This document presents 6 case studies of patients with pseudocyst of the pancreas. It describes the patients' presentations, diagnostic evaluations, treatments and outcomes. The document also provides background information on pseudocysts including definition, risk factors, clinical features, diagnostic evaluations and treatment options. It concludes that pancreatic pseudocysts are increasingly detected due to improved imaging but often asymptomatic, and the decision to treat depends on symptoms, complications or need to rule out other pathology. Intervention may include endoscopic or surgical drainage procedures.
The document discusses strategies for performing safe laparoscopic cholecystectomy, including obtaining the critical view of safety, using intraoperative cholangiography to help identify biliary anatomy, and employing bailout techniques such as partial or subtotal cholecystectomy if the critical view cannot be achieved to avoid potential bile duct injuries. It also describes error traps that can lead to injuries and strategies surgeons should follow to promote a culture of safety in laparoscopic cholecystectomy.
A 42-year-old male presented with abdominal pain for 20 days. Medical history revealed a past diagnosis of pancreatitis. Physical examination found a vague mass palpable in the epigastric and left hypochondrium region. Imaging studies including ultrasound and CT scan identified a cystic structure along the head and tail of the pancreas, with one cyst extending into the mediastinum. The patient underwent a laparotomy with roux-en-y cystojejunostomy to drain a pseudocyst measuring 15x12 cm communicating with a 10x8 cm cyst. Post-operative recovery was uneventful.
All you need to know about peri-ampullary cancer
Periampullary cancer is a common diagnosis with patient with progressive jaundice in northern part of India
Timely diagnosis and proper treatment in a way towards cure
The document describes various medical imaging tests and their findings and indications. It discusses x-rays of the chest, esophagus, stomach and intestines. It also mentions barium enema tests, mammograms, angiograms and other imaging exams along with what they show and what conditions they can help evaluate.
Primary retroperitoneal tumors are rare neoplasms that arise in the retroperitoneum and pelvis. Liposarcoma is the most common type of primary retroperitoneal tumor, while lymphoma is the most common retroperitoneal malignancy overall. These tumors often grow extensively before causing symptoms. Diagnostic imaging includes CT or MRI to evaluate the tumor characteristics and relationship to surrounding structures. Surgical resection with negative margins is the standard treatment for localized primary retroperitoneal sarcomas, while chemotherapy or radiation may be used in certain settings. Prognosis depends on tumor grade, stage, and ability to achieve a complete resection.
The patient presented with a large cystic mass in the pancreas. Imaging showed a 18.8x11cm pseudo cyst in the body and tail of the pancreas. Pseudo cysts are the most common cystic lesions of the pancreas, arising due to pancreatic duct disruption from acute or chronic pancreatitis. The patient underwent a cystogastrostomy to drain the cyst, as the cyst was large and causing symptoms. The procedure went smoothly and the patient recovered well.
Bile duct injury is a rare but potentially devastating complication of cholecystectomy that can result in biliary peritonitis, sepsis, and cirrhosis. It is most commonly caused by misidentification of structures during laparoscopic cholecystectomy. Management involves controlling infection, delineating biliary anatomy, and reestablishing biliary drainage, usually through surgical hepaticojejunostomy. Prevention relies on identification of anatomical variations, achieving a "critical view of safety" before duct division, and open conversion if needed. Proper management requires a multidisciplinary approach between surgeons, radiologists, and gastroenterologists.
This document discusses the management of common bile duct (CBD) stones. It begins by describing the causes, symptoms, signs, and diagnosis of CBD stones. CBD stones can be primary (formed in the duct) or secondary (passed from the gallbladder). Diagnosis involves blood tests, ultrasound, MRCP, and ERCP. Treatment depends on whether stones are detected before, during, or after cholecystectomy. Options include ERCP sphincterotomy and stone extraction, laparoscopic CBD exploration, open CBD exploration, and surgery like choledochoduodenostomy. For retained stones, additional options are extracting through a T-tube or dissolving chemically. The goal is to remove stones using the least
The document discusses strategies for performing safe laparoscopic cholecystectomy, including obtaining the critical view of safety, using intraoperative cholangiography to help identify biliary anatomy, and employing bailout techniques such as partial or subtotal cholecystectomy if the critical view cannot be achieved to avoid potential bile duct injuries. It also describes error traps that can lead to injuries and strategies surgeons should follow to promote a culture of safety in laparoscopic cholecystectomy.
A 42-year-old male presented with abdominal pain for 20 days. Medical history revealed a past diagnosis of pancreatitis. Physical examination found a vague mass palpable in the epigastric and left hypochondrium region. Imaging studies including ultrasound and CT scan identified a cystic structure along the head and tail of the pancreas, with one cyst extending into the mediastinum. The patient underwent a laparotomy with roux-en-y cystojejunostomy to drain a pseudocyst measuring 15x12 cm communicating with a 10x8 cm cyst. Post-operative recovery was uneventful.
All you need to know about peri-ampullary cancer
Periampullary cancer is a common diagnosis with patient with progressive jaundice in northern part of India
Timely diagnosis and proper treatment in a way towards cure
The document describes various medical imaging tests and their findings and indications. It discusses x-rays of the chest, esophagus, stomach and intestines. It also mentions barium enema tests, mammograms, angiograms and other imaging exams along with what they show and what conditions they can help evaluate.
Primary retroperitoneal tumors are rare neoplasms that arise in the retroperitoneum and pelvis. Liposarcoma is the most common type of primary retroperitoneal tumor, while lymphoma is the most common retroperitoneal malignancy overall. These tumors often grow extensively before causing symptoms. Diagnostic imaging includes CT or MRI to evaluate the tumor characteristics and relationship to surrounding structures. Surgical resection with negative margins is the standard treatment for localized primary retroperitoneal sarcomas, while chemotherapy or radiation may be used in certain settings. Prognosis depends on tumor grade, stage, and ability to achieve a complete resection.
