83 research outputs found
Ethical Dilemma: Is it Worthwhile Operating an End-Stage Pancreatic Cancer Patient with Acute Mesenteric Artery Ischemia? [Moralinėdilemma-ar verta operuoti paskutinės stadijos kasos vėžiu sergantį pacientą, kuriam pasireiškė ūminė mezenterinė išemija?]
No full textPancreatic cancer is as an aggressive malignancy with low survival rates. We present the first case of an operation of acute mesenteric ischemia performed in a patient with end-stage pancreatic adenocarcinoma. Through this case, we also discuss raising concerns regarding the management of severe complications such as acute mesenteric ischemia in patients with progressed pancreatic carcinoma. How ethical is to leave patients untreated? The decisions for management of patients with advanced disease are strongly based on the expected quality of life, ethical principles, different religions and spiritualities, and the burden of healthcare cost. © 2021 Christos Damaskos, Nikolaos Garmpis, Anna Garmpi, Vasiliki E. Georgakopoulou, Alexandros Patsouras, Georgia Sypsa, Athanasios Syllaios, Efstathios A. Antoniou
All that Glitters is not Cholecystitis. A Rare Presentation of Acute Pericarditis Mimicking Cholecystitis and Review of the Literature [Ne viskas, kas blizga, yra ūminis cholecistitas. Retas ūminio perikardito, imituojančio cholecistitą, atvejis ir literatūros apžvalga]
No full textAcute pericarditis is the most common inflammatory disorder of the pericardium, responsible for approximately 5% of visits to the emergency departments, concerning chest pain without myocardial infarction. We report a case of a 41-year-old man who presented to our hospital, complaining about retrosternal and epigastrium pain. The transthoracic echocardiogram showed pericardial effusion while the electrocardiogram and laboratory findings revealed acute pericarditis. An abdominal ultrasound revealed gallbladder edema. The pericardial effusion was treated with pericardial catheter insertion, diuretics, and nonsteroidal anti-in-flammatory drugs. This case shows that acute pericarditis can be clinically presented with many ways, one of them being gallbladder edema. Furthermore, in this case-based review we present all cases of simultaneous appearance of pericarditis and acalculous cholecystitis or gallbladder edema. © 2022 Anna Garmpi, Christos Damaskos, Nikolaos Garmpis, Vasiliki E. Georgakopoulou, Vaios Vasileios Kaminiotis, Evangelos Diamantis, Alexandros Patsouras, Athanasios Syllaios, Dimitrios Dimitroulis
Abdominal pain caused by a giant liver hydatid cyst and the management of the residual cavity in a tertiary public hospital in Greece
No full textDiagnosis and treatment of liver hydatid cysts may be challenging. Many surgical techniques have been proposed for the treatment of liver hydatid cysts, but the problem of the residual cavity still remains controversial and challenging, especially in giant liver hydatid cysts which are rare entities that have not been widely described in the literature so far. Capitonnage, external tube drainage and omentoplasty are the most commonly used techniques. Herein, we report the case of a 70-year-old man with a mild upper quadrant pain that proved to have a giant liver hydatid cyst, 21*14 cm2, occupying the entire right lobe of the liver. We describe a successful surgical approach with cyst unroofing and careful evacuation of the multiple daughter cysts by aspiration, and the effective management of the residual cavity by the combination of all three aforementioned techniques. © Athanasios Syllaios et al
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A Study of Anomalous Conduction in n-Type Amorphous Silicon and Correlations in Conductivity and Noise in Gold Nanoparticle-Ligand Arrays
No full textThis work explores two very different structural systems: n-type hydrogenated amorphous silicon (a-Si:H) and gold nanoparticles (AuNPs) suspended in a matrix of organic ligands. For a-Si:H, examination of the gas-phase concentration of dopant (1-6% PH3/SiH4) and argon diluent effects includes the temperature dependent conductivity, low-frequency electronic noise, and Raman spectroscopy to examine structure. It is found that a-Si:H samples grown with high dopant concentration or with argon dilution exhibit an anomalous hopping conduction mechanism with an exponent of p=0.75. An experimental approach is used to determine correlations between conduction parameters, such as the pre-exponential factor and the characteristic temperature, rather than an analysis of existing models to explain the anomalous conduction. From these results, the anomalous conduction is a result of a change in the shape of the density of states and not a shift of the Fermi level with dopant. Additionally, it is found that argon dilution increases the carrier mobility, reduces the doping efficiency, and causes a degradation of the short-range order. With AuNPs, a comparison of temperature dependent conductivity and low-frequency noise shows that the temperature coefficient of resistance (TCR) is independent of the length of interparticle distance while the noise magnitude decreases
