ABSTRACT
Authors report a case of large adrenal pseudocyst in a 53 year-old woman. A voluminous abdominal mass with malnutrition and dehydration symptoms were found. Surgical excision was difficult but complete after 6L fluid aspiration. Histologic examination showed fibrous and inflammatory cystic wall with groups of adrenal cells. No epithelial lining was present and the diagnosis of adrenal pseudocyst was made. Pathogenesis; histology; diagnosis and management were discussed
Subject(s)
Adrenal Glands , Case Reports , Pancreatic Pseudocyst/diagnosis , Pancreatic Pseudocyst/etiology , Pancreatic Pseudocyst/surgeryABSTRACT
Objective: Laparoscopic adrenalectomy has reduced the morbidity rate associated with the classical approaches. The authors herein evaluate their experience with this technique at the hospital of Chambery; France. Patients and Methods: The files of all patients subjected to laparoscopic adrenalectomy at the department of General and Thoracic Surgery between 1996 and 2000 were reviewed. A partial lateral decubitus flank approach at 45o was used. Results: The study included 12 patients; 8 of them were females and 4 males. The mean patient age was 45 years ranging from 26 to 69 years. The adrenal gland diseases encountered were Conn adenoma in 4; Cushing's syndrome in 3 (with one case of Cushing's disease); pheochromocytoma in 3 and incidentaloma in 2 cases. The mean tumor size was 5.5 cm (range 1.8 to 9 cm). The operative time ranged from 70 to 135 minutes for unilateral adrenalectomy and it was 322 minutes for bilateral adrenalectomy including the time needed for changing sides and repositioning. Only one patient (8.3) required laparotomy because of uncontrollable bleeding and hemodynamic instability. The mean hospital stay was 5.4 days (range 4 to 9 days) for unilateral adrenalectomy. Due to hormonal treatment; the mean hospital stay for patients subjected to bilateral adrenalectomy was 13 days. One patient (8.3) developed hematoma at the side of adrenalectomy and was treated with antibiotics and anti-inflammatory drugs. No mortality was encountered. Conclusion: This small series has shown that laparoscopic adrenalectomy is a very promising technique which can be recommended for tumors up to the size of 9 cm