ABSTRACT
Churg-Strauss syndrome or allergic granulomatosis and angiitis is an uncommon systemic vasculitis chracteristized by asthma, hypereosinophilia, mono or polyneuropathy, non-fixed pulmonary infiltrates, paranasal sinus abnormality and extravascular eosinophil infiltration. Gastrointestinal manifestations occur in about 42% of patients. However, ulcer formation in gastrointestinal tract mucosa is a rare manifestation, usually discovered upon laparotomy or autopsy. We experienced a case of 40-year-old woman with Churg-Strauss syndrome, who presented multiple colonic ulcers on colonoscopy. She also had bronchial asthma, polyneuritis, peripheral blood eosinophilia and hemorrhagic bullous skin lesions with extravascular eosinophil infiltration. She improved with high dose corticosteroid and cyclophosphamide. We report this case with a review of the literature.
Subject(s)
Adult , Female , Humans , Asthma , Autopsy , Churg-Strauss Syndrome , Colon , Colonoscopy , Cyclophosphamide , Eosinophilia , Eosinophils , Gastrointestinal Tract , Laparotomy , Mucous Membrane , Neuritis , Polyneuropathies , Skin , Systemic Vasculitis , Ulcer , VasculitisABSTRACT
PURPOSE: We report an initial experience with a retroperitoneal laparoscopic ablation of a peripelvic renal cyst. MATERIALS AND METHODS: Five patients (2 males, 3 females), with a mean age of 47 years (22 to 65) underwent a laparoscopic unroofing of a symptomatic peripelvic cyst. All patients complained of flank pain and an obstruction was observed in 3 patients. A laparoscopic ablation was performed retroperitoneally in all patients. Clinical parameters evaluated included the operative time, hospital stay, analgesic use, oral intake and complication rate. RESULTS: The mean operative time was 179 minutes (160-210 minutes). The mean postoperative hospital stay was 2.8 days (2-3 days). The mean analgesic requirement was 44mg of Piroxicam. Oral intake was started on postoperative day 1.4 (1-2 days). Complications included 1 case of subcutaneous emphysema and 1 case of peritoneal tearing, which were managed conservatively. The mean follow-up was 9.2 months (3-18 months) with no evidence of recurrence. CONCLUSIONS: A retroperitoneal laparoscopic ablation of a peripelvic renal cyst is technically feasible and effective alternative to an open cyst unroofing. However, it should be performed by an experienced urologic laparoscopist because of the location and association of these cysts with vessels of the renal hilum and collecting system.
Subject(s)
Humans , Male , Flank Pain , Follow-Up Studies , Laparoscopy , Length of Stay , Operative Time , Piroxicam , Recurrence , Subcutaneous EmphysemaABSTRACT
PURPOSE: We report an initial experience with a retroperitoneal laparoscopic ablation of a peripelvic renal cyst. MATERIALS AND METHODS: Five patients (2 males, 3 females), with a mean age of 47 years (22 to 65) underwent a laparoscopic unroofing of a symptomatic peripelvic cyst. All patients complained of flank pain and an obstruction was observed in 3 patients. A laparoscopic ablation was performed retroperitoneally in all patients. Clinical parameters evaluated included the operative time, hospital stay, analgesic use, oral intake and complication rate. RESULTS: The mean operative time was 179 minutes (160-210 minutes). The mean postoperative hospital stay was 2.8 days (2-3 days). The mean analgesic requirement was 44mg of Piroxicam. Oral intake was started on postoperative day 1.4 (1-2 days). Complications included 1 case of subcutaneous emphysema and 1 case of peritoneal tearing, which were managed conservatively. The mean follow-up was 9.2 months (3-18 months) with no evidence of recurrence. CONCLUSIONS: A retroperitoneal laparoscopic ablation of a peripelvic renal cyst is technically feasible and effective alternative to an open cyst unroofing. However, it should be performed by an experienced urologic laparoscopist because of the location and association of these cysts with vessels of the renal hilum and collecting system.