The patient presented with a large cystic mass in the pancreas. Imaging showed a 18.8x11cm pseudo cyst in the body and tail of the pancreas. Pseudo cysts are the most common cystic lesions of the pancreas, arising due to pancreatic duct disruption from acute or chronic pancreatitis. The patient underwent a cystogastrostomy to drain the cyst, as the cyst was large and causing symptoms. The procedure went smoothly and the patient recovered well.
Bile duct injury is a rare but potentially devastating complication of cholecystectomy that can result in biliary peritonitis, sepsis, and cirrhosis. It is most commonly caused by misidentification of structures during laparoscopic cholecystectomy. Management involves controlling infection, delineating biliary anatomy, and reestablishing biliary drainage, usually through surgical hepaticojejunostomy. Prevention relies on identification of anatomical variations, achieving a "critical view of safety" before duct division, and open conversion if needed. Proper management requires a multidisciplinary approach between surgeons, radiologists, and gastroenterologists.
This document discusses the management of common bile duct (CBD) stones. It begins by describing the causes, symptoms, signs, and diagnosis of CBD stones. CBD stones can be primary (formed in the duct) or secondary (passed from the gallbladder). Diagnosis involves blood tests, ultrasound, MRCP, and ERCP. Treatment depends on whether stones are detected before, during, or after cholecystectomy. Options include ERCP sphincterotomy and stone extraction, laparoscopic CBD exploration, open CBD exploration, and surgery like choledochoduodenostomy. For retained stones, additional options are extracting through a T-tube or dissolving chemically. The goal is to remove stones using the least
This document discusses surgical considerations for rectal cancer, including:
1. The total mesorectal excision (TME) technique aims to remove the mesorectum containing all lymph nodes, leading to low local recurrence rates of 3-4% after 5-10 years.
2. Pre-operative chemoradiotherapy can downstage tumours and improve survival, especially for T3/T4 tumours.
3. A modified TME removing the mesorectum at least 5cm below the tumour is acceptable for high and mid rectal cancers, as distal spread beyond this is rare.
4. Good surgical outcomes depend on meticulous technique, surgeon experience operating in the pelvis, and multidis
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
Biliary stricture is an abnormal narrowing of the bile duct. The most common cause is injury during cholecystectomy, accounting for 80% of non-malignant strictures. Bile duct injury can cause inflammation, fibrosis, scarring, and cirrhosis. Surgical treatment depends on when the injury is recognized, with immediate repair during surgery or delayed repair weeks later being options. Roux-en-Y hepaticojejunostomy is a common repair method that involves a mucosa-to-mucosa anastomosis of the bile duct to the jejunum. Factors like multiple prior repairs, proximal strictures, and surgeon inexperience can lead to poor outcomes.
This document provides an overview of the management of obstructive jaundice. It begins with definitions and classifications of jaundice. Obstructive jaundice can be intrahepatic or extrahepatic in origin. Common causes of intrahepatic cholestasis include viral hepatitis, alcoholic hepatitis, and drug toxicity. Extrahepatic obstructions are often due to choledocholithiasis (gallstones in the common bile duct), tumors, or strictures. Diagnostic imaging includes ultrasound, MRCP, ERCP, and intraoperative cholangiography. Treatment depends on whether the obstruction is pre-operative or discovered during cholecystectomy, and may involve ERCP, laparoscopic or open CBD exploration, or
1. The document discusses various types of pancreatic and biliary cancers including carcinoma of the head of pancreas, periampullary carcinoma, cholangiocarcinoma, and carcinoma of the gallbladder.
2. Treatment options are discussed including surgical resection procedures like the Whipple procedure or palliative options for unresectable tumors focusing on relieving jaundice, pain, or duodenal obstruction.
3. Complications of resection and palliative procedures are also summarized along with prognosis for different tumor types and stages.
This document discusses liver lesions and their appearance on various imaging modalities. It covers benign lesions like hemangioma, focal nodular hyperplasia and hepatic adenoma. Malignant primary lesions discussed are hepatocellular carcinoma and hepatoblastoma. Imaging features of hypervascular and hypovascular lesions on multiphasic CT are summarized. Hepatocellular carcinoma risk factors and clinical presentation are outlined. Imaging appearance of HCC on ultrasound, CT and MRI is described in detail. Hepatic metastases are also discussed along with hypervascular metastatic lesions.
This document provides guidance on the management of CBD injuries. It discusses:
- Recognizing injuries during or after cholecystectomy and appropriate next steps like drain placement or referral.
- Surgical repair approaches like end-to-end anastomosis or biliary enteric procedures depending on the type and location of injury.
- Managing injuries presenting later as biliary strictures or leaks, often through staged approaches using external drainage first.
- Techniques for different stricture types, including exposing healthy ducts proximally and creating mucosa-to-mucosa anastomoses to distal conduits.
A 34-year-old male presented with a 1-year history of a painless, progressively enlarging mass above the umbilicus. Examination revealed a 2x2 cm reducible swelling above the umbilicus that increased in size with coughing. Imaging showed a paraumbilical hernia. The patient underwent hernioplasty using an anatomical repair with mesh placement. Post-operatively, the patient recovered well without complications.
This document discusses the management of pancreatic fistulas. It defines pancreatic fistulas as leakage of pancreatic fluid resulting from pancreatic duct obstruction, which can be iatrogenic such as from surgery or ERCP, or non-iatrogenic due to conditions like pancreatitis. Initial management involves controlling pancreatic secretions with drain placement or TPN, correcting electrolyte imbalances, and evaluating the pancreatic duct with imaging. Most fistulas close spontaneously with drainage alone. For persistent fistulas, octreotide can help while ERCP with stenting has closure rates over 80%. Surgery is reserved for failures of other methods and involves duct decompression or resection. Risk factors for postoperative fistulas include duct size, texture, jaundice, and
1. A 60-year-old male presented with yellowish discoloration of the eye, itching all over the body, pale stools, loss of appetite, and weight loss.
2. Obstructive jaundice and periampullary carcinoma were suspected given his age, painless progressive jaundice, pruritis, pale stools, and weight loss.
