Chilaiditi syndrome is a rare condition occurring in 0.025% to 0.28% of the population. In these patients, the colon is displaced and caught between the liver and the right hemidiaphragm. Patients' symptoms can range from asymptomatic to acute intermittent bowel obstruction. Diagnosis is best achieved with CT imaging. Identification of Chilaiditi syndrome is clinically significant as it can lead to many significant complications such as volvulus, perforation, and bowel obstruction. If the patient is symptomatic, treatment is usually conservative. Surgery is rarely indicated with indications including ischemia and failure of resolution with conservative management.
Mesenteroaxial volvulus is a form of gastric volvulus that rotates around the short axis of the stomach. Mesenteroaxial volvulus typically presents secondary to an anatomical defect with symptoms that include epigastric pain, retching, dysphagia and early satiety. Our patient presented with episodic abdominal pain, nausea and vomiting for 2 years. Previous imaging was unremarkable but an esophagogastroduodenoscopy done when the patient most recently presented with abdominal pain revealed a mesenteroaxial volvulus. He underwent a laparoscopic gastrostomy-tube gastropexy and has not had any recurrence of his symptoms to date. This case illustrates the difficulties in diagnosing an intermittent volvulus as untimely imaging of a temporarily unfolded volvulus can delay diagnosis and treatment.
Carcinosarcoma of the prostate is an uncommon malignancy with poor long-term prognosis. The cancer is typically discovered at an advanced stage, and with less than 100 reported cases, there is limited literature concerning treatment options. Our patient presented with a history of benign prostatic hypertrophy, erectile dysfunction, and nocturia. Biopsy of his prostate indicated that the patient had prostatic adenocarcinoma, but histopathology after prostatectomy revealed carcinosarcoma. It has been over six years since this patient's diagnosis of carcinosarcoma. Over this span of time, he has received a radical prostatectomy, radiotherapy, and androgen ablative therapy. The patient also developed multiple lung metastases that have been treated with video-assisted thoracic surgery and stereotactic body radiosurgery. Overall, he has remained unimpaired and in good condition despite his aggressive form of cancer.
Introduction: Conventional body contouring techniques such as liposuction, although now far less invasive, still require extended periods of recuperation and the use of compression garments. Several noninvasive techniques for soft tissue, adipose, and dermal treatment have been reported in the literature as also producing circumferential measurement reductions in patients. These results can now be correlated to evidence-based scientific methodology versus anecdotal reports. Materials and Methods: Patients were treated using the VASER Shape (Sound Surgical Technologies, Louisville, Colo) as part of routine practice. Circumferential measurements were made before and after treatments. Results: Two hundred and four patients were treated in 741 treatment sessions at 12 centers in the United States beginning in June 2010. When measured immediately after treatment, the patients experienced a 0.8-in circumferential reduction in the abdomen and a 0.5-in reduction on the thighs. Circumferential reduction continued over the course of treatments, resulting in reductions of more than 2-in and 1-in, respectively, in the abdomen and thighs. In no cases were any analgesics or anesthesia provided to patients before or during treatment. In general, the patients reported that the treatment was pleasant and felt warm but not uncomfortable. After treatment, patients were able to continue with their normal daily routines. Patients reacted positively to the procedure and the immediacy of results, and many reported that their clothes fit better when they dressed after treatment. In addition to circumferential measurement changes, patients also reported the sensation of feeling tighter in the treated area and that the treated areas had smoother skin. Conclusions: The VASER Shape system presents a novel approach to achieving immediate circumferential measurement reduction noninvasively with no patient downtime.
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