Teratomas are neoplasms of the embryonic tissues that typically grow in the gonadal and sacrococcygeal regions of adults and children. Intrabdominal teratomas that occur in adolescent are rare and demand challenging management options. We report a case of an intraabdominal mature cystic teratoma in a 17-year-old female patient. Complete resection of the mass was performed by a laparotomy approach. Radiological imaging is helpful in preoperative diagnosis and planning. Multidisciplinary surgical team planning is also essential to avoid injury to the adjacent organs in duodenal teratoma operation. Complete surgical excision is the treatment of choice, and the prognosis of mature teratomas is excellent.
Lateral hernia is caused by patent or reopening of processus vaginalis that lead herniation of abdominal content into scrotal sac. These defects can cause atypical presentation of indirect inguinal hernia along with hydrocele. We present a case of a male 78-year-old with chief complain of painless swelling on right scrotum that gradually getting bigger since a year ago. During the examination we found trans-illuminable mass in the right scrotum along with protrusion of bowel contents at the inguinal region. Patient underwent herniotomy with mesh installation to fix the lateral inguinal hernia and then followed by hydrocele removal with Jaboulay’s technique. Prognosis of this patient is believed to be good. We have presented a case of a geriatric patient with right lateral inguinal hernias with encysted hydrocele which is a presentation that could be happen due to anatomy of the inguinal ring. This patient underwent herniotomy with mesh installation to fix the lateral inguinal hernia and this procedure maintains the principle of tension-free posterior wall, hence preventing recurrence. Then followed by hydrocele removal with Jaboulay’s technique to prevent any complications such as testicular atrophy, haematocele and pyelocele. Prognosis of this patient is believed to be good.
Background: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus (DM), resulting in loss of limb or life. Negative pressure wound therapy (NPWT) is an emerging therapeutic option in the management of DFU. This study aims to compare the efficacy of NPWT to conventional moist wound dressing in the management of DFU.Methods: Literature was searched from online public scientific databases, including PubMed, Google Scholar, ScienceDirect, and Portal Garuda. Our review included clinical trials and analytic studies comparing NPWT and conventional moist dressing to treat DFU published in 2017 or later. Outcome measures include the proportion of wound healing, healing time, ulcer size reduction, granulation time, amputation, infection, and bleeding.Results: We include 11 articles, including eight randomized clinical trials (RCTs), two retrospective analytic studies, and one non-random clinical trial. There was methodological variation between studies on the application of NPWT, outcome measures reported, and length of follow up. Results mostly showed NPWT yielded a higher proportion of complete wound healing, shorter healing time, granulation time, and faster ulcer size reduction rate. However, NPWT was not associated with a reduction of amputation risks.Conclusions: Our review found NPWT was superior in short-term treatment outcomes such as granulation time and wound closure; however, there was no difference in reducing amputation risk between NPWT and conventional moist dressing. Results are inconclusive due to variation in methodologies of included articles.
Hypospadias is a common congenital urogenital deformation. Its most frequent form is anterior hypospadias, where the urethral meatus was located at the glans (glandular), just below the glans (sub-coronal), or on the distal shaft. Various surgical procedures can be performed to correct anterior hypospadias. The most common used procedures are meatal advancement and glanduloplasty incorporated (MAGPI), tubularized incised plate (TIP), and Mathieu repair procedures. Choosing which procedure to date there are no guidelines on determining which procedure to perform or which will produce the best results. We conducted a review to compare the outcomes of each procedure, considering cosmetic and functional aspects, as well as risks of complications. The results showed lack of evidences that perform direct comparison among the different outcomes; therefore, we have to rely on observational and descriptive sources. However, available evidence painted a picture of somewhat comparable outcomes on all aspects between the three procedures for anterior hypospadias. The underlying theme was the importance of selecting the appropriate procedure for each patient, considering each patient’s unique anatomical presentation for the best cosmetic outcome, as well as the skill and confidence of each surgeon.
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