3. Key clinical features of obstructive jaundice include jaundice, intense pruritis, pale stools, loss of appetite and weight in patients typically aged 50-70 years.
Management of enterocutaneous fistulas involves several phases:
1) Recognition and stabilization including resuscitation, controlling sepsis and drainage, nutrition support, and skin care.
2) Investigation using fistulograms and CT scans to define the fistula anatomy and underlying pathology.
3) Decision on management which depends on factors predicting spontaneous closure like output, nutrition status and bowel health.
4) Definitive surgery including bowel resection and anastomosis if needed, otherwise a staged approach with bypass.
5) Post-surgical recovery focusing on preventing recurrent fistula and hernia.
Periampullary carcinoma refers to cancers that form near the ampulla of Vater. The four main types are adenocarcinoma of the pancreatic head, ampullary tumors, distal bile duct carcinomas, and duodenal carcinomas adjacent to the ampulla. Evaluation involves imaging like CT, MRI, and EUS to determine resectability. Resectable tumors are treated with surgery followed by chemotherapy, while borderline resectable tumors receive chemotherapy and radiation before surgery. Unresectable tumors are treated with chemotherapy and/or radiation. Adjuvant chemotherapy may improve survival for resected cancers.
This document summarizes information about pancreatic pseudocysts. It defines pancreatic pseudocysts as fluid collections contained by fibrous tissue that develop more than 4 weeks after acute or chronic pancreatitis. It describes the typical location, composition, and pathophysiology of pseudocysts. It also outlines the clinical presentation, diagnostic approach, natural history, potential complications, and treatment options for pancreatic pseudocysts, including percutaneous drainage, endoscopic drainage, and surgical drainage. The preferred intervention is typically endoscopic drainage given its less invasive nature, though surgery may be necessary for complicated or failed non-surgical cases.
LC is one most of laparoscopic surgery that general surgery resident should to achieving before graduate the training.This slide is referenced from SAGES technique.
The patient, a 65-year-old male, presented with rectal prolapse that had been progressively worsening over 10 days. Examination found a circumferential, reducible prolapse of rectal mucosa. The patient underwent a laparoscopic ventral mesh rectopexy procedure without complications and was recovering well on post-operative day 4 with no new issues.
Carcinoma rectum the complete aproach to how to investigate and treat a case ...nikhilameerchetty
this is a complete guide to the understanding of the anatomy clinical features and the latest investigation to the most modern methods of treating the case of carcinoma rectum , all the latest journal published and the ongoing trials hav been searched and incorporated
The Life Skills Institute is asking for a set of pilot user groups to come forward from business incubators and new businesses. Together we can make a difference to your confidence level as you set off on your journey. Cutting through jargon, giving 'rule of thumb' instructions, and personal resilience tools, this is designed for all, but particularly keeps in mind the way women seem to learn best - through articulation and self testing.
This document discusses surgical considerations for rectal cancer, including:
1. The total mesorectal excision (TME) technique aims to remove the mesorectum containing all lymph nodes, leading to low local recurrence rates of 3-4% after 5-10 years.
2. Pre-operative chemoradiotherapy can downstage tumours and improve survival, especially for T3/T4 tumours.
3. A modified TME removing the mesorectum at least 5cm below the tumour is acceptable for high and mid rectal cancers, as distal spread beyond this is rare.
4. Good surgical outcomes depend on meticulous technique, surgeon experience operating in the pelvis, and multidis
A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer
Biliary stricture is an abnormal narrowing of the bile duct. The most common cause is injury during cholecystectomy, accounting for 80% of non-malignant strictures. Bile duct injury can cause inflammation, fibrosis, scarring, and cirrhosis. Surgical treatment depends on when the injury is recognized, with immediate repair during surgery or delayed repair weeks later being options. Roux-en-Y hepaticojejunostomy is a common repair method that involves a mucosa-to-mucosa anastomosis of the bile duct to the jejunum. Factors like multiple prior repairs, proximal strictures, and surgeon inexperience can lead to poor outcomes.
This document provides an overview of the management of obstructive jaundice. It begins with definitions and classifications of jaundice. Obstructive jaundice can be intrahepatic or extrahepatic in origin. Common causes of intrahepatic cholestasis include viral hepatitis, alcoholic hepatitis, and drug toxicity. Extrahepatic obstructions are often due to choledocholithiasis (gallstones in the common bile duct), tumors, or strictures. Diagnostic imaging includes ultrasound, MRCP, ERCP, and intraoperative cholangiography. Treatment depends on whether the obstruction is pre-operative or discovered during cholecystectomy, and may involve ERCP, laparoscopic or open CBD exploration, or
1. The document discusses various types of pancreatic and biliary cancers including carcinoma of the head of pancreas, periampullary carcinoma, cholangiocarcinoma, and carcinoma of the gallbladder.
2. Treatment options are discussed including surgical resection procedures like the Whipple procedure or palliative options for unresectable tumors focusing on relieving jaundice, pain, or duodenal obstruction.
3. Complications of resection and palliative procedures are also summarized along with prognosis for different tumor types and stages.
This document discusses liver lesions and their appearance on various imaging modalities. It covers benign lesions like hemangioma, focal nodular hyperplasia and hepatic adenoma. Malignant primary lesions discussed are hepatocellular carcinoma and hepatoblastoma. Imaging features of hypervascular and hypovascular lesions on multiphasic CT are summarized. Hepatocellular carcinoma risk factors and clinical presentation are outlined. Imaging appearance of HCC on ultrasound, CT and MRI is described in detail. Hepatic metastases are also discussed along with hypervascular metastatic lesions.
This document provides guidance on the management of CBD injuries. It discusses:
- Recognizing injuries during or after cholecystectomy and appropriate next steps like drain placement or referral.
- Surgical repair approaches like end-to-end anastomosis or biliary enteric procedures depending on the type and location of injury.
- Managing injuries presenting later as biliary strictures or leaks, often through staged approaches using external drainage first.
- Techniques for different stricture types, including exposing healthy ducts proximally and creating mucosa-to-mucosa anastomoses to distal conduits.
