Gastric duplication cysts present with a variety of symptoms and complications including hematemesis. The massive upper gastrointestinal hemorrhage in our octogenarian patient indicates that there is no age limit in clinical manifestations of this rather common in the pediatric population, congenital malformation of the stomach.
A 33-yr-old, Caucasian male, smoker (40 pack-yr) presented to the current authors9 hospital complaining of a painful and swollen right breast, which had already lasted a few weeks. He had poor oral hygiene, had been subject to several teeth extractions over the previous 2 yrs and had sporadically used oral antibiotics. He denied fever, cough and shortness of breath or weight loss. The chest physical examination disclosed a painful large soft tissue mass (1068 cm) on the anterior right side of the chest wall, right in the upper part of the breast.Vital signs were normal, as were the results of the routine laboratory tests, with the exception of the erythrocyte sedimentation rate and the C-reactive protein, which were both elevated. The arterial blood gas analysis was within the normal range. The tuberculosis skin test was negative. The patient9s chest radiograph and the computed tomography (CT) scan are shown in figures 1 and 2, respectively. A surgical biopsy was performed under local anesthesia and the tissue histology is also shown in figure 3.
A 45-yr-old woman was admitted to our hospital for surgical treatment of obstructive jaundice. She was treated by a standard pancreatoduodenectomy (Whipple procedure). The biopsy of the specimen disclosed an adenocarcinoma of the ampulla of Vater. Six months before the appearance of the obstructive jaundice, she noted a sudden onset of many seborrheic keratoses on the upper part of her trunk and upper extremities. This, to our knowledge, is the first case of Leser-Trelat sign associated with adenocarcinoma of the ampulla of Vater.
A case of a benign cyst of the right adrenal gland resected laparoscopically is presented. The approach was through the right subcostal space mobilizing the right lobe of the liver and the right colonic flexure. The procedure was of 75 min duration and was uneventful. The patient was discharged the 3rd postoperative day free of postoperative pain. The advantages and disadvantages of this new modality for the treatment of adrenal gland cysts are discussed.
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