Malignant fibrous histiocytoma (MFH) represents the most common soft tissue sarcoma in adults. Visceral locations are uncommon and primary hepatic MFH is exceedingly rare.
This article evaluates the role of hydrocolonic sonography in the study of colon neoplastic lesions in daily gastroenterology practice. Consecutive patients referred for optical colonoscopy were randomly and prospectively enrolled to hydrocolonic sonography. All patients went through hydrocolonic sonography (HS) before optical colonoscopy (OS). In total, 108 patients (57 men), with an average age of 68.9 years, participated in the study. Indications for colonoscopy were colorectal cancer screening (50.0%), unspecific abdominal symptoms (45.4%), and liver metastasis or suspicious lymph nodes (4.6%). Inspection of the entire colon was possible in 86.8% of patients by OC and 89.6% of patients by HS. Globally, the sensitivity and specificity of HS in polyp detection were 24.2% and 99.7%, respectively. For polyps >10 mm, hydrocolonic sonography achieved sensitivity, specificity, positive predictive value, and negative predictive value of 80.0%, 99.7%, 92.8%, and 99.5%, respectively. Optical colonoscopy detected 12 cancers, all identified with hydrocolonic sonography, showing a sensitivity and specificity of 100%. The technique was well tolerated by 94.3% of patients. Hydrocolonic sonography is feasible, safe, well tolerated, and inexpensive, allowing the detection of polyps larger than 10 mm and colon cancer with good accuracy in this study population. In the appropriate setting, it may be a complementary technique in the study of the colon.
Children with splenic trauma are managed conservatively in most circumstances, and the need for surgical intervention is very rare. When surgical exploration in mandatory, splenic preservation is a worthwhile objective, using various suture methods, biomaterials, or resorbable prostheses. We present our experience over the past year with 5 severe splenic injuries. Three of these patients were treated operatively with a resorbable mesh, while the other two were managed percutaneously by selective embolization of the splenic artery under fluoroscopic control. We describe the embolization technique with its advantages, good outcome with low morbidity, and low economic and social cost.
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