ABSTRACT
Mid-esophageal diverticula are rare entities. Only symptomatic patients usually receive surgical treatment. Esophageal leakage is one of the most common complications after these procedures. Though in literature, operative management is the preferred treatment for esophageal fistula, conservative approach is described in case of small leaks. We report a case of an operated giant mid-esophageal diverticulum complicated with an esophageal fistula. The patient underwent a surgical treatment and recovered completely.
Subject(s)
Diverticulum, Esophageal/surgery , Esophageal Fistula/therapy , Postoperative Complications/therapy , Abscess/etiology , Abscess/surgery , Aged , Drainage , Esophageal Fistula/diagnostic imaging , Esophageal Fistula/etiology , Humans , Intubation, Gastrointestinal , Jejunostomy , Male , Mediastinal Diseases/etiology , Mediastinal Diseases/surgery , Postoperative Complications/diagnostic imaging , Postoperative Hemorrhage/surgery , Reoperation , Thoracic Surgery, Video-Assisted , Thoracotomy , Tomography, X-Ray ComputedABSTRACT
An unusual case of early double kidney transplant dysfunction due to abdominal compartment syndrome is herein reported. A 62-year-old woman on peritoneal dialysis underwent dual kidney transplantation. The grafts were positioned extraperitoneally in both iliac possae using standard techniques. Surgical procedures and immediate postoperative period were uneventful. The urine output was immediate and the creatinine decreased, but in a few days she developed severe ascites with reduced urine output, increased creatinine, and progressive changes on Doppler ultrasound. The patient underwent paracentesis: the kidney function recovered as well as the Doppler ultrasound. Kidney biopsy was negative for rejection or renal pathology. Graft dysfunction was related to the presence of ascites. A catheter inserted in the abdomen measured intra-abdominal pressure (IAP) of 14 mm Hg. IAP correlated with renal function showing that IAP probably explained renal flow modifications.
Subject(s)
Compartment Syndromes/physiopathology , Glomerulonephritis, Membranoproliferative/surgery , Kidney Transplantation/adverse effects , Postoperative Complications/physiopathology , Compartment Syndromes/surgery , Female , Glomerulonephritis, Membranoproliferative/therapy , Humans , Kidney Transplantation/methods , Middle Aged , Peritoneal Dialysis/adverse effects , Portasystemic Shunt, Transjugular Intrahepatic , Treatment OutcomeABSTRACT
Cystic lymphangioma is an uncommon benign pathology, usually reported in children, rarely in adult. Its embryopathogenesis is still controversial: it seems to arise from the lymphatic vessels, mainly in the cervico-cranial district. It is macroscopically characterised by multiple cystic non-communicating concamerations. Definitive diagnosis used to be intraoperative and was usually an unexpected finding. Nowadays, with modern imaging technologies, CT and MRI, diagnosis can be assumed before intervention even though certain diagnosis can still be reached only with histological examination. Imaging techniques can help for a precise mapping of the lesion and definition of its limits with the other structures, improving therapeutic success. Various therapeutical options are reported in literature, but complete surgical excision is still considered the best approach and the most successful. The Authors report their experience and review the literature on cystic lymphangioma in adult.
