Ectopic pancreas (EP) is defined as the presence of pancreatic tissue outside the pancreas with no anatomical connection to the pancreas. It is also known as pancreatic heterotopia, accessory pancreas, aberrant pancreas, or pancreatic rest. The first case of EP was described in 1727 when pancreatic tissue was identified in the ileal diverticulum. Abdominal pain and lower gastrointestinal bleeding are the most common symptoms. On histopathological examination, EP can be classified into four subtypes. Once identified and diagnosed, the treatment is surgical resection and the post-operative course is asymptomatic in most cases. We describe a rare case of EP, which was discovered on the CT scan of the abdomen as a jejunal mass and successfully treated with surgical resection. We have also described the possible role of chromogranin A for diagnosing EP cases and for post-operative follow-up.
The study is a retrospective cross-sectional study carried out in the Department of Pathology of Premier Hospital, Abuja, on specimens received over a one-year period. Four hundred and eighty-six samples of endometrial biopsies and curettings from women presenting with abnormal uterine bleeding sent to the histopathology laboratory were analyzed. The most common biopsies were those of product of conception which accounted for 304 cases (62.6%). Most of the cases of endometrial hyperplasia were typical. Endometritis and chorioamnionitis were the inflammatory conditions seen. Twenty-three women had molar pregnancies. The most common cause of abnormal uterine bleeding in this population is retained products of conception. There may be need to retrain some of the staff involved in the management of pregnancy related complications. There is need to further evaluate pregnancy related complications to ascertain the causes and circumstances responsible for them so as to appropriately direct interventional protocols.
Parasitic leiomyomas are rare occurrences that may mimic malignancy and thus present a diagnostic dilemma. They are thought to arise from a pedunculated subserosal leiomyoma that undergoes torsion and detaches from the uterus, surviving by revascularization from adjacent structures, or from iatrogenic implantation during surgery, more common with the clinical popularity of laparoscopic surgery and power morcellation. We report a case of parasitic leiomyoma with degenerative changes in a 57-year-old female who was initially found to have a 6.5-cm left adnexal mass and multiple submucosal and intramural masses consistent with leiomyoma by abdominal pelvic computerized tomography test (CT) 7 years prior to presentation. She experienced severe abdominal discomfort that persisted after total abdominal hysterectomy and a 7.8-cm mass was found in the left pelvic cavity on reevaluation. Grossly, the pelvic mass was a 6.5-cm tan-gray ovoid firm mass with a 4.0-cm cystic cavity. The cut surfaces of the solid areas/cyst wall were gray-white and firm with focal yellow streaks. Microscopically, there was central cystic degeneration, with cyst wall showing extensive granulation tissue. The solid portion also showed extensive hyaline degeneration, fibrosis, and perinodular hydropic degeneration. Smooth muscle differentiation was evident at the periphery of the mass, confirmed by strong staining with desmin and smooth muscle actin. This represents a parasitic leiomyoma left behind following the first procedure and it developed degenerative changes. In addition to the high index of suspicion for malignancy in assessing adnexal masses, degenerating parasitic leiomyomas should be included in the differential diagnosis of such mass lesions.
Introduction/Objective Blood products are precious resources obtained from donors who donate with the intention to help people. These blood products however do not always go to the patients, instead sometimes ending up in the waste. It is inevitable to have some degree of the wastage due to limited blood product shelf life, the inherent need to have stock on hand at all times, and the often unpredictable demand of these products. However, it is possible to minimize the wastage of blood products with careful management of inventories, proper documentation, and education1. In this study, we aim to identify the amount and cost of wasted blood products at Staten Island University Hospital in 2020, the reasons behind the wastage, and solutions to reduce the wastage. Methods/Case Report A retrospective statistical analysis of blood product waste data in 2020 was performed manually with Microsoft Excel. Wastage rate and average cost was calculated, the reasons behind the wastage were identified, and low cost interventions to reduce wastage were planned. Results (if a Case Study enter NA) Total number of the wasted blood product is 425 which represents 3.8% of the total inventory at a total cost of $ 97,309.46 which does not include the hours spend by the lab personnel for the wasted products. The most wasted blood component is fresh frozen plasma (FFP) (Table 1). Thawing the frozen blood products (FFP and cryoprecipitate) significantly shortens the shelf life and triggers a lot of wastage through expiration (Table 2). 32.5 % of the wasted products are wasted due to expiration on the shelf (Diagram 1). Other reasons for the wastage includes patient unreadiness, patient refusal, late return of unused products etc. (Graph 1). Conclusion Educating clinical and laboratory team members about the reasons for wasted blood products and strategies to reduce it might significantly reduce the wastage. Appropriate activation and immediate deactivation of massive transfusion protocol (MTP) would be one of the most important aspect of this education. Expired thawed blood product is the largest contributor to wastage, and MTP is the main reason for thawing. Preventing unnecessary MTP activation minimizes over-thawing and therefore minimizes the expiration and wastage. Documentation of the wasted blood product should be improved to better identify the reasons behind wastage.
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