Purpose. To review and identify the most accurate ways of diagnosing and treating adventitial cystic disease (ACD) of the venous system. Methods. Cases of ACD were collected through three popular medical databases, including PubMed, Cochrane, OVID, and MEDLINE. After reviewing the literature, the sites of occurrence of 323 cases of adventitial cystic disease were documented, and all cases of arterial ACD were excluded. The clinical features, treatment, and subsequent course of 45 cases of venous ACD are included in this paper. Results. After reviewing all 45 cases of venous ACD , we have confirmed that the most common vessel affected is the common femoral vein, which reproduces the most common symptom of venous ACD: asymmetric lower extremity swelling worsening over time. Conclusion. Venous ACD most commonly affects the common femoral vein. When unilateral leg swelling occurs with or without a noticeable mass, ACD should be considered. It is best confirmed with CT venography and the treatment of choice is transluminal cyst evacuation and excision.
HighlightsFrequency of sliding hernias containing the bladder is only 5.6–12.5%.TAPP approach is preferred over a TEP approach in the laparoscopic repair of a sliding hernia.An open Lichenstein repair should be used in cases of recurrent hernias with severe complications, such as extensive adhesions or incarceration.Method of repair should be individualized based on careful analysis of clinical presentation and diagnostic findings.
An unusual finding in an adult patient with an infected urachal cyst, was treated surgically using the Da Vinci robot. A 26-year-old woman was admitted to our hospital with complaints of lower abdominal pain and burning sensation with urination. She was diagnosed with lower urinary tract infection, treatment did not help her symptoms and further evaluation of CT revealed complex enhancing mass superior to the urinary bladder. The differentials included inflammatory cause such as an abscess, neoplastic mass, urachal cyst, vitello intestinal fistula and urachal sinus. Da Vinchi robotic diagnostic laparoscopy was performed to obtain an accurate assessment and treatment. After cystoscopy followed by laparoscopic exploration of the abdominal and pelvic cavity further helped to narrow down a diagnosis of remnants of urachus. Pathology of the excised specimen showed inflammation without evidence of malignancy and confirmed Urachal cyst. The patient had an uneventful post-operative course.
Thoracic aortic mobile thrombus is a rare and significant source of peripheral, visceral, as well as cerebral emboli. A 51-year-old female with a history of emergency left brachial artery embolectomy 5 months previously was referred to our unit for evaluation of a mobile thrombus in the descending thoracic aorta. We describe the successful primary treatment of a symptomatic mobile thrombus in the thoracic aorta by using a stent graft.
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