{"title":"Congenital diaphragmatic hernia with intrathoracic kidney: case report, review of the literature, and strategy for treatment in neonates and infants.","authors":"Yannick Vancampenhout, Stijn Heyman, Daphne Arnold, Stefanie Devriendt, Dirk Vervloessem","doi":"10.1080/00015458.2024.2419705","DOIUrl":"10.1080/00015458.2024.2419705","url":null,"abstract":"<p><strong>Background: </strong>Congenital diaphragmatic hernia (CDH) is a rare developmental defect in the diaphragm, occurring in 2 in 10,000 births. Herniation of intraperitoneal organs through the diaphragmatic opening is always present, however few cases mention the herniation of retroperitoneal organs, such as a kidney. Due to the rarity of this condition, the optimal treatment strategy remains unclear.</p><p><strong>Methods: </strong>A PubMed search was conducted, gathering all published reports of CDH with intrathoracic herniation of the kidney. Cases of isolated intrathoracic kidney without CDH and cases of traumatic hernia were excluded. Patients who underwent surgical repair before the age of 5 years were included for further analysis.</p><p><strong>Results: </strong>Thirty-seven cases were found from 1970 to 2022. The approach used for surgical repair was not mentioned in 55.6% of cases. 52.9% of the remaining patients were treated through laparotomy, whereas in 23.5% a thoracoscopy was performed. A primary repair of the hernia was performed in 88.6%. A hernia sac was noted in 70%. Most patients had a normal origin of the renal vessels and reduction of the intrathoracic kidney was achieved in 78.8%. Moreover, we report a case of CDH with intrathoracic kidney treated through thoracoscopic repair.</p><p><strong>Conclusion: </strong>A thoracoscopic approach is effective for the treatment of CDH with an intrathoracic kidney case with an associated intrathoracic kidney. A therapeutic strategy for CDH with intrathoracic kidney is suggested based on data from published cases.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"44-52"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2025-02-01Epub Date: 2024-07-02DOI: 10.1080/00015458.2024.2371697
Filipa Jácome, Mariana Basílio Martins, Alexandre Sarmento, Andreia Coelho, Marina Dias-Neto, Ahmed Khairy, Eduardo Ocke-Reis, José Andrade, João Rocha-Neves
{"title":"Blood group is a long-term cardiovascular risk factor after carotid endarterectomy.","authors":"Filipa Jácome, Mariana Basílio Martins, Alexandre Sarmento, Andreia Coelho, Marina Dias-Neto, Ahmed Khairy, Eduardo Ocke-Reis, José Andrade, João Rocha-Neves","doi":"10.1080/00015458.2024.2371697","DOIUrl":"10.1080/00015458.2024.2371697","url":null,"abstract":"<p><strong>Background: </strong>ABO blood group system has been clinically related to an increased incidence of cardiovascular diseases. Preliminary data relating Rhesus (Rh) factor and these outcomes also have been published. Our aim was to analyse the impact of blood group on the short and long-term outcomes after carotid endarterectomy (CEA).</p><p><strong>Materials and methods: </strong>From 2012 to 2019, patients from a referral centre who underwent CEA for atherosclerotic carotid stenosis were prospectively followed. Our primary outcomes were long-term major adverse cardiovascular events (MACEs) and all-cause mortality. Secondary outcomes were perioperative complications and myocardial injury after non-cardiac surgery (MINS). Median follow-up was 50 months (interquartile range 21-69). Time-to-event analysis was used to determine the effect of ABO and Rh groups in long-term outcomes.</p><p><strong>Results: </strong>One hundred and eighty-four patients were included, with a mean age of 70.1 ± 9.1 years. Eighteen (25.7%) patients with O type and 48 (42.1%) patients with non-O type presented coronary artery disease (odds ratio [OR]: 2.313, 5-95% confidence interval (CI) 1.245-4.297, <i>p</i> = .008). Patients Rh<sup>+</sup> presented significantly more congestive heart failure, 23 (14.7%), <i>p</i> = .03. The incidence of MACE in the long-term was higher in non-O patients (adjusted hazard ratio: 2.034; CI: 1.032-4.010, <i>p</i> = .040). Rh<sup>-</sup> patients, presented a higher incidence of perioperative MINS. However, there was no statistically significant association with long-term risk of MACE.</p><p><strong>Conclusion: </strong>The incidence of MACE in long-term analysis was higher in non-O blood type and 30-day MINS was significantly more common amongst Rh<sup>-</sup> patients. The benefit from a more complete preoperative cardiac study in these patients should be performed.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"14-21"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2025-02-01Epub Date: 2024-07-31DOI: 10.1080/00015458.2024.2384687