Laparoscopic repair of Amyand's hernia complicated with acute appendicitis. Report of a case
No full textThe presence of vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. Amyand's hernia complicated with acute appendicitis is an extremely rare entity with challenging diagnosis and large debate about the optimal treatment option. We report a case of a 58-year-old man presenting to the Emergency Department with an incarcerated right inguinal hernia. At laparoscopy, an inflamed appendix was identified within the inguinal canal, representing an indirect Amyand's hernia. A laparoscopic appendicectomy was performed followed by a trans-abdominal pre-peritoneal mesh repair of the aforementioned hernia. We report this rare clinical entity raising physicians' awareness to include acute appendicitis within an Amyand's hernia in the differential diagnosis of incarcerated inguinal hernias, along with a successful minimally invasive surgical approach
An extraordinary rare anastomotic band causing food bolus obstruction following uneventful minimally invasive esophagectomy: endoscopic treatment
No full textThe most common long-term complication post esophagectomy implicating the esophagogastric anastomosis is stricture-induced stenosis leading to late postoperative dysphagia. Herein, we present a case of a male patient readmitted to our Upper Gastrointestinal Department due to a food bolus obstruction through an anastomotic epithelial band arisen from a prior esophagogastric anastomosis performed 5 months earlier. A band transection in between two hemostatic clips placed on both sides of the band, followed by a release and fragmentation of the foreign body into several pieces led to its final transoral removal endoscopically. The patient experienced a direct resolution of his dysphagia and discharged on the same day. At 6 months follow-up, he remains symptom-free. In conclusion, endoscopic state-of-the-art techniques when combined with standard hemostatic surgical principles in a minimally invasive manner are excellent tools for the management of post-esophagectomy syndromes
Irreversible electroporation in a case of pancreatic leiomyosarcoma: a novel weapon versus a rare malignancy?
No full textAbstract Background Primary pancreatic leiomyosarcoma is an extremely rare entity that needs high clinical suspicion in order to diagnose it at an early stage. Clinical characteristics, diagnosis, and management still remain challenging and controversial, especially in advanced stages, when tumor invades adjacent vessels and organs or gives distant metastases. Case presentation Herein, we describe a case of a 57-year-old woman suffering from advanced pancreatic leiomyosarcoma with thrombosis of the superior mesenteric vein, as well as liver lesions which were suspicious for metastasis. Multidisciplinary team decided for upfront chemotherapy to assess tumor response. Follow-up imaging after the completion of chemotherapy led tumor board to decide for subsequent surgical exploration. The patient underwent exploratory laparotomy and irreversible electroporation ablation of the pancreatic tumor. Postoperative course was uneventful, and she was discharged 10 days later with a plan to receive adjuvant therapy. To the best of our knowledge, this is the first case of pancreatic leiomyosarcoma ever reported, treated with this novel technique of irreversible electroporation that could be an alternative and feasible way for the management of these rare malignancies. Conclusions In conclusion, primary pancreatic leiomyosarcoma is a rare and highly malignant tumor associated with poor prognosis. Nowadays, R0 surgical resection remains the cornerstone treatment, combined with adjuvant and/or neoadjuvant chemotherapy prior to resection. In the advanced setting, when major vessel invasion and distant metastases occur, chemotherapy along with irreversible electroporation ablation could be a helpful and possibly effective modality for the management of this highly aggressive tumor
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