4 research outputs found
Pseudomyxoma Peritonei Presenting as Acute Appendicitis: Clinical and Imaging Findings
A 30-year old man presented with symptoms and signs of acute appendicitis. Abdominal imaging via ultrasound and computed tomography detected a mass in the right iliac fossa. Exploratory laparotomy revealed an appendiceal mass and gelatinous peritoneal fluid, while histopathology confirmed the diagnosis of pseudomyxoma peritonei arising from a mucocele of the appendix and attributed to an appendiceal cystadenocarcinoma. The clinical and imaging findings of this rare case are herein presented
Fungal infection of aortoiliac endograft: A case report and review of the literature
Infection of aortoiliac endografts is, to date, a rare complication of
endovascular surgery. Staphylococcus species are the most common
responsible pathogens, just as in cases with infected grafts after open
aortic surgery. We report a case of a 65-year-old man with a history of
diabetes mellitus and bladder cancer who developed stent-graft infection
3 years after endovascular treatment for a 5.6 cm abdominal aortic
aneurysm. The diagnosis of endograft infection was established
radiologically by computed tomographic scans. After intravenous
administration of antibiotics and fluids to improve his clinical
condition, the patient underwent surgical excision of the infected
prosthesis and a bifurcated rifampicin-impregnated Dacron graft was
placed in situ. Cultures from the purulent fluid around the aorta and
from the endograft revealed development of Candida albicans. To our
knowledge, this is the first case of an infected endograft due to a
fungus. The patient died from septic shock 3 days postoperatively in the
intensive care unit
Surgical management of extracranial internal carotid aneurysms by cervical approach
Background: Extracranial internal carotid artery aneurysms (EICAA) are
rare vascular problems with a great potential for lethal thromboembolic
episodes.
Methods: From 1994 to 2004, nine patients with EICAA, seven men and two
women, were surgically treated for 10 aneurysms in our department.
Aneurysm led to hemispheric symptoms in six cases (two hemispheric
strokes and four hemispheric transient ischaemic attacks). The cause was
fibrodysplasia in two cases, atherosclerosis in four cases, trauma in
two cases and spontaneous dissection in two cases. All aneurysms were
treated surgically by the cervical approach using shunting. Extended
cervical approach was necessary in four patients with high-lying
aneurysms. Nine aneurysms were totally resected and successful
revascularization was carried out. Open aneurysmorrhaphy with vein patch
angioplasty was carried out in one case of a saccular aneurysm.
Results: There were no perioperative deaths or transient ischaemic
attacks or strokes. Four patients developed cranial nerve deficits: one
had hoarsness, two had partial facial paralysis (patients with extended
cervical approach) and one had tongue deviation. These neurological
symptoms were observed in large aneurysms (> 4.5 cm) and disappeared
within 14 months. No neurological complication was observed in a follow
up that ranged from 6 months to 10 years.
Conclusions: Surgical repair of EICAA, especially with total resection
and arterial reconstruction, is strongly recommended. Extended cervical
approach has many technical difficulties but can allow treatment of
high-lying aneurysms