Combined Flexible URS and percutaneous ‘through and through’ puncture of an intra-renal cyst with internalisation of drainage, to treat calyceal obstruction and recurrent stones
Publication date: Available online 21 January 2020Source: Urology Case ReportsAuthor(s): Joseph Santiapillai, Sachin AgrawalAbstractA 61 year old gentleman had a large renal cyst, thought to be causing a ‘pseudo-hydrocalyx’ leading to recurrent stones. Definitive treatment with laparoscopic deroofing was planned, however intra-operatively this was abandoned due to complex anatomy and scared adherent tissue. Patient went on to have a flexible ureteroscopy and ‘through and through’ puncture of an intrarenal cyst with PCNL to treat his stones and renal cyst simultaneously. CT scan 12 months later showed no new stone formation and no residual cyst. Percutaneous puncture of a renal cyst combined with flexible ureteroscopy is an effective method when treating large renal cysts.
ConclusionsThis study demonstrated the feasibility of total laparoscopic pancreaticoduodenectomy combined with vascular resection and artificial vascular graft reconstruction in properly selected cases of pancreatic cancer with vein involvement after neoadjuvant chemotherapy. It is worth noting that skilled laparoscopic technicians and effective teamwork are necessities for safe completion of the procedure.
Authors: Pereira S, Salgueiro A, Rosa P, Peixoto C, Ferreira M, Silva D Abstract Primary hyperaldosteronism (PA) is the most common cause of secondary arterial hypertension and is frequently undiagnosed. It affects all ages but is more frequent between 20 and 60 years old. The clinical presentation is variable, and the diagnosis is based on screening and, in equivocal cases, confirmatory tests. A 19-year-old student presented with complaints of extreme fatigue, arterial hypertension, hypokalemia and metabolic alkalosis, raising a high index of suspicion for PA. Screening tests were performed and its expressiveness ...
There is still a debate about the role of laparoscopy in trauma. CT scan is the gold standard in the diagnosis of abdominal injuries, nonetheless, its sensitivity for mesenteric, diaphragmatic and hollow viscus injuries is low. The efficacy of laparoscopy to identify these lesions and play a therapeutic role as well has been demonstrated. Compared to laparotomy, it has shown a significant reduction in length of stay (LOS) and morbidity.
Conclusion: We should consider pseudotumor-like IgG4-RD as a differential diagnosis for solitary renal lesion although the incidence is low.
ConclusionsSacrococcygeal curvature and distance as well as tumour distance from the anal margin were associated with specimen quality in anterior resection. Coccygectomy was not performed as completely as surgeons thought. Surgeons should include sacrococcygeal bony anatomy in rectal cancer surgical planning to potentially improve outcomes in both anterior resection and eLAPE approaches.
This article describes a patient who presented to the ED with abdominal pain, nausea, and vomiting. A CT scan revealed dilated loops of bowel with an adjacent air-filled structure, possibly related to an internal hernia. Meckel diverticulum was discovered on diagnostic laparoscopy and a mesodiverticular band was lysed; the diverticulum was left in situ. The patient did well without further invention needed.
CONCLUSIONS: Small bowel obstruction resulting from LAGB tubing is an uncommon complication which was reported in few cases. Although bariatric surgery currently represents the best treatment option for morbid obesity and its related- diseases, peri- and post-operative complications have always to be taken into account. KEY WORDS: Adjustable gastric band complications, Bariatric surgery, Bowel obstruction, CT scan, LAGB tube. PMID: 32945272 [PubMed - in process]
We report a patient with glucagonoma differentiation into a malignant form after 13 years. A 63-year-old asymptomatic man was evaluated for an enhancing lesion at the distal pancreas. Physical examination was normal. Laboratory values were normal except for an elevated serum glucagon level (206 pg/mL, Ref. 50 –150). Somatostatin and other tumor markers were normal. A PET scan confirmed abnormal uptake at the distal pancreas, correlating with a CT scan. The patient underwent laparoscopic distal pancreatectomy with resection of a 2.6-cm mass which predominantly expressed glucagon. Serum glucagon levels n ormalized imme...
ConclusionsPost-cardiosurgical patients admitted to ICU have a relatively high rate of NOMI, in which CT-scan is often initially non-conclusive. Our data and those from the literature seem to show that in such cases bed-side DL may be an advantageous and safe procedure to avoid needless laparotomy and enables a more tailored open surgery.
Abstract The management of patients with penetrating abdominal trauma has significantly changed in recent years. While exploratory laparotomy was the gold standard in Germany in all patients up to the 1970s, selective nonoperative management (SNOM) is increasingly being discussed in hemodynamically stable patients without pathological findings in computed tomography (CT) scan or extended focussed assessment with sonography for trauma (eFAST). A standard algorithm taking a balance between invasiveness, patient safety and the use of resources into account has still to be implemented in Germany. The present...