A 34-year-old male presented with a 1-year history of a painless, progressively enlarging mass above the umbilicus. Examination revealed a 2x2 cm reducible swelling above the umbilicus that increased in size with coughing. Imaging showed a paraumbilical hernia. The patient underwent hernioplasty using an anatomical repair with mesh placement. Post-operatively, the patient recovered well without complications.
This document discusses the management of pancreatic fistulas. It defines pancreatic fistulas as leakage of pancreatic fluid resulting from pancreatic duct obstruction, which can be iatrogenic such as from surgery or ERCP, or non-iatrogenic due to conditions like pancreatitis. Initial management involves controlling pancreatic secretions with drain placement or TPN, correcting electrolyte imbalances, and evaluating the pancreatic duct with imaging. Most fistulas close spontaneously with drainage alone. For persistent fistulas, octreotide can help while ERCP with stenting has closure rates over 80%. Surgery is reserved for failures of other methods and involves duct decompression or resection. Risk factors for postoperative fistulas include duct size, texture, jaundice, and
1. A 60-year-old male presented with yellowish discoloration of the eye, itching all over the body, pale stools, loss of appetite, and weight loss.
2. Obstructive jaundice and periampullary carcinoma were suspected given his age, painless progressive jaundice, pruritis, pale stools, and weight loss.
3. Key clinical features of obstructive jaundice include jaundice, intense pruritis, pale stools, loss of appetite and weight in patients typically aged 50-70 years.
Management of enterocutaneous fistulas involves several phases:
1) Recognition and stabilization including resuscitation, controlling sepsis and drainage, nutrition support, and skin care.
2) Investigation using fistulograms and CT scans to define the fistula anatomy and underlying pathology.
3) Decision on management which depends on factors predicting spontaneous closure like output, nutrition status and bowel health.
4) Definitive surgery including bowel resection and anastomosis if needed, otherwise a staged approach with bypass.
5) Post-surgical recovery focusing on preventing recurrent fistula and hernia.
Periampullary carcinoma refers to cancers that form near the ampulla of Vater. The four main types are adenocarcinoma of the pancreatic head, ampullary tumors, distal bile duct carcinomas, and duodenal carcinomas adjacent to the ampulla. Evaluation involves imaging like CT, MRI, and EUS to determine resectability. Resectable tumors are treated with surgery followed by chemotherapy, while borderline resectable tumors receive chemotherapy and radiation before surgery. Unresectable tumors are treated with chemotherapy and/or radiation. Adjuvant chemotherapy may improve survival for resected cancers.
This document summarizes information about pancreatic pseudocysts. It defines pancreatic pseudocysts as fluid collections contained by fibrous tissue that develop more than 4 weeks after acute or chronic pancreatitis. It describes the typical location, composition, and pathophysiology of pseudocysts. It also outlines the clinical presentation, diagnostic approach, natural history, potential complications, and treatment options for pancreatic pseudocysts, including percutaneous drainage, endoscopic drainage, and surgical drainage. The preferred intervention is typically endoscopic drainage given its less invasive nature, though surgery may be necessary for complicated or failed non-surgical cases.
LC is one most of laparoscopic surgery that general surgery resident should to achieving before graduate the training.This slide is referenced from SAGES technique.
The patient, a 65-year-old male, presented with rectal prolapse that had been progressively worsening over 10 days. Examination found a circumferential, reducible prolapse of rectal mucosa. The patient underwent a laparoscopic ventral mesh rectopexy procedure without complications and was recovering well on post-operative day 4 with no new issues.
Carcinoma rectum the complete aproach to how to investigate and treat a case ...nikhilameerchetty
this is a complete guide to the understanding of the anatomy clinical features and the latest investigation to the most modern methods of treating the case of carcinoma rectum , all the latest journal published and the ongoing trials hav been searched and incorporated
The Life Skills Institute is asking for a set of pilot user groups to come forward from business incubators and new businesses. Together we can make a difference to your confidence level as you set off on your journey. Cutting through jargon, giving 'rule of thumb' instructions, and personal resilience tools, this is designed for all, but particularly keeps in mind the way women seem to learn best - through articulation and self testing.
This document promotes invitation cards from a website called Happy Invitation for anniversary parties. It emphasizes that invitations are important to set the tone for a celebration and introduce the party theme to guests. The document includes the website URL and encourages making presentations more fun.
This document provides information about Alytus Kindergarten "Tale" in Lithuania, including:
1) It was established in 1967 and has had three directors over its history.
2) In 1985 it underwent major repairs and in 1997 and 2002 it was renovated.
3) It currently has 10 groups totaling 175 children from ages 1-6, and employs 18 teachers to provide preschool education programs and promote health, ethnicity, social skills, and substance abuse prevention.
4) The kindergarten aims to nurture children's development and prepare them for school through various programs, activities, and community outreach events.
Este documento contiene las autobiografías de 5 estudiantes: Daniel Alexander, Carla Alejandra, Pablo Roberto, Carlos Ulises y sus respectivas edades, lugares de origen, aspiraciones y experiencias de vida. Cada uno presenta información personal como su nombre, edad, familia y algunos detalles sobre sus gustos e intereses.
The document discusses the production and distribution of the film "The Unknown" by AMP Productions and 500 Distribution Co. AMP Productions took inspiration from other low-budget independent film companies like Big Talk Productions and Blumhouse Productions. While low budgets limit technology and big stars, they allow for more creative freedom and opportunities for new talent. 500 Distribution Co. will have a smaller release for "The Unknown" compared to major studios due to lower marketing/advertising budgets and an online-only distribution model.
O documento descreve uma campanha da Unimed Fortaleza chamada "Dia de Bicicletar" que incentivou as pessoas a usarem bicicletas como meio de transporte. A campanha ofereceu bicicletas gratuitas para uso e realizou pesquisas que mostraram que as pessoas não compartilhavam o hábito de andar de bicicleta por acharem isso não interessante o suficiente. A estratégia proposta foi uma campanha nas redes sociais com a hashtag #vamosbicicletar e o objetivo de 10.000
A webinar hosted by CHIME. It shared thoughts on one of my areas of interest – harnessing both business intelligence and health IT, for more effective measurement of healthcare performance.
