Mediastinal extension of pancreatic pseudocysts causing portal hypertension.

Pancreatic pseudocysts are fluid-filled masses with a pseudo-capsule that appear following a pancreatic injury. Pseudocysts are the most frequent cystic lesions of the pancreas, representing about 85% of all pancreatic cysts. The possible complications of pancreatic pseudocysts include infections, hemorrhage, intestinal stenosis or obstruction, and rupture into nearby organs or the peritoneal/retroperitoneal cavity. However, mediastinal extension of pancreatic pseudocysts with portal hypertension is rare. We present a case of an 18-year-old male with a history of weight loss over a 10-month period, presenting with an abdominal lump, hemoptysis, abdominal pain, and dyspnea. He was diagnosed with large pancreatic pseudocysts that extended into the mediastinum by ultrasonography (US) and contrast-enhanced computed tomography (CT) examination. Portal hypertension occurs as a result of portal vein compression. A histopathological examination proved conclusive of pancreatic pseudocysts. The patient was treated with surgery, where the cyst was drained.

Congenital megaureter presenting as intraabdominal cystic masses in a pediatric patient at Hasan Sadikin hospital: A case report.

We describe a case of a 2-year-old girl with congenital megaureter presenting as intraabdominal cystic masses. The patient presented with a lump in abdomen that has been getting bigger since birth accompanied by pain. Ultrasonography that was taken when the patient was 2 years old showed a cystic mass with thick septation and pelvocaliectasis of the left kidney. One month after US, patient underwent 3D CT Scan which showed cystic masses in the upper to lower abdomen with no visualization of the normal structure of the left kidney and ureter. Non-contrast MRU that was taken 3 month after the CT Scan showed a thick-walled cystic mass resembling a tortuous tubular mass associated with the pelvocalyceal system without any distal obstruction. VCUG examination that was taken 2 weeks after the non-contrast MRU showed no reflux. This case reports can help clinicians to confirm persistent urinary tract dilatation, exclude the presence of VUR and differentiate primary megaureters from other causes of hydronephrosis including obstruction of the VUJ, posterior urethral valves, and ureterocele from radiological studies.

Drug-Coated Balloon Versus Drug-Eluting Stent in Patients With Femoropopliteal Artery Disease: A Systematic Review and Meta-Analysis.

OBJECTIVE: In this systematic review and meta-analysis, we aimed to compare drug-coated balloon (DCB) to drug-eluting stent (DES) in patients with femoropopliteal lesions in terms of restenosis, target lesion revascularization (TLR), and mortality. METHODS: A comprehensive literature search was performed through PubMed, Scopus, and Embase databases. The intervention group was patients receiving percutaneous balloon angioplasty using the DCB. The control group was patients receiving percutaneous intervention using the DES. The primary outcome was restenosis, and the secondary outcomes were TLR and mortality. RESULTS: There were 4 studies comprising 812 patients (906 lesions) included in this systematic review and meta-analysis. The rate of restenosis was .19 [.13, .26] in DCB and .24 [.20, .28] in DES. There was a trend toward lower rate of restenosis (OR .73 [.52, 1.03], P = .074; I2: 46.3%) for DCB use compared to DES use. The rate of TLR was .11 [.08, .14] in DCB and .17 [.14, .21] in DES. TLR was lower (OR .61 [.41, .92], P = .017; I2: 1.2%) in the DCB group compared to the DES group. There were no significant differences in mortality (OR 1.38 [.78, 2.44], P = .268; I2: 0%) among the two groups. Meta-regression analysis showed that the rate of restenosis in DCB in this pooled analysis was affected by sex (reference: male, coefficient -.004, P = .009), smoking (coefficient: .003, P = .010), and total occlusion (coefficient: .008, P = .004). CONCLUSION: DCB use in patients with femoropopliteal lesion was associated with similar rate of restenosis, lower TLR, and similar mortality rate compared to DES use.

Third Ventricular Floor Bowing Indicates Surgical Success in Patients Undergoing Endoscopic Third Ventriculostomy-Systematic Review and Meta-Analysis.

OBJECTIVE: This meta-analysis aimed to evaluate the prognostic performance of third ventricular floor bowing (TVFB) as a marker for surgical success in patients undergoing endoscopic third ventriculostomy (ETV). METHODS: We performed a comprehensive literature search for studies comparing ETV success in patients with TVFB compared with those without using PubMed, SCOPUS, Embase, and EuropePMC. TVFB was defined as inferior bowing or bulging deformation or convex third ventricular floor. Surgical success was defined as resolution of symptoms post surgery and requires no further intervention for hydrocephalus. The outcome was surgical success in patients with TVFB compared with those without TVFB. The effect estimate was reported as odds ratio (OR). RESULTS: Five studies comprising 439 patients were included in this meta-analysis. The prevalence of overall surgical success was 42%. The prevalence of surgical success was 85% in patients with TVFB. TVFB was associated with increased success rates (OR 5.94 [95% confidence interval 3.07, 11.5], P < 0.001; I2: 26.04%, P = 0.248). TVFB was associated with sensitivity 0.83, specificity 0.54, positive likelihood ratio 1.8, negative likelihood ratio 0.32, diagnostic OR 6, and area under curve 0.81 (0.77-0.84) for surgical success. Presence of TVFB confers to a 56% rate of surgical success, and no TVFB confers to a rate of 19% surgical success. The association between TVFB and surgical success was not affected by age (coefficient: -0.03, P = 0.474) and aqueductal stenosis (P = -0.05, P = 0.237). CONCLUSIONS: This meta-analysis showed that the presence of TVFB was associated with increased ETV success.