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Upper quadrant

Nicholas M Pantelides, Jeyaram R Srinivasan
BACKGROUND: Implant rippling is a frequent complication following breast augmentation or implant-based reconstruction and results in significant patient dissatisfaction. Traditionally, the treatment has been to replace the implant, often placing it in a subpectoral pocket to reduce the risk of recurrence. Other techniques, such as increasing the implant size or tightening the capsule, can also be used. Recently, however, there has been much interest in alternative treatments, including fat grafting or insertion of an acellular dermal matrix...
March 15, 2018: Aesthetic Plastic Surgery
Chao-Bo Chen, Wei-Dong Hu, Wan-Wen Zhao, Yan-Yan Gu, Hong-Wei Hou, Zheng Pan
Caroli disease is a rare congenital disorder characterized by nonobstructive dilatation of intrahepatic ducts. In cases with symptomatic intrahepatic manifestations, treatment should correspond to the type with hepatic resection for localized disease and transplantation for diffuse forms. If possible, complete resection of the cysts can cure the symptoms and avoid the risk of malignancy. A 66-year-old woman presented to Wuxi Xishan People's Hospital with recurrent intermittent upper quadrant abdominal pain...
March 2018: Annals of Surgical Treatment and Research
Michael Riverso, Michael Chang, Consuelo Soldevila-Pico, Jinping Lai, Xiuli Liu
Kratom is an herbal product derived from the leaves of Southeast Asian Mitragyna speciosa trees. It has traditionally been used by indigenous people to relieve fatigue and manage pain, diarrhea, or opioid withdrawal. The use of kratom has become more commonplace in the United States for similar purposes. Only rare reports of kratom liver toxicity exist in the literature but without histologic characterization. Herein, we report one case of kratom use-associated liver toxicity in a 38-year-old patient. The patient complained of dark colored urine and light colored stools after using kratom...
February 2018: Gastroenterology Research
Deepali Prakash, Leandro Siragusa, Saj Wajed, Antonio Manzelli
Gastrointestinal stromal tumours (GISTs) are typically defined as solid masses arising from the GI tract, most commonly from the stomach and small intestine. They seldom present in a cystic form. Management of cystic masses arising from the GI tract may pose a diagnostic predicament. We had one such case that presented itself with complaints of a slow growing intra-abdominal mass. An ultrasound scan demonstrated a thick-walled cystic lesion arising from the pelvis. Further imaging evaluations in the form of a CT scan revealed a complex large cystic mass arising from left upper quadrant (see Figure 1)...
March 5, 2018: BMJ Case Reports
Babak Shekarchi, Seyed Zia Hejripour Rafsanjani, Nima Shekar Riz Fomani, Mojtaba Chahardoli
Introduction: Using bedside ultrasound in diagnosing acute cholecystitis in the emergency department (ED) can save time, help the decision making process and allocate resources wisely. This study aimed to evaluate the diagnostic accuracy of bedside right upper quadrant (RUQ) ultrasonography in detection of acute cholecystitis. Method: In this diagnostic accuracy study, patients presenting to ED, suffering from RUQ pain in favor of acute cholecystitis underwent RUQ ultrasonography in emergency and radiology departments and interrater agreement between reports was calculated...
2018: Emergency (Tehran, Iran)
Athanasios Douskos, Aris Giannos, Sofoklis Stavrou, Maria Sotiropoulou, Eleni Feida, Constantine Dimitrakakis, Peter Drakakis, Alexandros Rodolakis
INTRODUCTION: Lobular breast carcinoma includes lobular carcinoma in situ (LCIS) and invasive lobular carcinoma (ILC). The association of LCIS with total metastatic lobular breast cancer is very rare. PRESENTATION OF CASE: We present a case of a totally metastatic lobular breast cancer in an asymptomatic 64-year-old postmenopausal woman, with no suspicious microcalcifications in mammography. A total hysterectomy with bilateral salpingo-oophorectomy, pelvic lymphadenectomy, infracolic omentectomy and appendectomy was performed along with a quadrantectomy of the upper outer quadrant of left breast, and systematic isolateral lymphadenectomy of the left axilla...