SVG is text-based
Resolution Independent
Reducing HTTP Request
Styling and Scripting
Can be animated and Edited
Smaller File Size
SVG is XML and works within other language formats
SVG is easily edited
Healthcare organizations are unique business entities that present challenges for optimally organizing governance, people, and services for next-generation BI. Learning from other industries that have adopted the concept of the business intelligence competency center (BICC), this article explores the available options and evaluates which service and organizational model appears to best fit healthcare providers and similarly complex organizations.
O documento descreve um projeto no Ceará chamado "Cuidar do Futuro" onde oftalmologistas voluntários realizam exames de vista gratuitos em escolas públicas e incentivam doações de óculos para ajudar estudantes com problemas de visão, reduzindo a evasão escolar. Uma campanha de crowdfunding foi lançada para arrecadar fundos para doação de óculos.
This document provides an overview of LinkedIn Talent Solutions and analytics on KLA Tencor's use of LinkedIn for recruiting. It shows that KLA Tencor has over 500,000 members in its talent pool on LinkedIn, with over 100,000 engaged. Metrics are provided on InMail response rates, job posts and applications, career page views, and hires influenced by LinkedIn. The document also compares these metrics to peer companies and discusses how LinkedIn can help measure and improve KLA Tencor's employer brand.
The document discusses the growing demand for data storage and computing power driven by increasing technology usage, data creation, and connectivity needs. It notes that this data revolution is shaping economic and social changes globally. However, it also raises concerns about the rising costs and environmental impacts of current data center models. The document advocates that the data center industry needs to modernize facilities, improve energy efficiency, develop standards and partnerships, and effectively communicate their role to stakeholders to meet rising demand in a sustainable way.
Annular pancreas is an uncommon condition in adults.
The ring formation generally originates from the failure of
normal clockwise rotation of ventral pancreas. First
described by Tiedmann in 1818, its incidence is
1:20,000 population. It has bimodal presentation i.e is seen
either in Infants or in 4th & 5th decade of life.
A Bleeding Abdominal Tumor(Pseudopappilary Pancreatic Tumor)Nasir Mahmood
A 27-year old female presented with abdominal pain and vomiting. Physical examination revealed a large abdominal mass. Imaging showed a large heterogeneous mass in the abdomen. The patient underwent surgery where a large solid and cystic mass involving the pancreas and surrounding structures was removed. Histopathology of the mass found it to be a solid pseudopapillary neoplasm of the pancreas, a rare low-grade malignant tumor that predominantly affects young women. The patient recovered well after surgery.
Laparoscopic Management Of Pseudocyst Pancreas.pptxVarunraju9
The treatment focus of psedo pancreatic cyst is shifting slowly in to minimally invasive procedures and the scientific data is assuring it's long standing future with good results.
A 4-year-old girl presented with abdominal distension and mild constipation. Imaging studies revealed a large fluid collection in her abdomen. A paracentesis was performed and fluid analysis showed characteristics of a lymphatic cyst. During an exploratory laparotomy, a large multicystic mass was discovered originating from the omentum. The mass was surgically removed. Histopathological examination confirmed it was an omental cyst. The girl recovered well after surgery. Omental cysts are rare congenital lesions that can present in both children and adults with non-specific abdominal symptoms. Complete surgical excision is the treatment of choice.
The abdominal cocoon syndrome is described as a rare entity in which part or whole of the small bowel is enclosed in a fibrous membrane. This case report is of a 35 years old woman who had a provisional diagnosis of ovarian cyst. Intraoperatively she was found to have abdominal cocoon syndrome. Laparotomy with cystectomy was done. She developed subacute intestinal obstruction 5 days later. This was managed conservatively.
1. A 47-year-old male presented with abdominal pain, back pain, weight loss, and worsening diabetes. Imaging showed ill-defined masses in the pancreas. Differential considerations included pancreatic malignancy or autoimmune pancreatitis.
2. Endoscopic ultrasound-guided fine needle aspiration of the masses was nondiagnostic but showed no malignancy. Surgery found an infiltrative pancreatic mass but biopsy again showed no malignancy.
3. Follow up showed jaundice and imaging characteristics suggestive of autoimmune pancreatitis. Histopathology and elevated IgG4 supported a diagnosis of type 1 autoimmune pancreatitis. The patient was started
A 32-year-old woman developed a liver abscess 44 days after undergoing a laparoscopic sleeve gastrectomy (LSG) for treatment of morbid obesity and diabetes. She initially recovered well from the LSG but later developed abdominal pain, vomiting, and fever. A CT scan revealed a 12x5 cm abscess in her liver. Drainage of the abscess yielded 400ml of pus. Antibiotic treatment and drainage of the abscess over subsequent days led to improvement of her symptoms and laboratory abnormalities. The abscess was considered a rare but possible complication of LSG due to the surgery being classified as clean-contaminated and the patient's comorbidities compromising her immune system.
The patient is a 45-year-old female presenting with sudden abdominal pain for 3 hours in her epigastric and right upper quadrant areas. She reports one episode of vomiting and a subjective fever. Her vital signs show elevated blood pressure, heart rate, and temperature. Physical exam reveals tenderness in the epigastric and right upper quadrants. Based on her history and exam findings, she is suspected to have acute cholecystitis.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Case History of Dedifferentiated LiposarcomaVictor Effiom
This document summarizes the case history of a 24-year-old male who presented with abdominal distension, difficulty breathing, and weight loss. Imaging and exploratory surgery revealed a giant intra-abdominal mass weighing 20kg, which was removed. Histopathology determined the mass was a dedifferentiated liposarcoma. The patient required multiple blood transfusions post-operatively to manage anemia, but was eventually discharged and doing well on follow up.
