[Cystic lymphangioma of the adrenal gland. Three misleading cases].
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Keywords:
Lymphangioma
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Lymphangioma
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Eighteen patients with 26 pelvic lymphocoeles following radical hysterectomy underwent percutaneous therapeutic intervention with either needle aspiration, or catheter drainage. In eight patients a percutaneous needle aspiration under sonographic control was performed. Five out of eight patients were successfully managed with needle aspiration, three of them requiring repetitive aspirations. Thirteen patients, with a total of 21 lymphocoeles underwent catheter drainage. Seventeen of the 21 lymphocoeles completely resolved. Redrainage was performed in four cases and it was successful in two of them. The duration of the catheter drainage was 8 to 34 days. Nine of the lymphocoeles were infected at initial drainage. Two patients underwent surgery because of increased volume of output. Percutaneous drainage is a safe and effective method and should be considered as the initial treatment for all patients with postoperative lymphocoeles.
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Cystic lesions of the adrenal gland present as either benign disorders (cystic lymphangioma and pseudocysts) or malignant lesions (neuroblastoma, pheochromocytoma, and metastases). Ultrasound is generally the initial examination because it can detect the lesion, confirm its fluid content, and analyze its internal structure. CT scanning is the reference examination for delineating the topography and extent of a lesion, especially when it is large. MRI also can assess the contents of a cystic adrenal mass, most notably hemorrhage. Although imaging can characterize the cystic nature of a lesion, it sometimes fails to establish a specific diagnosis. In such cases, it is mandatory to perform fine-needle aspiration, with biologic determinations of aspirated fluid and cytologic analysis. Percutaneous fluid aspiration may be an alternative to surgery for the symptomatic benign adrenal cyst.
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Debridement (dental)
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Closure (psychology)
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Hydatid cyst
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Objective:To investigate the method and effect of the laparoscopic surgery in the treatment of congenital hepatic cyst.Methods:From March 2000 to March 2009,82 cases(16 males,66 females,aged 19-81 years,mean age 46 years) with congenital hepatic cyst received laparoscopic fenestration drainage were analyzed retrospectively,the operation duration,bleeding volume and complications were observed.Results:All procedures were successfully accomplished.The operation duration was 30～120 min,mean time 46 min,the amount of bleeding volume was 20～100 ml,mean 46 ml.There was no conversion to open abdominal operation.There was 5 cases recurrence in 6 months to 9 years follow-up.Conclusion:Laparoscopic fenestration drainage is a safe,reliable surgical approach in hepatic cyst patients with minimal injury and rapid healing,and should be the preferable choice for the patients with congenital hepatic cyst.
Fenestration
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Secondary aorto-enteric fistula (SAFE) is a late but dreaded complication of abdominal aortic surgery with an overall mortality ranging from 30% to 70% in different series. Most commonly the patients with SAFE, present with the massive gastrointestinal bleed or other symptoms such as sepsis, lower extremity ischemia, abdominal pain, septic arthritis, and multicentric osteomyelitis. Treatment requires prompt diagnosis, and surgery. We present a case of para-prosthetic graft to bowel fistula in a patient who was asymptomatic and has presented for treatment of ventral wall incisional hernia.
Bleed
Aortoenteric Fistula
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Objective To summarize the clinic diagnosis and treatment of simple renal cysts.Method The clinical data of 62 patients with simple renal cysts were retrospectively analysed.There were 29 male and 33 female patients.The age ranged from 43 to 69 years with 55.8 years on average.The diameter of the cysts were 6.8±2.1cm.Among the 62 patients,57 had half-side cyst and 5 double.Twelve patients had the complication of hypertension and lumbago.Eleven patients were treated by percutaneous aspiration,41 by conventional open surgery for cyst unroofing;and 10 by laparoscopic unroofing of the cysts.Results Each group has achieved desirable results.Transcutaneous puncture sclerotherapy had a shorter hospital stay,more rapid recovery and relatively lower cost.However,the recurrence occurred in some cases.There was no recurrence for open surgical and laparoscopic unroofing therapies,in addition the latter had the advantages of less invasive,effective,short hospital stay and rapid recovery.Conclusion Each treatment protocol has its advantages and disadvantages.The optimal treatment goal can be achieved if appropriate procedures are applied based on patients' clinic symptoms and conditions.
Open surgery
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