February 12, 2018: International Journal of Surgery Case Reports
Hichem Jerraya, Ali Gaja, Mehdi Khalfallah, Chadli Dziri
Primitive hydatid disease of diaphragm is very rare. The preoperative diagnosis of this hydatid location represents a challenge for the radiologist. We reported a case of primitive hydatid cyst of the diaphragm not associated with other hydatid localizations which was diagnosed preoperatively. A 70 year-old woman with no previous medical history, complained of abdominal pain in the right upper quadrant for 7 months. The physical exam and the laboratory tests were unremarkable. Abdominal ultrasound showed multiloculated cystic lesion which appeared to be located in the hepatic dome suggestive of hydatid cyst of the liver...
April 2017: La Tunisie Médicale
Andrew Cameron, Kosalan Akilan, David Carr
Infectious mononucleosis is typically a self-limited viral infection of adolescence and early adulthood that resolves in a period of weeks, causing no major sequelae. We describe a case of a healthy 18-year-old female diagnosed with infectious mononucleosis who also presented with right upper quadrant abdominal pain, moderate transaminitis, and cholestatic biochemistry. An ultrasound revealed acute acalculous cholecystitis, generally a condition seen in the context of critical illness. Further investigating emergency department patients with infectious mononucleosis is often not indicated, but may be important for those who present atypically...
March 1, 2018: CJEM
Jia-Yan Huang, Qiang Lu, Ji-Bin Liu
RATIONALE: Hemorrhage, one of complications after liver biopsy, is often identified immediately after the procedure while delayed liver rupture is relatively rare. PATIENT CONCERNS: A 45-year-old woman was diagnosed with undetermined liver cirrhosis and abnormal liver function. To determine the etiology and severity of liver cirrhosis, ultrasound-guided liver biopsy was arranged. The patients did not complain any pain during the procedure. Ultrasound examination on postoperative day1 (POD 1) and MRI on POD 3 showed no evidence of hematoma and ascites...
March 2018: Medicine (Baltimore)
Waseem M Seleem, Amr Shaaban Hanafy, Samir I Mohamed
OBJECTIVE: Despite the therapeutic and surgical interventions for the management of gastroesophageal reflux disease (GERD), yet the high cost and the post-operative complications had led to a significant socioeconomic burden. The aim was to evaluate the safety and efficacy of endoscopic band ligation (EBL) in the management of refractory GERD. METHODS: A total of 150 patients with refractory GERD were assigned to an EBL group (banding was done at four quadrants just at the gastroesophageal junction (GEJ) (n = 75) or to a control group (optimized dose of PPI, n = 75)...
February 28, 2018: Scandinavian Journal of Gastroenterology
Qiu N Lee, Gabriel Ayonmigbesimi Akra, Augustus G Kigotho, Mahsa Seyed Ahadi
The incidence of hepatocellular carcinoma (HCC) in pregnancy is rare but is typically aggressive, with a 1-year survival rate of 23%. One of the complications of HCC is spontaneous rupture, resulting in haemoperitoneum. A 36-year-old pregnant Chinese immigrant who was positive for hepatitis B virus and in her first trimester presented to the emergency department of Wyong Hospital, Hamlyn Terrace, New South Wales, Australia, with severe epigastric and right upper quadrant pain and haemodynamic instability. Spontaneous rupture of a heterotopic pregnancy was initially suspected...
February 27, 2018: BMJ Case Reports
Darija Jurišić, Katia Novak Lauš, Irena Sesar, Tomislav Kuzman
The aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). The study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual field defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual field and quadrant excesses...
June 2017: Acta Clinica Croatica
Kevin G Buell, Alexandra Burke-Smith, Vishal Patel, Josef Watfah
A 58-year-old female presented to the emergency department with intermittent right upper quadrant pain and nausea. On examination, the patient was tender and Murphy's sign was elicited. A presumptive diagnosis of acute cholecystitis was made but an ultrasound of the abdomen revealed a thin-walled gallbladder without calculi. A computed tomography (CT) scan of the abdomen and pelvis demonstrated fat stranding involving the greater omentum and the right paracolic gutter. The patient was diagnosed with a focal omental infarction and underwent emergency laparoscopic surgery...