This case report describes a 14-year-old female who presented with abdominal pain and weight loss. She was found to have both biliary dyskinesia and superior mesenteric artery syndrome (SMA syndrome). Biliary dyskinesia was confirmed by a HIDA scan showing poor gallbladder function. An upper GI series showed duodenal obstruction consistent with SMA syndrome due to rapid weight loss. She underwent open cholecystectomy and duodenojejunostomy to address both conditions simultaneously. Postoperatively, she continued to experience gastric symptoms requiring nutritional support. She was eventually discharged tolerating full feeds.
This document provides guidelines for evaluating and managing abnormal uterine bleeding (AUB). It outlines the history and examination findings that should be obtained. It recommends laboratory tests, imaging studies, and procedures like endometrial biopsy that can help determine the cause of AUB. The document then describes the general management approaches for different causes of AUB, including non-hormonal and hormonal medical treatments as well as surgical options. It provides specific treatment guidelines for different AUB types based on patient factors like desire for fertility preservation or contraception.
1. A 31-year-old pregnant woman experienced acute fetal distress during labor and underwent an emergency cesarean section, delivering a healthy baby girl.
2. Postpartum, the woman developed hematuria and left flank pain. Imaging revealed a tear in her left renal pelvis causing hydronephrosis.
3. She underwent left percutaneous nephrostomy and cystoscopy, which identified a bladder injury possibly related to stitches from the cesarean section. The injuries were successfully treated without need for nephrectomy.
solitary kidney with a stone, Ivu cas studyShatha M
This case study summarizes an intravenous urogram (IVU) performed on a 53-year-old female patient with a solitary left kidney and history of kidney stones. The IVU involved taking a series of x-ray images before, during, and after injection of contrast medium to evaluate the kidney and detect any stones. The IVU revealed two small renal stones in the lower pole of the left kidney with no obstruction. The conclusion was that the patient had two small left renal stones with no back pressure effect.
The spleen is normally located in the left upper quadrant of the abdomen. This case presents a 20-year-old female with abdominal pain who was found to have a torsed wandering spleen at the center of her abdomen. Wandering spleen is a condition where the spleen lacks normal ligamentous support, causing it to be mobile within the abdomen. At surgery, her enlarged spleen was found to have torsed along its vascular pedicle, cutting off its blood supply. A splenectomy was performed to remove the non-viable spleen. Histopathology confirmed splenic infarction due to the torsion.
Similar to Case series of pseudocyst of pancreas (20)
The document discusses recent advances in wound healing, including silver-based dressings, negative pressure therapy, advanced dressings like hydrocolloids and alginates, skin substitutes, growth factors, and hyperbaric oxygen therapy. Silver dressings provide antimicrobial properties and sustained silver ion release. Negative pressure therapy promotes wound healing through macro and micro strain. Advanced dressings maintain a moist wound environment. Skin substitutes and growth factors can accelerate healing.
This document summarizes recent advances in pancreatic cancer. It covers molecular genetics and tumor biology, methods for early detection of precursor lesions, investigation modalities like imaging tests and tumor markers, surgical management approaches including criteria for resectability, and adjuvant treatment modalities like chemotherapy and radiation. Newer chemotherapy regimens have improved survival rates and some targeted therapies show promise. Multidisciplinary treatment at high-volume centers results in better outcomes. While improvements have been made, pancreatic cancer remains difficult to treat and more research is still needed.
Pseudocyst of the pancreas and benign cystic neoplasms are two types of pancreatic cysts that can develop. Pseudocysts are collections of fluid that develop after pancreatitis and usually resolve on their own, but sometimes persist and cause complications. Benign cystic neoplasms include mucinous cystic neoplasms that are more common in women and involve mucin-producing epithelium, and intraductal papillary mucinous neoplasms which involve cystic growths and epithelial changes along the pancreatic ducts. Both conditions are generally diagnosed using imaging tests and investigated further if complications arise or if malignancy cannot be ruled out, with surgical resection as the treatment in some cases.
This document outlines the steps in an open appendectomy procedure. It begins with a description of surgical anatomy including variations such as ectopic or absent appendix. It then discusses pre-operative preparation, incision sites, and identification of the appendix. The key steps are: delivering the cecum into the wound, identifying the appendix base, applying clamps and removing the appendix from tip to base while ligating vessels. The appendix is then ligated and the stump may be cauterized before closing tissue layers and applying dressings. Variations for complicated cases are also noted.
This document discusses the diagnostic approaches used for carcinoma of unknown primary (CUP) in the neck. The goals are to clarify the histology of nodal metastases and detect the primary tumor. Investigations include a thorough history and physical exam, fine needle aspiration cytology (FNAC), imaging like CT, MRI and PET-CT scans of the head, neck, chest and abdomen, endoscopy, and molecular assays. If the primary is not detected, examination under general anesthesia with biopsies of suspicious sites is recommended. Together these diagnostic tests aim to identify the origin and stage of the cancer.
This document describes a case of a 22-year-old male who presented with abdominal pain after a blunt injury and was diagnosed with a transected pancreas and duct disruption based on exploratory surgery findings. The patient underwent primary pancreatic duct repair with stenting and drainage. He recovered uneventfully and was discharged on post-op day 15. Pancreatic injuries can be difficult to diagnose due to their protected location and often subtle early symptoms. A high index of suspicion is needed to identify such injuries.
Chronic pancreatitis is a chronic inflammatory condition of the pancreas characterized by progressive fibrosis of the pancreatic parenchyma and loss of function. It has multiple etiologies but alcohol use is the most common cause. Patients experience abdominal pain, steatorrhea from maldigestion, and can develop diabetes. Treatment involves pain management, pancreatic enzyme replacement, and in severe cases, surgery such as drainage procedures or pancreatic resections.
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Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
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The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
5. Chronic Collection of amylase-rich fluid enclosed in a non-
epitheliazed wall of fibrous(collagen) or granulation tissue.
