• Title/Summary/Keyword: asymptomatic patient

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Serous cystic neoplasm: Do we have to wait till it causes trouble? Season 2

  • Min Chul Shin;Hye Yeon Yang;Ji Su Kim;Chang Moo Kang
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.217-219
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    • 2023
  • A 50-year-old male presented gradually growing pancreatic body mass. An abdominal computed tomography showed a 9.9-cm mass, larger than the 8.9-cm mass one year ago. As the patient did not have complaints for any symptomatic problems, the gastroenterologist decided to check it with regular follow-up. However, as the tumor grew faster than expected, the patient was recommended for surgical resection. Laparoscopic pylorus preserving pancreaticoduodenectomy was done. Since the tumor abutted to the superior mesenteric vein and the portal vein, wedge resection of vessel was inevitable. Pathology was serous cystadenoma. The patient was discharged without postoperative complications. Herein, we report this case with asymptomatic large serous cystic neoplasm treated by laparoscopic approach. The appropriateness of current guidelines for surgery in serous cystic neoplasm is also discussed.

Treatment of Pulmonary Sequestration with Thoracoscopic Approach (폐분리증의 치료와 흉강경적 절제술의 경험)

  • Cho, Min-Jeng;Kim, Tae-Hoon;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.154-161
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    • 2010
  • Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

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Isolated Spinous Process Fracture of the $7^{th}$ Cervical Vertebrae in a Novice Golfer: a case report (골프 초보자에서 발생한 제 7경추 극돌기 골절 -1예 보고-)

  • Hwang, Jung Chul;Chung, Duke Whan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.11 no.2
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    • pp.96-98
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    • 2012
  • Fractures of isolated spinous processes of cervical and thoracic vertebrae are called as Clay shoveler's fracture. Such fractures related to sports activities are quite rare. In this report, a case of 27-year-old male with isolated spinous process fracture of C7 during golf swing is reported. The patient was prescribed on muscle relaxant and analgesic therapy. Cervical immobilization was maintained for four weeks with a cervical collar. The patient gradually recovered and was asymptomatic. He started playing golf twice a week after 5 months from the onset of pain.

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Incidental findings in a consecutive series of digital panoramic radiographs

  • MacDonald, David;Yu, Warrick
    • Imaging Science in Dentistry
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    • v.50 no.1
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    • pp.53-64
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    • 2020
  • Purpose: The aim of this study was to determine the prevalence of incidental findings(IFs) on digital dental panoramic radiographs(DPRs) of asymptomatic patients attending a general dental practice. Materials and Methods: This was a retrospective study of 6,252 consecutive digital (photostimulatable phosphor) DPRs of patients who visited a Canadian general dental practice for a complete new patient examination. The IFs were grouped into dental-related anomalies, radiopacities and radiopacities in the jaws, changes in the shape of the condyles, and other findings in the jaws, such as tonsilloliths and mucosal antral pseudocysts. Their prevalence was determined. Results: Thirty-two percent of the DPRs showed at least 1 IF. The highest prevalence was found for dental-related anomalies(29% of all DPRs), of which impacted teeth were the most prevalent finding (24% of all DPRs), followed by idiopathic osteosclerosis(6% of all DPRs). A lower prevalence was noted for tonsilloliths(3%), and the prevalence of root tips, mucosal antral pseudocysts, and anomalies in condylar shape was approximately 1% each. Conclusion: The observed prevalence of 32.1% for IFs of any type underscores the need for a dental practitioner to review the entire DPR when a patient presents for an initial dental examination (or check-up) or for dental hygiene. Only a single IF (a central giant cell granuloma) provoked alarm, as it was initially considered malignant. Similarly, impacted teeth and suspected cysts need careful evaluation upon discovery to determine how they may be optimally managed.

The Adult Form of Pulmonary Hamartoma -Two Case Report- (폐(肺)에 발생한 Hamartoma 치험 2예)

  • Lee, D.Y.;Yoon, Y.J.;Cho, B.K.;Hong, S.N.;Rkee, O.S.;Choi, I.J.
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.90-93
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    • 1976
  • Pulmonary hamartoma is often incidental, asymptomatic finding on routine chest roentgenogram. It has been considered a congenital malformation. Since the original description by Albrecht in 1908, it has been classified into two types, a small, fibrocartilaginous mass in adults, and a cystic lobar mass in infants. We experienced two cases of pulmonary hamartoma which proved to be the adult form of hamartoma. One was located in left upper lobe of a 58 year old male patient, the other was located in the perihilar region of the right middle lobe of a 38 year old male patient. The former case was treated by wedge resection: the latter by right middle lobectomy and the postoperative courses of both cases were very good and without complication.