December 13, 2017: Curēus
Peng Sun, Jiewei Chen, Jiabin Lu, Rongzhen Luo, Mei Li, Jiehua He
Breast metastases from solid non-breast tumor types are rare; however, they should be always considered in the differential diagnosis of a breast lesion owing to the associated poor patient prognosis and the requirement of different therapeutic strategies compared with those used to treat primary breast cancer. The aim of the current study was to summarize the characteristics of metastases to the breast in a southern Chinese population. The medical records and pathological sections of 22 patients with pathologically confirmed extra-mammary metastases to the breast that presented to Sun Yat-sen University Cancer Center between January 2000 and December 2015 were retrospectively reviewed...
March 2018: Oncology Letters
Simon Kirste, Gian Kayser, Anne Zipfel, Anca-Ligia Grosu, Thomas Brunner
BACKGROUND: Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors occurring in various anatomic regions. Although diagnostic criteria and treatment management are not established, current treatment options consist of surgery and chemotherapy including mTOR inhibitors. Stereotactic body radiation therapy (SBRT) is a non-invasive ablative treatment which has shown excellent control rates for more common types of unresectable liver tumors and metastases. In this report we present a rare case of PEComa of the liver that was treated by stereotactic radiotherapy followed by resection...
February 20, 2018: Radiation Oncology
Waldo Sepulveda, Jose H Ochoa, Daniel Cafici, Amy E Wong, Federico Badano, Elena Andreeva, Elena Y Andreeva
Introduction: Congenital splenic cysts are a rare cause of abdominal cystic masses in the fetus. We describe nine cases of this condition, the largest reported experience to date. A review of the literature for similar cases was also performed. Methods: Cases of congenital splenic cyst were collected from three prenatal diagnostic centers and from a dedicated website of prenatal diagnosis. Information regarding clinical and sonographic findings was obtained by reviewing ultrasound reports and medical records...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
Jessica K Dyson, Ulrich Beuers, David E J Jones, Ansgar W Lohse, Mark Hudson
Primary sclerosing cholangitis is a rare, chronic cholestatic liver disease characterised by intrahepatic or extrahepatic stricturing, or both, with bile duct fibrosis. Inflammation and fibrosis of bile ducts and the liver are followed by impaired bile formation or flow and progressive liver dysfunction. Patients might be asymptomatic at presentation or might have pruritus, fatigue, right upper quadrant pain, recurrent cholangitis, or sequelae of portal hypertension. The key diagnostic elements are cholestatic liver biochemistry and bile duct stricturing on cholangiography...
February 13, 2018: Lancet
Sundas Hasan, Robert Fearn
We report a case of a previously healthy female patient who initially presented with fever, jaundice and right upper quadrant pain three days after dilatation and stenting of a stricture of the common bile duct (CBD). During an earlier admission, the patient had undergone endoscopic retrograde cholangiopancreatography (ERCP) having presented with fevers and biliary dilatation on ultrasound. The ERCP features were more consistent with Mirizzi's Syndrome. The patient subsequently underwent subtotal cholecystectomy and later developed a CBD stricture, requiring repeat ERCP and stent insertion...
February 15, 2018: BMJ Case Reports
Yue Wu, Xiao-Ni Wang, Ningli Wang, Ying Han, Daqing Ma, Yan Lu
Background We investigated the regularity changes of the retinalnerve fiber layer (RNFL) and macular ganglion cell complex (mGCC) of the amnestic Mild Cognitive Impairment (aMCI) patients in this prospective cohort study. Methods Twenty-four aMCI patients and 30 health controls, who are more than 60 years old, were recruited into the study. The RNFL and the mGCC average thickness were measured with fourier-domain optical coherence tomography (FD-OCT). Results Compared with that in the controls, the intraocular pressure (IOP) was significantly lower in the aMCI patients...
February 15, 2018: International Journal of Neuroscience
Osman Fatih Arpağ, Ahmet Dağ, Bozan Serhat İzol, Gülcan Cimitay, Ersin Uysal
BACKGROUND: Tumor necrosis factor alpha (TNF-α) is an inflammatory mediator whose levels are increased in the gingival crevicular fluid and blood serum in the case of chronic periodontitis. OBJECTIVES: The aim of this study was to determine the effect of vector ultrasonic system (VUS) on the levels of TNF-α in gingival crevicular fluid (GCF) and the clinical parameters in patients with chronic periodontitis. MATERIAL AND METHODS: The study protocol was conducted using split-mouth design in 30 patients with chronic periodontitis...
December 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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