Isolated or non-isolated duodenal obstruction: perinatal outcome following prenatal or postnatal diagnosis

Objectives To determine whether the pre- or postnatal diagnosis of either isolated or non-isolated duodenal obstruction (DO) is associated with different outcomes. Methods A single-center retrospective analysis was carried out of 91 cases diagnosed with a DO between January 1991 and little 2003. Data oil the diagnosis, treatment and outcomes of The cases were gathered, and differences between the groups were analyzed. Results Twenty-eight cases of DO were diagnosed before and 63) after birth. Of 15 presumed isolated cases in the prenatally diagnosed group, four revealed associated or chromosomal anomalies after birth. The types of obstruction present there significantly different between the prenatally (n = 11) and postnatally (n = 27) detected subsets of isolated DO. The prenatally detected subset displayed a lower median gestational age at delivery lower median birth weight and a higher prematurity rate (8/11 vs. 8127). The diagnosis of DO occurred significantly later ill the postnatally defected subset than the postnatal confirmation of the diagnosis in the prenatally detected cases. In the non-isolated cases of DO, no difference was found in the type of chromosomal or associated anomaly or the type of obstruction between the prenatally detected (n = 17) and postnatally detected subsets (n = 36). Trisomy 21 was present in 7/17 (41%) 221,36 (61%) cases, respectively Two terminations and three intrauterine deaths occurred in the prenatal non-isolated subset. The liveborn infants from the prenatally detected non-isolated subset (n = 12) showed a significantly higher prematurity rate (9/12 vs. 14/36), lower median birth weight and earlier conformation of diagnosis after delivery. After surgery, outcome was similar between both subsets of isolated and non-isolated DO. All the infants with all isolated DO survived. Neonatal death occurred in three prenatally and five postnatally diagnosed cases with non-isolated DO. Conclusions The outcome of prenatally and postnatally diagnosed DO is not essentially different despite more prematurity and a lower birth weight lit the former. Of the prenatally detected cases of DO assumed to be isolated, 2,25% revealed additional chromosomal or associated anomalies after delivery, which influenced outcome. Copyright (c) 2008 ISUOG. Published by John Wiley & Sons, Ltd

Retroperitoneal paraganglioma presenting as right-sided varicocele: case report

Varicocele, the most important identifiable pathological cause of male infertility, is rarely observed on the right side. In isolated cases of right-sided varicocele, the presence of retroperitoneal masses compressing the inferior vena cava should be considered by further investigation. The retroperitoneal masses that are detected tend to grow rapidly due to their location and may be very large at the time of diagnosis. Soft tissue sarcomas are the most common cause of retroperitoneal masses, while paragangliomas are rare causes. Retroperitoneal paragangliomas should be diagnosed via detection of symptoms caused by hormonal activity, observation of the compression effect of the mass, or incidentally during imaging studies. SIMILAR CASES PUBLISHED: This study presents the first case of retroperitoneal paraganglioma in a 41-year old man as isolated right-sided varicocele that has been described in the published reports