RESUMO
BACKGROUND: Simple hepatic cysts are commonly occurring lesions that are usually asymptomatic and require no treatment. Hepatic cyst infection, however, is considered a severe complication. We report a case of hepatic cyst infection following pancreatoduodenectomy with repeated fever lasting for almost 3 years, and two cysts were infected successively. CASE SUMMARY: A 72-year-old woman diagnosed with adenocarcinoma of duodenal papilla underwent pancreatoduodenectomy with Child reconstruction. She then suffered repeated occurrences of bacteremia and hepatic cyst infection for 3 years. Blood cultures were positive for Klebsiella pneumoniae and Escherichia coli a total of 7 times and 4 times, respectively. During the early stage, we suspected that postoperative reflux cholangitis was the cause of fever and bacteremia. Multiple cysts were observed, so it was difficult to determine which cyst was infected. Through repeat examination, we found the focus of infection, and we treated the patient with antimicrobials and performed percutaneous cyst drainage. The patient did not experience another cyst infection for more than 4 years. CONCLUSION: Biliary reconstruction inducing hepatic cyst infection is easily misdiagnosed as biliary reflux infection, Repeated imaging examination is a method for identifying the infected focus.
RESUMO
We report what we believe to be potential improved performance for a Nd:YAG discrete path slab amplifier configuration based on a hybrid resonator system. The amplifier is driven by a Q-switched 0.3 mJ nanosecond oscillator that generates an initial laser pulse at a repetition rate of 5 KHz and has beam quality of M2<1.3. The input pulse makes 12 passes through the slab amplifier to yield 25 mJ output pulse energy at the absorbed pump power of 878 W. A corresponding optical-to-optical efficiency of 14.3% was obtained, and the beam quality factors M2 in the unstable and stable direction were 1.7 and 1.5, respectively. No detectable signs of amplified spontaneous emission were observed.
