The study presented a case of a patient with a glomus tumor of the stomach, a mesenchymal neoplasm manifesting with upper gastrointestinal bleeding (Forrest IB). The patient was operated twice. First, he underwent elective laparotomy, during which Billroth I (Rydygier's method) gastric resection was performed. This his was followed by Billroth II resection with Braun's anastomosis. Histopathological examination revealed glomus tumor tissue. Literature data on the glomus tumor of the stomach are presented.
A superior vena cava (SVC) aneurysm is an extremely rare case of vascular malformation in the chest cavity. This is a report of a case of a 57-year-old woman with a saccular SVC aneurysm which was 8 cm wide. The chest computed tomography (CT) scan confirmed a giant 75 mm × 79 mm × 81 mm mass containing the contrast medium from SVC, constricting the right lung parenchyma, narrowing the right innominate vein, in contact with the anterolateral chest cavity wall, and adjoining the superior mediastinum.Under general anesthesia and employing the median sternotomy approach, using a cardiopulmonary bypass (CPB), the venous aneurysm was successfully resected. The postoperative period was uneventful. Radical surgical resection using a sternotomy and a CPB is recommended. and was entirely constricting the right upper lobe of the lung. After the mass was dissected from the right phrenic nerve and the surrounding tissue, we used a vascular clamp to exclude the neck of the aneurism. The mass was detached; the neck of the aneurysm was continuously sutured and strengthened with teflon felt patches (Figure 2).A histopathological examination was conducted and this confirmed that the mass which had been removed was a part of a venous blood vessel. A control CT scan and chest X-ray was done after surgery ( Figure 3). Because of an uneventful postoperative period, the patient was discharged on the 5th day after the procedure. DiscussionA vein aneurysm is an extremely rare phenomenon in medicine. In 1963, Abbot and Leight introduced a classification of aneurysms and divided them into four groups (congenital, acquired, pseudo-aneurysm, and arteriovenous aneurysm) (2). The fusiform aneurysm constitutes the vast majority. In our case we are presenting a saccular aneurysm, which has only been described in literature a few times. Such aneurysms are usually asymptomatic and are usually diagnosed accidentally in routine chest X-rays. Detailed diagnostics include a CT scan or magnetic resonance imaging (MRI). Aneurysms might be congenital, or caused by inflammation or by the degeneration of the vascular wall, but in most cases their cause is unknown (3). They might be solitary or they may coexist with cystic hygromas and angiomas. In asymptomatic patients where the diameter of the aneurysm is less than 40 mm, we might proceed conservatively, using anti-plaque therapy and periodic scans (4). Aneurysms which are larger, growing, symptomatic or containing thrombus require radical surgical treatment (3,5,6). Part of the thrombus forming the sack of the aneurysm can break away and cause pulmonary embolism or lung infarct which may lead to the patient's death (7,8). Particular caution is required in this circumstances. Thanks to CPB, our patient was protected from pulmonary embolism and lung infarct. The use of CPB should be considered not only when the thrombus formation is detected, but also in the case of calcification in the wall of the aneurysm (5). In our opinion, the type of surgical approach presented here gives better insight ...
Carotid endarterectomy is equally effective as CAS in stroke prevention, but is associated with a higher incidence of cranial nerve palsy, access site hematoma and other non-stroke complications. Symptomatic patients had a higher incidence of stroke, regardless of the treatment method.
Strokes are one of the leading causes of death, morbidity, and disability worldwide, mainly among elderly people. It is also the third most common cause of years of life being lost, indicating a high risk of premature mortality. Revascularisation with endarterectomy (CEA) is effective in reducing the risk of death and strokes in patients with carotid artery stenosis, but the effect of invasive treatment on quality of life (QoL) still needs attention. To shed more light on the patients’ perspective on this health condition, we carried out a review of the literature which aimed to analyze the level of health-related QoL among stroke survivors, with special attention to patients who had been treated with CEA. Strokes significantly reduce the level of QoL, which may subsequently be improved in the course of treatment with CEA. Patients experience a reduced level of QoL in the early postoperative period, but at 1 year following CEA, the level of QoL remains stable and is similar to that of chronically ill patients. The domains of QoL which are most affected are physical and emotional functioning, which also serve as markers for decreased QoL in the long term. Older age and comorbidities are predictors of worse QoL. Stroke survivors require proper care both immediately after a stroke happens and during the long-term rehabilitation. Measurement of QoL and of the determining factors that contribute to a reduced level of QoL, as well as focusing on determinants of QoL in stroke survivors may help to reduce patients’ disability and improve their daily functioning in society as well as reducing the cost of health care.
Tumors of the appendix are extremely rare and constitute about 0.4% of all tumors of the gastrointestinal tract. The most common benign neoplasm is mucinous cystadenoma, which can be found in 0.6% of all excised appendices and it rarely produces any symptoms. We present the case of a female patient who underwent surgery in the Department of Surgery due to suspicion of an appendicular abscess. On the postoperative pathology study, the diagnosis of a tumor of the appendix (mucinous cystadenoma) was made. Mucinous cystadenoma is rarely included in the differential diagnosis of a non-specific abdominal pain accompanied by non-characteristic laboratory test results and imaging studies. There are no unequivocal guidelines and algorithms of managing this disease. Long-term prognosis is good in the case of a benign tumor.
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