A giant abdominal cyst with raised levels of carbohydrate antigen 19-9.

A 53-year-old woman was admitted with upper abdominal discomfort. Clinical examination revealed a mass of the upper left quadrant. Computed tomography disclosed a giant cystic lesion of 19 x 16 cm compressing the body and tail of the pancreas as well as the left kidney. Endoscopic ultrasound showed an anechoic lesion with multiple septa. Diagnostic fine needle aspiration was performed. Intracystic carcinoembryonic antigen and lipase values were normal. However, carbohydrate antigen 19-9 level was elevated (3433 UI/ml) and cytologic examination was compatible with a pancreatic serous cystadenoma. Prompted by the symptoms and the lack of a definite diagnosis, the patient underwent cystectomy. Surprisingly the histological diagnosis was that of a benign renal cyst. To date, only one case of a giant renal cyst has been reported with high levels of CA 19-9. With this case report we would like to demonstrate that giant renal cysts may present high levels of CA 19-9 and mimic the endoscopic ultrasound aspect and cytologic features of pancreatic cysts.

Duodenal diverticulitis. CT diagnosis and conservative management.

Though duodenal diverticula are frequent and most often asymptomatic, they can cause serious complications. We present a case of duodenal diverticulitis without perforation, diagnosed by CT and treated conservatively by means of endoscopic maneuvers and medical therapy. A review of the recent literature regarding duodenal diverticula, complications, diagnosis and management is included.

Hepatic cystic mass with a daughter cyst: a feature of mucinous cystadenoma.

The authors describe the US and CT features of a hepatic mucinous cystadenoma presenting as a hepatic cystic mass with a daughter cyst in a 50-year-old female patient. The contribution of the current imaging modalities is analyzed and a review of the literature is presented.

Laparoscopic treatment of secondary infected pancreatic collections after an acute pancreatitis: two cases.

We report two cases of secondary infected pancreatic necrosis following a pancreatitis treated by a laparoscopic approach. The treatment consisted in a necrosectomy and the installation of a system of drainage and lavage.

[Aneurysm of the splenic artery: an uncommon etiology of segmental portal hypertension]. / L'anévrysme de l'artère splénique: une étiologie exceptionnelle d'hypertension portale segmentaire.

A patient presented with gastrooesophageal varices secondary to splenic vein compression by a splenic artery aneurysm. Splenectomy and aneurysm resection ensured a good clinical result and disappearance of the segmental portal hypertension.

Measuring the rupture stress point of biological sealant-collagen bonding: validation of a technique used after hepatectomy.

The aim of this experimental study was to measure the rupture stress point of a fibrin clot situated on a liver, in realistic surgical conditions. The experimental method was carried out with a machined wooden cylinder bonded on the liver, connected with a wire to a setup and pulled at a constant speed, and a sensor was placed on the wire measuring the applied strength. This method, realized in the dog, made it possible to validate a precise and reproducible method designed for testing the adhesive characteristics of biological sealant-collagen bonding on the liver.

[Primary inguinal hernia: Lichtenstein's ambulatory hernioplasty: early clinical results and economic implications. Study of the initial 130 surgical cases]. / Hernie inguinale primaire: hernioplastie ambulatoire selon Lichtenstein: premiers résultats cliniques et implications économiques. Etude des 130 premiers cas opérés.

The authors report their preliminary experience of 130 ambulatory treatment under local anesthesia of primary inguinal hernia. This method of treatment is very well accepted by the patients. There are few early recurrences. This method of treatment is very cost-effective.