","authors":"Manrique A. Guerrero, Mariam Selevany, M. Sridhar, P. Hanna, Jamshed Zuberi","doi":"10.14740/JCS374","DOIUrl":"https://doi.org/10.14740/JCS374","url":null,"abstract":"Cecal diverticulitis (CD) is a rarely seen and studied condition in American medicine. CD presents in a manner that is almost clinically indistinguishable from acute appendicitis. Both CD and acute appendicitis present with exceedingly similar symptoms including, but not limited to, right lower quadrant (RLQ) pain, fever, and vomiting. The diagnosis of CD is usually made during an operation and is seldom caught preoperatively. Although a fair number of CD cases have been reported since its discovery, only a handful of patients concurrently had a history of cystic fibrosis (CF). We report a rare case of CD that was initially believed to be appendicitis in a male patient with CF. Intraoperatively, a diagnosis of CD was reached due to identification of a single diverticulum in the cecal region with inflammatory changes consistent with microperforation. A partial cecectomy was performed and the patient was discharged 4 days later with resolution of symptoms. J Curr Surg. 2019;9(1):13-16 doi: https://doi.org/10.14740/jcs374","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81467421","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}
We present a rare case of primary acinic carcinoma in the breast, which is almost always associated with salivary glands. We will discuss the multidisplinary approach to treatment, highlighting the role of chemotherapy and radiation. Additionally, this tumor was seen on magnetic resonance imaging (MRI), which is not a readily used diagnostic test for breast disease, emphasizing its diagnostic sensitivity in these patients. J Curr Surg. 2019;9(1):11-12 doi: https://doi.org/10.14740/jcs373
{"title":"Treatment Challenges of Primary Acinic Cell Carcinoma of the Breast","authors":"Sundus Abbasi, L. Hopkins","doi":"10.14740/jcs373","DOIUrl":"https://doi.org/10.14740/jcs373","url":null,"abstract":"We present a rare case of primary acinic carcinoma in the breast, which is almost always associated with salivary glands. We will discuss the multidisplinary approach to treatment, highlighting the role of chemotherapy and radiation. Additionally, this tumor was seen on magnetic resonance imaging (MRI), which is not a readily used diagnostic test for breast disease, emphasizing its diagnostic sensitivity in these patients. J Curr Surg. 2019;9(1):11-12 doi: https://doi.org/10.14740/jcs373","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80360443","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}
Torsion of the vermiform appendix (TMA) is a rare entity that is often clinically indistinguishable from acute appendicitis. Primary torsion results from anatomical abnormalities and secondary torsion results from obstructive pathologic processes such as mucinous cystadenomas. Torsion secondary to a mucinous cystadenoma is found in 0.2-0.3% of appendectomies. The diagnosis of TVA is difficult, requiring histological confirmation after surgical intervention. We present a rare case of TVA in a 35-year-old woman with abdominal pain for 2 days. J Curr Surg. 2019;9(1):9-10 doi: https://doi.org/10.14740/jcs358
{"title":"Torsion of the Vermiform Appendix Secondary to Mucinous Cystadenoma","authors":"Sundus Abbasi, M. Lopez-Viego","doi":"10.14740/JCS358","DOIUrl":"https://doi.org/10.14740/JCS358","url":null,"abstract":"Torsion of the vermiform appendix (TMA) is a rare entity that is often clinically indistinguishable from acute appendicitis. Primary torsion results from anatomical abnormalities and secondary torsion results from obstructive pathologic processes such as mucinous cystadenomas. Torsion secondary to a mucinous cystadenoma is found in 0.2-0.3% of appendectomies. The diagnosis of TVA is difficult, requiring histological confirmation after surgical intervention. We present a rare case of TVA in a 35-year-old woman with abdominal pain for 2 days. J Curr Surg. 2019;9(1):9-10 doi: https://doi.org/10.14740/jcs358","PeriodicalId":93115,"journal":{"name":"Journal of current surgery","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80926675","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：