Hepatic cerebrospinal fluid pseudocyst mimicking hydatid liver disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>An abdominal pseudocyst is a rare complication of a ventriculo-peritoneal shunt. Etiological factors include infection, obstruction and dislodgement. This is the first report of a hepatic cerebrospinal fluid pseudocyst mimicking hydatid liver disease.</p> <p>Case presentation</p> <p>We report the case of an 18-year-old Caucasian male patient who presented with a hepatic pseudocyst secondary to a ventriculo-peritoneal shunt, misdiagnosed as hydatid disease of the liver.</p> <p>Conclusion</p> <p>Hepatic pseudocysts, a rare complication of a ventriculo-peritoneal shunt, have similar clinical and radiological characteristics to those of hydatid liver disease. The formation of a pseudocyst should always be considered in patients with ventriculo-peritoneal shunts <it>in situ</it>.</p

Pancreatic Anastomosis Disruption Seven Years Postpancreaticoduodenectomy

We are reporting a case of a 22 year-old female patient, who underwent a pancreaticoduodenectomy previously for a solid-pseudopapillary neoplasm of the pancreas and was re-admitted seven years later with a pancreatic leak following disruption of the pancreatico-jejunal anastomosis. Exploratory laparotomy revealed a large collection at the level of the pancreatic anastomosis with major disruption of the pancreatico-jejunal anastomosis. The pancreatic stump was refreshed as well as the jejunal site and a duct to mucosa anastomosis was performed. She remains well with a follow up of 18 months

Successful one stage operation for a synchronous, duodenal carcinoma, colonic carcinoma and renal oncocytoma in an adult patient

We report a rare case of synchronous duodenal carcinoma, colonic carcinoma and renal oncocytoma successfully treated using a one-stage surgical approach. Potential risk factors for multiple primary malignancies associated with duodenal carcinoma are discussed. This case illustrates several practice points for consideration: 1. Patients presenting with small intestinal carcinomas have a higher than average chance of developing second primary tumors in other organs; this should be taken into consideration during staging and follow-up. 2. For full staging of patients presenting with small bowel tumors, upper and lower gastrointestinal endoscopy and PET scanning should be considered. 3. A one-stage surgical procedure can be used safely and successfully for multiple synchronous primary tumors

Comparison of Clinical and Radiographic Efficacy of Particles versus nBCA/Onyx in Middle Meningeal Artery Embolization for Chronic Subdural Hematoma

Different embolic materials are utilized in MMA embolization of chronic subdural hematoma per operators’ discretion. We aim to compare the clinical and radiographic efficacy of different embolic materials in a pooled retrospective cohort of two US centers

Primary undifferentiated embryonal sarcoma of the liver mistaken for hydatid disease

Primary undifferentiated embryonal sarcoma of the liver is a rare tumor with a peak incidence between the ages of 6 and 10 years. We report a case of a primary hepatic undifferentiated embryonal sarcoma arising in a 21-year-old male mistaken for hydatid disease of the liver. The rapid recurrence of this tumor along the site of attempted percutaneous drainage illustrates some important management points regarding this malignancy

Inflammatory pseudo-tumor of the liver: a rare pathological entity

Inflammatory pseudo-tumor (IPT) of the liver is a rare benign neoplasm and is often mistaken as a malignant entity. Few cases have been reported in the literature and the precise etiology of inflammatory pseudotumor remains unknown. Patients usually present with fever, abdominal pain and jaundice. The proliferation of spindled myofibroblast cells mixed with variable amounts of reactive inflammatory cells is characteristics of IPT. We reviewed the literature regarding possible etiology for IPT with a possible suggested etiology

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

BACKGROUND: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide. METHODS: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters. RESULTS: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 per cent of patients (2901 of 4223). Major complication rates (Clavien–Dindo grade at least IIIa) were 24, 18, and 27 per cent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 per cent; however, it was 41 per cent in low-to-middle- compared with 19 per cent in very high-HDI countries. CONCLUSION: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

System design effects on online impulse buying

Purpose – Integrating the two-system (reflective vs. impulsive) model and the “stimulus-organismresponse” framework, the purpose of this paper is to construct and empirically test a model that examines online impulse buying as a phenomenon triggered by system design factors. Design/methodology/approach – A laboratory experimental design with a 2x2 full factorial design involving 151 undergraduate students was used to validate the effects of system design stimuli on online impulse buying. Interactivity and vividness, two design factors, were manipulated and a fictitious VCD movie store was created, with four storefronts representing each combination of treatments. Findings – A compelling and sociable virtual experience as conceptualized with telepresence and social presence has a significant effect on buying impulses over and above traditional marketing/product stimuli. Such virtual experience can be created through the usage of interactive and vivid website features. Furthermore, cognition positively moderates the relationship between buying impulse and the actual purchasing behavior. Practical implications – The findings provide valuable guidance in website design that can stimulate online impulse buying. The results also indicate the importance of providing cognitive intervention at the purchasing stage. Originality/value – A significant extension of the “stimulus-organism-response” framework is to introduce presence as the system stimulus that captures the overall virtual experience and to specify the associated design features; i.e. interactivity and vividness. By incorporating the two-system model, this study offers a theoretical underpinning of the role of cognitive processing in impulse buying