Follow after
Acute Pancreatitis(5-15%)
Chronic Pancreatitis(20-38%)
Trauma
4- 8 weeks from the onset of AP
Single or multiple or multilobulated
6. Duct leak
Intrapancreatic or extend beyond into other cavities or
compartments
Regress spontaneously 50%
Chronic pseudocysts may persist
Thick-walled or large (over 6 cm in diameter)
Lasted for a long time (over 12 weeks)
Arisen in the context of chronic pancreatitis
9. US,CT
- Identification of
pseudocyst and
differentiates from
abscess
EUS- Guided FNA
Differentiates
between chronic
pseudocyst and cystic
neoplasms
ERCP/MRCP
ductal
communication,ductal
anomalies, chronic
pancreatitis,plan treatment
10. Amylase- Level usually high in pseudocysts, but
occasionally in tumours
Cytology- Inflammatory cells in pseudocyst
CA 19-9,CEA and MUCIN – negative
12. Endoscopic Surgical
Distance of pseudocyst to the
gastrointestinal wall <1 cm
Size>5 cm, gut compression, single
cyst, mature cyst, no disconnected
segment of pancreatic duct
Complications
Drainage internally
Stomach
Duodenum
Jejunum
Recurrence <5%
14. Case 1
36 year female presented with complaints of yellowish discolouration of
eyes, high coloured urine,pale stools for 1 month associated with upper
abdominal discomfort and intense itching. No vomiting/ugi bleed. H/o
treatment for Acute Pancreatitis 6 months before. No addictive habits.
No other contributory history. O/e Icteric,non-tender epigastric mass of
size 8 x 6 cm extending to right hypochondrium, smooth surface,firm in
consistency,no movement with respiration. No free fluid and other
systems were normal.
Transabdominal USG revealed a pseudocyst from head of pancreas
compressing the CBD causing dilation of CBD and IHBR. CECT - 7.3 x 6.7 x
5.1 cm pseudocyst from head of pancreas compressing the CBD(1.2cm).
TBR-6.3mg%. SAP- 517 IU/L. Coagulation profile-Normal.
UGI Scopy- Normal
15. Patient was taken up for surgery and a Roux loop
Cystojejunostomy was done which relieved the
biliary compression. Post operatively the total
bilirubin was 3.2 on POD 4 and subsequently
returned to normal level. Cyst fluid amylase
was 1210 IU and cytology negative for malignant
cells. Cyst wall HPE – Inflammatory tissue. Patient
was relieved of symptoms and no post operative
complications. Review
USG after 2 months, no radiologically detectable
pseudocyst.
16. Case 2
A 32-year-old male was admitted with complaints of upper abdominal pain and jaundice of 3 months duration. A history of a
passage of clay-colored stools and high-colored urine was present. The patient gave a history of acute abdominal pain
following a binge of alcohol 6 months ago which was managed conservatively. On examination he was icteric and pruritic
marks were present all over the body. Abdominal examination revealed an epigastric mass of size 7*6 cm, which was firm in
consistency, had the upper border not made out, and which did not move with respiration. The liver was enlarged and
palpable 3 cm below the right costal margin. A liver function test showed elevated serum bilirubin of 16 mg/dL (normal < 1
mg/dL), the direct component being 14 mg/dL (< 0.8 mg/dL), and serum alkaline phosphatase was 206 IU/L (normal value
20–140 IU/L). CA 19-9 was within normal limits (less than 10 IU/Ml.Recently diagnosed DM started on Insulin
USG abdomen - 8*7cm hypoechoic lesion arising from the head of the pancreas with dilatation of the intrahepatic and
extrahepatic biliary tree. The common bile duct (CBD) measured 1.1 cm in diameter. Cholelithiasis was also seen.
MRCP and CECT-confirmed the USG findings of a pseudocyst arising from the head of the pancreas compressing the distal
CBD, causing dilatation of biliary radicles
CECT showed additional features of chronic calcific pancreatitis involving the body and tail of the pancreas.
UGIendoscopy - normal gastric and duodenal mucosa with extraneous compression of the antropyloric region of the stomach
and duodenum.
17. After optimizing the general condition of the
patient and achieving glycemic control, he was
taken up for surgery. Intra-operative findings
concurred with the imaging studies. In view of
the proximity of the cyst to the duodenum,
cystoduodenostomy was done.
Cholecystectomy was done and an
intraoperative cholangiogram performed via the
cystic duct showed a stricture in the terminal
common bile duct. A choledocho-
pseudocystostomy was performed for biliary
drainage
The post-operative period was uneventful, with
the patient becoming clinically anicteric after 10
days and biochemical parameters normalizing
after 25 days. Hpe of the cyst wall was negative
for malignancy The patient has been on follow-
up for 16 months with no specific complaints.
Follow-up USG showed no residual pseudocyst
and a normal intra- and extrahepatic biliary
tree.
18. Case 3
48 year male chronic alcoholic presented with complaints of fullness in upper abdomen for 4
months. No h/o fever/ vomiting/jaundice/bowel/bladder disturbances. H/o anorexia and
weight loss +. H/o three episodes of acute pancreatitis conservatively managed since 4 years.
Stopped alcohol after the second episode. No h/o exocrine pancreatic insufficiency. Recently
diagnosed DM on OHAs. On examination, thin built and ill nourished,anicteric,flat abdomen,
firm to hard non tender, oval mass of size 6 x 5 cm in epigastrium,not moving with respiration
with restricted mobility. Other systems normal.
Blood parameters and amylase,lipase and LFT normal range.Ca 19-9 – 12 IU
Transabdominal USG – 4.3 x 5 cm cystic lesion in body of pancreas with altered echoes.
MRCP- ? Chronic Pseudocyst of pancreas. ? IPMN of pancreatic body. No e/o calcifications in
parenchyma or ductal system.
Usg guided FNAC- No e/o tumour cells in the material studied.
UGI Scopy- pan gastritis
19. Surgery- Roux loop Cysto-Jejunostomy
Follow up- HPE- Chronic Inflammatory
cells.
Cyst Fluid- Amylase- 774 IU
6 months after surgery – no
radiologically detectable cyst.
