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AbstractPituitary adenomas are commonly benign neoplasms which may manifest with a wide variety of symptomatology. Typically, ACTH- producing tumors of the pituitary gland present with central fat deposition, abdominal striae, moon facies, buffalo hump, osteoporosis, hypertension, hirsutism, gonadal dysfunction, immunosuppression, and less commonly with hyperglycemia due to insulin resistance. We report the case of a 58-year-old male patient with an ACTH producing pituitary microadenoma and type...
AbstractLinitis plastica refers to the diffuse submucosal spread of scirrhous carcinoma in a hollow organ, resulting in constriction and inelasticity of the organ. It is best known to occur in the stomach. Linitis plastica of the colon is rare, and more commonly occurs in the rectum and sigmoid colon from metastatic gastric or breast cancer. We report a case of linitis plastica of the ascending colon in a 69-year-old female as the initial presentation of ovarian carcinoma. Luminal narrowing, poor...
Experience of using a spray-type anti-adhesion barrier in laparoscopic surgery for colorectal cancer
AbstractLaparoscopic surgery has spread worldwide and become a standard procedure among many abdominal surgical fields. The incidence of postoperative adhesion, which is a typical postoperative complication, is considered low compared with that after laparotomy. However, once complications develop, such as adhesion-induced intestinal obstruction and chronic abdominal pain, the low-invasiveness of laparoscopic surgery can decrease markedly. While we have previously used a sheet-type anti-adhesion...
AbstractNecrobiosis lipoidica is an idiopathic dermatosis of unknown origin, occurring mainly in patients with diabetes. Splenic abscesses are rare entities. We report a case with concomitant necrobiosis lipoidica and splenic abscess. A 58-year-old man presented to emergency center with a two day history of left upper abdominal pain, general malaise, and pyrexia. On both lower legs the patient had skin lesions. The contrast-enhanced computed tomography of the abdomen revealed splenomegaly and splenic...
AbstractExocrine cancer of pancreas is the fourth leading cause of death in the USA among both men and women. Contrast enhanced multidetector-row computer tomography (MDCT) is the current modality of choice for the detection of distant metastasis in pancreatic cancer as a part of pre-operative workup, which helps decide on resectability. Authors present a first ever reported case of an incidental liver metastasis found on intra-operative wedge hepatic biopsy during Whipple's procedure for pancreatic...
AbstractDespite the advances in the surgical techniques and technology in colorectal surgery, the development of rectal anastomotic stricture is a common problem. In some case series, the incidence is estimated to be as high as 30%. Some of the known risk factors for developing a stricture include anastomotic leak and ischemia. Treatment options range from frequent dilations using digital rectal examinations and dilators if the stricture is low or endoscopic balloon dilations for higher strictures....
AbstractSitus inversus totalis (SIT) is rare congenital anomaly characterized by an inversion of the thoracic and abdominal viscera that crates a mirror image. Recently, several laparoscopic operations have been reported in patients with SIT. We herein report the case of a 76-year-old woman with ascending colon cancer who received a laparoscopic right colectomy. She was discharged on the 12th day after the operation, without any complications. Laparoscopic surgery in the patients with SIT remains...
AbstractPulmonary artery sarcoma is a rare and highly malignant neoplasm. Early diagnosis and a multidisciplinary approach including surgical treatment and optimal medical therapy could prolong survival. Since the clinical symptoms and imaging findings of pulmonary artery sarcoma mimic pulmonary embolism, definitive diagnosis and surgical intervention are often delayed. In this report, a case of pulmonary artery sarcoma that was initially misdiagnosed as pulmonary embolism is presented.
AbstractEwing's sarcoma is a rare and aggressive tumor which classified as peripheral primitive neuroectodermal tumor. It commonly arises in the long bones of the extremities and rarely in the head and neck region. Localization of the sinonasal tract is a rare occurrence thus the number of clinical studies published in the literature are limited. The diagnosis of this tumor requires a histopathological examination, immunohistochemistry and cytogenetic analysis. Ewing's sarcomas are characterized...
