Endoscopic Management of Dysphagia in Plummer–Vinson syndrome

Plummer‑Vinson syndrome (PVS), (also called Paterson‑Brown‑Kelly syndrome or sideropenic dysphagia) is an extremely rare syndrome which includes iron-deficiency anemia, dysphagia, and esophageal webs. If left untreated, progressive dysphagia can supervene and the patient is at risk of developing pharyngeal or esophageal squamous-cell carcinoma. Treatment consists of supplementation of iron and endoscopic dilations or surgery for the esophageal web. We describe the case of a 17-year-old women with Plummer- Vinson syndrome whose dysphagia was successfully treated with endoscopic dilation. She remains in good general condition 3 months after treatment

Ultrasound Can Facilitate Percutaneous Endoscopic Gastrostomy Tube Insertion in the Non-Transilluminated Abdominal Wall

Percutaneous endoscopic gastrostomy (PEG), first described in the 1980s, is an enteral nutrition route used for long-term nutrition in patients who cannot be fed by mouth for various reasons but have no gastrointestinal disturbance. It is inserted percutaneously into the stomach with the aid of an endoscope. However, the light of the scope may not be seen in some patients due to certain reasons (obesity, prior operations). In this case, it is not safe to send the needle through the abdominal wall. Ultrasound can facilitate the procedure and also reduce adjacent organ injury

Rectus sheath hematoma: three case reports

<p>Abstract</p> <p>Introduction</p> <p>Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen.</p> <p>Case presentation</p> <p>We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment.</p> <p>Conclusion</p> <p>Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.</p

A comparison of perioperative outcomes in elderly patients with malignant liver tumors undergoing laparoscopic liver resection versus radiofrequency ablation

Liver resection is the treatment option with the best chance for cure in patients with malignant liver tumors. However, there are concerns regarding postoperative recovery in elderly patients, which may lead to a preference of non-resectional therapies over hepatectomy in this patient population. Although laparoscopic liver resection (LLR) is associated with a faster recovery compared to open hepatectomy, there are scant data on how elderly patients tolerate LLR. The aim of this study was to analyze the perioperative outcomes of LLR in elderly patients with hepatic malignancies, with a comparison to laparoscopic RFA (LRFA)

A New Technique of Radiofrequency-assisted Ultrasound-guided Needle-localized Laparoscopic Resection of Disappearing Colorectal Liver Metastases

The management of disappearing colorectal liver metastases in the postadjuvant chemotherapy setting is challenging. We describe a novel technique that facilitates laparoscopic resection of disappearing metastatic liver lesions with great precision. Details of this new technique are described in 2 patients with colorectal cancer synchronously metastatic to the liver. Both patients had small indistinct intraparenchymal liver lesions after adjuvant chemotherapy. A video displays the steps of the procedure. Both patients presented with colorectal cancer with synchronous liver metastasis. They received FOLFOX regimen after resection of their primary. They both responded to adjuvant chemotherapy. On repeat posttreatment imaging, the liver lesions became smaller and indistinct. With laparoscopic ultrasound, subtle parenchymal heterogeneities were identified. The lesions were initially ablated with a wide radiofrequency ablation zone. Then, without removing the needle, the prongs were deployed to the borders of the parenchymal heterogeneity. Using an ultrasonic vessel sealer, the lesions were resected. Final pathology identified 1 viable focus of cancer in each patient. Both patients were discharged home uneventfully on their second postoperative day. There were no complications. We have described a novel technique that could facilitate precise resection of intraparenchymal small indistinct or disappearing liver metastases of colorectal origin. This option should be kept within the armamentarium of the laparoscopic liver surgeon managing patients with malignant liver tumors

Laparoscopic management of liver metastases from uveal melanoma

Background Although uveal melanoma is a rare disease, its metastasis to the liver is associated with a poor survival. The aim of this study is to analyze the survival after surgical treatment of uveal melanoma metastases to the liver

Oncologic results of laparoscopic liver resection for malignant liver tumors

BackgroundThere are scant data regarding oncologic outcomes of laparoscopic liver resection (LLR). The aim of this study is to analyze the oncologic outcomes of LLR for malignant liver tumors (MLT)