1/119. A rare case of completely isolated duplication cyst of the alimentary tract.A rare case of a gastrointestinal cystic duplication in a 7-day-old infant is described. The duplication diagnosed antenataly at 25 weeks of gestation was found during surgery to be separated from the gastrointestinal tract, hanging on a vascular pedicle, with no connection to the mesentery. The duplication was excised, and postoperative follow-up of 14 months was uneventful. The possible pathogenesis of this malformation is discussed.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/119. Gasless laparoscopy under epidural anesthesia for adnexal cysts during pregnancy.OBJECTIVE: To evaluate laparoscopic adnexal cystectomy during pregnancy using an open technique with a whole abdominal wall-lift method under epidural anesthesia. STUDY DESIGN: Seven cases of adnexal cysts during pregnancy were resected using a gasless laparoscopic (extracorporeal) method with a whole abdominal wall-lift. We performed this procedure without using general anesthesia or CO2 pneumoperitoneum. RESULTS: All operations were performed successfully without complications. All patients resumed normal activity within one week. The subsequent antenatal courses of the patients were uneventful. There were no severe complications during the operations or postoperative courses. Six patients had vaginal deliveries of normal infants at term. No abnormal findings were found in the antenatal course of patient 7 until 30 weeks of gestation. CONCLUSION: Based on our limited experience, this procedure may be safe.- - - - - - - - - - ranking = 2.5260317045298keywords = gestation, pregnancy (Clic here for more details about this article) |
3/119. Haemorrhage into non-functioning adrenal cysts--report of two cases and review of the literature.Adrenal cysts are a rare condition and are usually non-functioning and asymptomatic. Most of the reported cases were incidental findings or discovered at autopsy. However, large cysts have a tendency to develop complications such as intracystic haemorrhage and rupture, which can present as an acute surgical emergency. We report two cases of adrenal cysts with intracystic haemorrhage. One patient presented with persistent non-specific upper abdominal pain, investigations with ultrasound (US) scan and computed tomographic (CT) scan revealed a left adrenal cyst and gallstones. Simultaneous cholecystectomy and adrenalectomy was performed with resultant relief of symptoms. The second patient presented with acute abdominal pain simulating acute surgical abdomen. Preoperative CT scan showed a large cystic lesion in the region of the tail of the pancreas with radiological evidence of haemorrhage but was unable to confirm its origin. The cyst was found to have arisen from the left adrenal gland at laparotomy; left adrenalectomy with complete excision of the cyst was done. histology showed pseudocyst with haemorrhage in both cases. Pseudocyst is the commonest histological type encountered clinically. We believe the second case is related to pregnancy and childbirth as the patient presented during puerperium and the cyst, even though very large in size (25 x 15 x 15 cm), was not noted during antenatal screening with US scan.- - - - - - - - - - ranking = 0.25433861742163keywords = pregnancy (Clic here for more details about this article) |
4/119. prenatal diagnosis of cystic bladder distension secondary to obstructive uropathy.We report the perinatal findings of a huge midline posterior cystic bladder distension secondary to lower urinary tract obstruction and prune-belly syndrome in a male fetus. A 40-year-old woman, gravida 3, para 0, was referred at 21 gestation weeks with sonographic findings of anhydramnios and a fetus with a 9.5 x 6.0 cm intra-abdominal cystic mass containing two chambers. The in utero ultrasound-guided fetal bladder drainage using a single needle aspiration and the ultrasound follow-ups of fetal bladder filling provided a diagnostic aid. This method helped to show the position of the bladder and the cystic bladder mass as well as the status of communication in response to decompression or filling of the fetal bladder. cytogenetic analysis revealed a 46,XY karyotype. autopsy showed agenesis of the posterior urethra, prominent megacystis, a cystically distended mass arising from the lower posterior bladder, hydronephrosis, megaureters, and anorectal agenesis with an intestinal blind end adherent to the posterior wall of the uterus. There were no urogenital duplication, hindgut duplication, or urachal abnormalities. The contracted bladder had a full-thickness muscular wall with a trigone and two ureteral orifices while the cystically distended bladder did not have any opening and was lined by a very thin wall. histology of the cystic bladder wall demonstrated typical urothelium, lamina propria and muscularis propria. The pathogenesis and differential diagnosis of cystic bladder distension are discussed.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
5/119. Spontaneous resolution of an in utero perirenal urinoma associated with posterior urethral valves.Ultrasound imaging of a 26-week-gestation fetus demonstrated a large, nonemptying bladder. At 27 weeks, a distended, thick-walled bladder, left hydronephrosis, and a perirenal urinoma were present, without ascites. observation was undertaken, as the amniotic fluid volume was normal. At 29 weeks, the left perirenal fluid collection persisted but, at 30 weeks, was absent. After delivery at 36 weeks, no ultrasound evidence for perirenal urinoma or ascites was present. Isotope renal scan showed preserved renal function bilaterally. This case illustrates that in utero urinomas associated with posterior urethral valves can resolve spontaneously, with preservation of renal function.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