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Surgical treatment of pulmonary aspergillosis (폐 Aspergillosis 의 외과적 치료)

  • 유회성
    • Journal of Chest Surgery
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    • v.17 no.2
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    • pp.269-274
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    • 1984
  • Since tuberculosis was a common pulmonary disease in Korea, Aspergillosis was easily misdiagnosed as tuberculosis and an acute form of Aspergillosis was misinterpreted as pneumonia because of their similarities in the X-ray findings. This investigation is designed to illustrate the clinical features and preoperative diagnosis and surgical role in the management of this disease. In a retrospective review of operative cases from Jan. 1963 through Dec. 1983, 36 cases were analyzed. Peak age incidence lies in the 3rd decade [41.7%]. All cases had a history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis and the most common chief complaint was hemoptysis [69.5%]. Only nine cases [25%] showed cavitary lesions with mycetoma and preoperative sputum study for fungus showed low positive valve [42.3%]. Anatomical location of lesion was located mainly upper lobe [66.7%] and most of cases were managed by lobectomy. We experienced 7 cases of complication; they were postoperative empyema, hepatic failure, esophageal varix bleeding. Postoperative pathologic findings showed that 29 cases [80.5%] were combined with tuberculosis 3 cases were combined with bronchiectasis and 4 cases were not combined with other disease. In conclusion, when the patient has a longstanding history of pulmonary tuberculosis and has a hemoptysis, he must be suspected fungus super infection. Resectional surgery is the treatment of choice for symptomatic localized disease and needed resection in asymptomatic patient to prevent possible fatal sequelae in the future.

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If the Patient Complains Persistent Pain after the Operation, What Should We Do? (거골 골연골병변: 수술 후 지속적인 통증을 호소하는 경우 무엇을 해줄 수 있나?)

  • Lee, Hyeon;Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.69-74
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    • 2020
  • Osteochondral lesions of the talus (OLT) can heal and remain asymptomatic, or they can progress to deep ankle pain on weight bearing and the formation of subchondral cysts. Treatment varies from nonoperative treatment to open and arthroscopic procedures. Operative procedures include marrow stimulation techniques (abrasion chondroplasty, multiple drilling, microfracture), osteochondral autografts or allografts, and autologous chondrocyte implantation. Among these treatments, arthroscopic marrow stimulation techniques have been the preferred initial surgical treatment for most OLT. Despite these treatments, many patients complain of persistent pain even after surgery, and many surgeons face the challenge of determining a second line of treatments. This requires a thorough re-evaluation of the patient's symptoms as well as radiological measures. If the primary surgical treatment has failed, multiple operative treatments are available, and relatively more invasive methods can be administered. On the other hand, it is inappropriate to draw a firm conclusion in which methods are superior.

Rapidly Calcified Epidural Hematoma in a Neonate

  • Yu, Dong-Kun;Heo, Dong-Hwa;Cho, Sung-Min;Cho, Yong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.98-100
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    • 2008
  • We report a very rare case of a rapidly calcified chronic epidural hematoma (EDH) in a neonate. A 26-day-old female infant was referred to us from a regional hospital because of drowsy mentality and a seizure attack. She was delivered through caesarian section because normal spontaneous vaginal delivery was prolonged and failed. At birth, mild scalp swelling was found on the right frontal area. Scalp swelling was spontaneously resolved and she was discharged without any problems. On the 25th day after her birth, the baby presented with drowsiness and hypotonia following a generalized tonic-clonic seizure. Magnetic resonance imaging (MRI) and a computed tomography (CT) scan revealed a chronic EDH that had a thick layer of calcification. A small burr-hole trephination was performed and a single silastic drainage catheter was inserted. After the operation, a total of 12 ml of liquefied hematoma was drained, and the patient's mentality improved from drowsiness to alertness. The patient was asymptomatic when discharged.

A Retained Polyethylene Catheter Fragment in Superior Vena Cava - A case report- (상대정맥내 폴리에틸렌관 잔존물 치험 1례)

  • 김주현
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.134-137
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    • 1980
  • This represents a case report of the retained polyethylene catheter fragment in superior vena cava. A 39 year old male was admitted to this Korea University Hospital a short time after compression wound on abdomen with heavy cement material in emergency room, a polyethylene catheter was introduced into the right subclavian vein through a needle. But when the polyethylene catheter was attempted to withdraw the catheter was severed by the beveled tip of the needle. Later that day, chest X-ray disclosed the presence of the fragment extending from right subclavian vein to the superior vena cava. {Fig. 1 and Fig. 2]. Local exploration by way of an infraclavicular incision was unsuccessful in locating the catheter fragment. Another attempt was then made remove the catheter by means a biotome, which is originally a device for the biopsy of the myocardium, introduced through the right great saphenous vein. This procedure, though well tolerated by the patient, was in vain. After 11 days later, during that time he was taken a laparotomy with drain, another operation for removal of retained catheter fragment was performed through median sternotomy. After exposure of the right subclavian vein, innominate vein, and superior vena cava, an incision 1 cm in |length was made directly over the palpated catheter. The catheter immediately was picked upward and removed. The length of the catheter was approximately 8 cm. [Fig 3 ] There was no evidence of thromboembolism from the catheter or other complications. The patient made an uneventful recovery, and was discharged asymptomatic on the 9th postoperative day.

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Extra-Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass

  • Lim, Junghyeon;Cho, Sung Woo;Lee, Hee Sung;Kim, Hyoung Soo;Kim, Yong Han;Park, Bong Suk
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.308-311
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    • 2017
  • A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.