AbstractSplenic rupture in the absence of major trauma is a rare occurrence, which may occur by idiopathic means or a specific pathologic process. One such condition, amyloidosis, involves the extracellular deposition of abnormally folded 'amyloid' protein, which can affect the spleen. Protein infiltration in the organ may cause splenomegaly and potentially capsular rupture in advanced cases. We describe a 68-year-old male with a history of end-stage renal disease status-post living donor renal transplant...
AbstractIncidental appendiceal neuroendocrine tumors (ANETs) occur in 0.2–0.7% of surgical resections for suspected appendicitis (Moris, Tsilimigras, Vagios, Ntanasis-stathopoulos, Karachaliou, Papalampros, et al. Neuroendocrine neoplasms of the appendix: a review of the literature. Anticancer Res [Internet]. 2018;38:601–11.). It's a rare entity, clinically challenging and has controversy surrounding its management. A 69-year-old male presented to our clinic with acute right lower quadrant abdominal...
AbstractA case of a newly diagnosed calcified gallbladder cancer is presented, who had pre-existing porcelain gallbladder. Due to the advanced stage of the disease at presentation, the patient had a poor outcome. The investigation and management of gallbladder carcinoma is discussed as well as the relationship with porcelain gallbladder. We conclude that there is only a weak association between porcelain gallbladder and gallbladder cancer, but because gallbladder cancer typically presents late, a...
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Publication date: Available online 29 March 2019Source: Journal of Surgical EducationAuthor(s): Alaina D. Geary, Donald T. Hess, Luise I.M. PernarObjectiveTeaching medical students and junior residents are key components of a surgical resident's role. How surgical residents are formally prepared for their teaching role is not well described. The aim of this study was to characterize the status of formal Resident-as-Teacher Programs (RATPs) in U.S. general surgery residency programs. We also sought...
Publication date: Available online 28 March 2019Source: Journal of Surgical EducationAuthor(s): Valerio Celentano, Karen G. FlashmanIntroductionThe inflammation encountered in Crohn's disease makes a minimally invasive approach challenging due to a thickened mesentery, fistulas, abscesses, and large phlegmons with high reported rates of conversion and septic complications. Aim of this study was to evaluate the feasibility of a stepwise approach to training in laparoscopic surgery for complex Crohn's...
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Publication date: Available online 29 March 2019Source: Journal of the American College of SurgeonsAuthor(s): Hunter B. Moore, Ernest E. Moore, Michael P. Chapman, Kirk Hansen, Mitchel J. Cohen, Frederic M. Pieracci, James Chandler, Angela SauaiaAbstractBackgroundElevated D-Dimers in injured patients with paradoxically low fibrinolysis activity measured by viscoelastic assays has been speculated to be "occult" fibrinolysis. However, an alternative explanation is these patients have previously activated...
Publication date: Available online 29 March 2019Source: Journal of the American College of SurgeonsAuthor(s): Nabil Wasif, Matthew Neville, Richard Gray, Patricia Cronin, Barbara A. PockajAbstractBackgroundThe majority of newly diagnosed breast cancer in the United States is in women older than 65 years who may have additional co-morbidities. Balancing the risks and benefits of treatment should take into account these competing risks of death.Study DesignThe SEER-Medicare database was used to identify...
Publication date: Available online 28 March 2019Source: Journal of the American College of SurgeonsAuthor(s): Rebekah A. Campbell, Derek S. Young, Courtney N. Shaver, Samuel K. Snyder, Stacey A. Milan, Terry C. Lairmore, Douglas K. McDonaldAbstractBackgroundPatients with primary aldosteronism undergo imaging of the adrenal glands after confirmation of the disease. Adrenal venous sampling (AVS) is a useful adjunct to imaging, and advocates believe that AVS should be performed prior to surgical management....
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