6/119. Blake's pouch cyst: an entity within the Dandy-Walker continuum.Abnormal cerebrospinal fluid (CSF) collections within the posterior fossa are defined by the Dandy-Walker complex (DWC) and by arachnoid cysts (AC). The DWC includes the Dandy-Walker malformation (DWM), the Dandy-Walker variant (DWV) and the mega-cisterna magna (MCM). In addition, Tortori-Donati et al. added persistent Blake's pouch cyst (BPC) as an independent entity within the DWC. BPC represents a posterior ballooning of the superior medullary velum into the cisterna magna. All of these malformations are overlapping developmental anomalies characterized by varying degrees of malformation of the medullary vela, the cerebellar vermis and hemispheres, the fourth ventricle choroid plexus, the posterior fossa subarachnoid cisterns and the enveloping meningeal structures. We present two cases of persistent BPC detected in two adult women without history of gestational or subsequent growth problems. They underwent neuroradiological investigation because of headache and because of recurrent episodes of loss of consciousness, respectively. The MRI findings included tetraventricular hydrocephalus, wide communication of the fourth ventricle and the cystic posterior fossa (i.e. BPC), inferior posterior fossa mass effect with or without hypoplasia of both the cerebellar vermis and the medial aspects of the cerebellar hemispheres, and absence of communication between fourth ventricle and the basal subarachnoid space in the midline posteriorly. Persistent BPC is defined by a failure of embryonic assimilation of the area membranacea anterior within the tela choroidea associated with imperforation of the foramen of Magendie. Typically this condition becomes symptomatic early in life. In the current cases the normal function of the laterally positioned foramina of Luschka probably helped to maintain some CSF flow between intraventricular and subarachnoid spaces, with the establishment of a precarious equilibrium characterized by a compensatory enlargement of the cerebral ventricular system (i.e. hydrocephalus).- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
7/119. Endodermal cyst of septum pellucidum and pregnancy: a case report.BACKGROUND: Endodermal or Neurenteric cysts are commonly found in spine. Their intracranial occurrence is rare and such a cyst in the septum pellucidum is exceptional.METHOD: We report a woman, with 33 week pregnancy, presenting in a semiconscious state due to raised intracranial pressure (ICP) due to hydrocephalus caused by a large lesion in the septum pellucidum. Computed tomography (CT) revealed the lesion which was better characterised by the magnetic resonance imaging (MRI). First baby was delivered by LSCS and bilateral ventriculo-peritoneal shunts were inserted; and later on the cyst was excised.RESULT: There was full neurological recovery following the insertion of VP shunt. After excision of cyst cerebrospinal fluid (CSF) pathway was established and shunts could be removed. Post-operative period was complicated by septic ventriculitis. Eventually patient was discharged home in excellent condition. CONCLUSION: Endodermal cyst of septum pellucidum is an uncommon condition. Such lesions may be large when revealed, good outcome is expected after surgical excision.- - - - - - - - - - ranking = 1.2716930871081keywords = pregnancy (Clic here for more details about this article) |
8/119. Omphalocele and umbilical cord cyst. prenatal diagnosis.We present a case of intrauterine fetal death at 32 week's gestation with omphalocele, umbilical cord allantoic cyst and polyhydramnios. Ultrasound diagnosis of anomalies was performed at 23 weeks of gestation. Fetal karyotype was normal: 46 XX. This association has been found to have a high rate of chromosomal abnormalities, especially trisomy 18. It's difficult to explain the reason why intrauterine fetal death has happened; one possible hypothesis is that the cord cyst, compressing umbilical vessels, have caused intrauterine vascular compromise of blood flow.- - - - - - - - - - ranking = 2keywords = gestation (Clic here for more details about this article) |
9/119. Persistent large choroid plexus cyst. A case report.BACKGROUND: Prenatally diagnosed choroid plexus cysts regress or resolve spontaneously during pregnancy. A persistent large choroid plexus cyst with a prenatal diagnosis has not been reported previously. CASE: A 28-year-old, healthy primigravida was referred to our department at 32 weeks' gestation for a suspected fetal intracranial anomaly. ultrasonography revealed a lateral ventricle 13 mm in width. The ventricle was dilated only in the atrium region. The choroid plexus was not distinct from the inner wall of the ventricle and did not fill the atrium of the lateral ventricle. The patient was followed with bi-weekly ultrasonography until delivery, and the left ventricular width increased from 13 to 17 mm. At 38 weeks' gestation the patient delivered a 3,350-g girl. magnetic resonance imaging showed a 1.7 x 2.5 x 3.0-cm cyst in the left lateral ventricle. Follow-up magnetic resonance imaging scans at 6 and 11 months showed unchanged findings. Clinical and neurologic examinations at 11 months of age showed normal development. CONCLUSION: Although small (< 1 cm), postnatally persistent choroid plexus cysts are clinically insignificant variants of normal; the prognosis of large, persistent cysts (> or = 1 cm) is less clear. Long-term neurologic follow-up is mandatory for these neonates.- - - - - - - - - - ranking = 2.2543386174216keywords = gestation, pregnancy (Clic here for more details about this article) |
10/119. prenatal diagnosis and follow up of congenital splenic cyst: a case report.We report a case of congenital splenic cyst that was identified by prenatal sonography at 25 gestational weeks. Serial scans demonstrated an increase in size during the prenatal period but after birth the cyst progressively decreased in size until its complete regression at 6 months of age.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
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