20. Case 4
54year male non alcoholic presented with complaints of pain in upper left quadrant of
abdomen radiating to back for 6 months. No h/of fever /vomiting/ jaundice/bowel/bladder
disturbances. No H/o anorexia and weight loss . H/o one episode of acute pancreatitis
conservatively managed before 7 months. No addictive habits. On examination,anicteric,no
pallor, upper abdomen fullness +. Tenderness + epigastrium and left hypochondrium. Ill
defined mass occupying the above quadrants,no organomegaly/freefluid.Other systems
normal.
Blood parameters and amylase,lipase and LFT normal range.
Transabdominal USG – 8.6 x 6.4 cm cystic lesion in tail of pancreas abutting the spleen.
Another cyst of size 3.2 x 2.2 cm in body of pancreas. ? Pseudocyst ? Cystic neoplasm
MRCP- Pseudocyst of pancreas in body and tail abutting spleen. To r/o Cystic neoplasm.
Usg guided FNAC- No e/o tumour cells in the material studied.
UGI Scopy- ulcer + pre pyloric region. HPE- Chronic non-specific inflammation
21. Surgery – Roux loop cystojejunostomy
Follow up- HPE- non specific Inflammatory cells.
Cyst Fluid- Amylase- 1564 IU
3 months after surgery – symptomatic relief,
radiologically cyst not seen in tail of pancreas. 2 x
2cm seen in body of pancreas.
22. Case 5
32 year male chronic alcoholic presented with complaints of acute onset
epigastric pain for 2 days. H/o fever & vomiting +.No h/o
jaundice/bowel/bladder disturbances. H/o anorexia +. Last binge of
alcohol 1 day before admission.On examination, moderately built and
nourished,anicteric,tachypnoeic,tachycardic,flat abdomen,upper
abdomen movement reduced with respiration,epigatric tenderness and
guarding +.BS sluggish. . Other systems normal.
CXR – No e/o hollow viscus perforation.
Amylase – 2150 IU, Lipase – 983 IU .LFT normal range.
Transabdominal USG – bulky edematous pancreas with surrounding fat
stranding and fluid collection.
CECT Abdomen- F/s/o Acute Pancreatitis with Acute fluid collection and
minimal left pleural effusion.
UGI Scopy- erosive antral gastritis
23. Patient managed as acute moderate pancreatitis
conservatively.
After 1 month patient reported with complaints of
abdominal discomfort and difficulty in breathing on
exertion. No h/o fever or vomiting. On examination,
epigastric fullness +. 10 x 6 cm smooth surfaced,firm
non-tender mass occupying epigastrium,right and left
hypochondrium. Left base breath sounds were
absent.
24. Trans abdominal ultrasound – Pseudocyst of pancreas occupying body and tail with left pleural effusion and
ascites
Cect abdomen - Pseudocyst of pancreas occupying body and tail with left pleural effusion and ascites. Wall
thickness 4mm.
Conservatively managed. 6 weeks after- cyst size reduced to 4 x 3 cm.
25. Case 6
26 year male presented with Abdominal pain for 2 weeks-Acute
onset,Epigastrium to start with later became diffuse,Continuous,pricking
pain,radiating to back,relieved by leaning forward and with medications.H/o
non-bilious vomiting immediately after food intake + for the past one week.H/o
constipation + x 3 days. H/o yellowish discolouration of sclera with passage of
high coloured urine and clay coloured stools x 4 days +. No h/o fever
/pruritus/abdominal distension/recent loss of weight/loss of appetite.H/o
intermittent epigastric pain x 3 months. No comorbidities. Chronic Alcoholism x
3 yrs >360ml/day-last drink 8 days back
Not Anaemic,Deeply Icteric,No clubbing,No Generalised Lymphadenopathy,No
Pedal Edema
Examination of Abdomen- Abdomen flat, Tenderness + Epigastrium,Right
Hypochondrium,No guarding/rigidity,No obliteration of liver dullness,No
mass/organomegaly,No free fluid,Murphys sign –ve.
26. Ultrasound Abdomen: Normal study
UGI SCOPY: Pangastritis/Erosive Antral
Gastritis,Bulbar healed duodenal
lesions.Submucosal lesion at D2 entry with luminal
obstruction ?Pseudocyst causing duodenal
obstruction.
SVS: Extrinsic compression at the level of D2,scope
not passed beyond
CECT ABDOMEN: Possibility of stricture at the
junction of 3rd and 4th part duodenum causing
luminal obstruction
MRCP: ?Intramural Pseudocyst in the submucosal
layer of Duodenum at the junction of D2,D3
Patient was managed conservatively and clinically
improved.
Follow up serial radiological investigations showed
gradual regression and disappearance after 12
weeks
27. Conclusion
Due to progress in sensitivity and more widespread availability of diagnostic
imaging techniques, the incidence of pancreatic pseudocysts seems to be
increasing steadily. .
In the above series the different presentations of pseudocyst of pancreas and the
different techniques of management was elaborated
The majority of these cysts are asymptomatic, and the decision whether or not to
operate is not always straightforward
The apparent question is how to proceed after the detection of an asymptomatic
pancreatic cyst choosing one of the following options: no further investigations,
additional imaging ± fine needle aspiration (FNA), surveillance, or
surgical/endoscopic treatment.
Intervention is contemplated if the patient has Symptoms,if complications develop
or a distinction has to be made between a pseudocyst and a tumour
28. References
Sabiston textbook of surgery,19th edition
Schwartz’s Principles of surgery,9th edition
Novel Technique in the Management of Obstructive Jaundice Caused by
Pancreatic Pseudocyst , Archives of ClinicalExperimental Surgery,Gautham
Krishnamurthy, Venkatesh Gottumukala, A Rajendran, P Darwin
www.giejournal.org ,GASTROINTESTINAL ENDOSCOPY Volume 77, No. 6 : 2013
World J Gastroenterol 2009 January 7; 15(1): 38-47 wjg@wjgnet.com World
Journal of Gastroenterology ISSN 1007-9327
Pancreatic pseudocysts (Part I)Article by John Baillie, MB, ChB, FRCP,Durham,
North Carolina