ABSTRACT
This case report describes a 77-year old woman with a leiomyosarcoma of subhepatic inferior caval vein. The presented symptom was unspecific abdominal pain. Ultrasound and CT suggested a primary liver tumor. MRI revealed retroperitoneal location of the neoplasm. The tumor was resected completely and ICV was replaced by a PTF-graft. Vascular leiomyosarcoma is a rare tumor entity, which often is diagnosed in advanced stage. Depending on location it can be mistaken for neoplasms of other organs.
Subject(s)
Abdominal Pain/diagnosis , Abdominal Pain/etiology , Leiomyosarcoma/complications , Leiomyosarcoma/diagnosis , Vascular Neoplasms/complications , Vascular Neoplasms/diagnosis , Vena Cava, Inferior/surgery , Abdominal Pain/prevention & control , Aged , Diagnosis, Differential , Female , Humans , Leiomyosarcoma/surgery , Liver Neoplasms/complications , Liver Neoplasms/diagnosis , Treatment Outcome , Vascular Neoplasms/surgeryABSTRACT
INTRODUCTION: Aim of the palliative therapeutic procedure should be a fast, efficient and pain free treatment of the malignant pleural effusions. PATIENTS AND METHOD: Since 1995 the results of malignant pleural effusions treatment were analyzed retrospectively in 46 patients who underwent 51 video-assisted TTP. The most frequent origin of malignant pleural effusion was breast cancer, followed by bronchial carcinoma. Precondition for video-assisted TTP was the verification of a malignant pleural effusion by cytology. RESULTS: Following TTP one patient suffered from pneumonia, two recurrent diseases occurred. Four patients died due to their severe primary malignancy. Average hospitalization was 8 days (3-55). CONCLUSION: Video-assisted TTP is the standard procedure in palliative treatment of malignant pleural effusion; the recurrence rate is low and the technique minimal invasive.
Subject(s)
Palliative Care , Pleural Effusion, Malignant/surgery , Pleurodesis/methods , Talc/therapeutic use , Thoracic Surgery, Video-Assisted/methods , Adult , Aged , Aged, 80 and over , Breast Neoplasms/mortality , Breast Neoplasms/surgery , Carcinoma, Bronchogenic/mortality , Carcinoma, Bronchogenic/surgery , Cause of Death , Female , Gastrointestinal Neoplasms/mortality , Gastrointestinal Neoplasms/surgery , Humans , Lung Neoplasms/mortality , Lung Neoplasms/surgery , Male , Middle Aged , Pleural Effusion, Malignant/mortality , Postoperative Complications/mortality , Treatment OutcomeSubject(s)
Inflammation/etiology , Intestine, Small/transplantation , Muscle, Smooth/pathology , Transplantation, Homologous/pathology , Chemokine CCL2/genetics , Cyclooxygenase 2 , Humans , Interleukin-6/genetics , Isoenzymes/genetics , Membrane Proteins , Monitoring, Intraoperative , Prostaglandin-Endoperoxide Synthases/genetics , Reperfusion , Reverse Transcriptase Polymerase Chain Reaction , Time FactorsABSTRACT
The spontaneous gastric rupture without a preexisting gastric ulcer is an extremely rare event. In the case presented we report the occurrence of a gastric rupture in context with a giant left scrotal hernia. The entire intestine was transposed into the hernial sack and this obviously led to a chronic distension of the stomach and finally to the spontaneous gastric rupture. Other reasons of a spontaneous gastric rupture as well as the surgical therapy are discussed. Important are a fast diagnosis and surgical revision in order to prevent patients from a massive diffuse peritonitis.
Subject(s)
Hernia, Inguinal/complications , Scrotum , Stomach Rupture/etiology , Aged , Dilatation, Pathologic , Hernia, Inguinal/diagnostic imaging , Hernia, Inguinal/surgery , Humans , Male , Peritonitis/diagnostic imaging , Peritonitis/etiology , Peritonitis/surgery , Radiography , Risk Factors , Rupture, Spontaneous , Scrotum/diagnostic imaging , Scrotum/pathology , Scrotum/surgery , Stomach Rupture/diagnostic imaging , Stomach Rupture/surgeryABSTRACT
Appendicocutaneous fistula represents a rare form of enterocutaneous fistulas, that can occur following acute appendicitis, drainage of a perityphlitic abscess or an appendectomy. This case report describes the unique occurrence of an appendicocutaneous fistula as complication of abdominal drainage in absence of one of the above mentioned diseases.
Subject(s)
Appendix , Carcinoma, Transitional Cell/surgery , Cutaneous Fistula/etiology , Drainage/instrumentation , Intestinal Fistula/etiology , Postoperative Complications/etiology , Ureteral Neoplasms/surgery , Aged , Appendectomy , Cutaneous Fistula/surgery , Humans , Intestinal Fistula/surgery , Male , Neoplasm Recurrence, Local/etiology , Neoplasm Recurrence, Local/surgery , Postoperative Complications/surgery , ReoperationABSTRACT
From 1989 to 1995, 25 ICU-patients underwent cholecystectomy for acute acalculous cholecystitis (AAC). Preoperative diagnosis remains difficult and ultrasound imaging proved to be the most valid instrument for early diagnosis. Predisposing factors like duration of respiratory failure, extent of surgery, amount of blood loss and mode of analgesia were analyzed. Undelayed surgical treatment was important to avoid further complications such as gangrene or perforation of the gall bladder.
Subject(s)
Cholecystitis/mortality , Critical Care/statistics & numerical data , Postoperative Complications/mortality , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Cause of Death , Cholecystectomy , Cholecystitis/etiology , Cholecystitis/surgery , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/surgeryABSTRACT
The emergency treatment of the enterothorax is problematic due to weak lung functions and unstable hemodynamics, and because it does not influence the stage of maturity of the lungs. By delayed operation children with a critical starting position have a greater chance to survive, after their condition has been stabilised by intensive care treatment. During the stabilising period we managed to decrease the FiO2 level below 50% and to decrease the pCO2 level to 43 +/- 13 mm Hg in our patients (n = 10). Furthermore we succeeded to raise the O2 degree of saturation from 72 +/- 13 to 89 +/- 9%. The pH level went up from 7,238 +/- 0,181 to 7,394 +/- 0,060. If the condition of the patients worsens during the stabilising period--in our patients the stabilising period was between 12 and 24 hours--immediate operation is indicated. We have no experience so far in using ECMO in such situations.