Kartik Sharma, Yashwant Raj Sakaray, Satish S N, Cherring Tandup, Siddhant Khare, Ajay Savlania, Ashish Gupta, Harish Bhujade, Sant Ram, Lileswar Kaman
{"title":"Effect of laparoscopic cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in post menopausal women.","authors":"Kartik Sharma, Yashwant Raj Sakaray, Satish S N, Cherring Tandup, Siddhant Khare, Ajay Savlania, Ashish Gupta, Harish Bhujade, Sant Ram, Lileswar Kaman","doi":"10.1080/00015458.2024.2384687","DOIUrl":"10.1080/00015458.2024.2384687","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic cholecystectomy (LC) is the gold standard management for benign gallbladder diseases. It has been observed that there is alteration in vitamin D levels and bone mineral density after cholecystectomy due to altered enterohepatic circulation. With increase in average age expectancy of the population, low levels of vitamin D levels and osteoporosis after cholecystectomies might cause increased health care burden.</p><p><strong>Methods: </strong>A prospective observational study was planned between 1 January 2022 and 30 June 2023 in the Department of General Surgery at PGIMER Chandigarh, a tertiary care hospital in north India. One hundred and three post-menopausal women who underwent LC and met the inclusion and exclusion criteria were included in the study. All participants underwent estimation of vitamin D and bone mineral density preoperatively and third-post operative month (POM).</p><p><strong>Results: </strong>The mean age of the patients was 58.46 ± 7.44. Pain abdomen was present in 68(66%) patients, 18 had epigastric discomfort and 17 had dyspepsia. The mean levels of vitamin D decreased from 21.92 at the baseline to 20.12 at third POM (<i>p</i> < .001). There was a significant change in <i>t</i> score Femoral Neck (-1.12 vs -1.15, <i>p</i> < .001) and Lumbar spine L1-L4 - 1.98 vs -1.98 (<i>p</i> = .033). <i>z</i>-scores of the femoral neck were -0.34 vs -0.54 (<i>p</i> < .001) and of lumbar spine L1-L4 were -0.95 vs 1.02 (<i>p</i> < .001). The decrease in fracture risk for the femoral neck (<i>p</i> = .344) and the lumbar spine (<i>p</i> = .223) was not statistically significant.</p><p><strong>Conclusion: </strong>There is a significant decrease in vitamin D and BMD levels after LC in post-menopausal females.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"29-32"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-04-04DOI: 10.1080/00015458.2024.2336676
Paolo Ossola, Andrea Borasi, Andrea Barberis, Silvia Marola, Francesco Ghiglione, Giuseppe Pentassuglia, Barbara Puligheddu, Paolo Riccardo Brustio, Ilaria Messuti, Marco Bononi, Renzo Leli, Fabio Lanfranco
{"title":"Early parathyroid hormone (PTH) level as a predictor of post-surgical hypoparathyroidism.","authors":"Paolo Ossola, Andrea Borasi, Andrea Barberis, Silvia Marola, Francesco Ghiglione, Giuseppe Pentassuglia, Barbara Puligheddu, Paolo Riccardo Brustio, Ilaria Messuti, Marco Bononi, Renzo Leli, Fabio Lanfranco","doi":"10.1080/00015458.2024.2336676","DOIUrl":"10.1080/00015458.2024.2336676","url":null,"abstract":"<p><strong>Introduction: </strong>Post-operative hypocalcemia and postoperative persistent hypoparathyroidism remain the most common complications after thyroidectomy. Many approaches have been developed to prevent them, but actually, a common protocol is not yet individuated.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the results of a prospectively collected database. We dosed PTH preoperatively and 4 h after surgery (PTH_4); calcium was evaluated preoperatively, on the first (I_POD) and on the second postoperative day (II_POD). Hypocalcemia was defined when calcium <8 mg/dl. PTH_4 and I_POD calcium serum levels are identified to predict postoperative hypocalcemia.</p><p><strong>Results: </strong>Three hundred and forty-eight patients were enrolled, 37 patients resulted as hypocalcemic on I_POD and 41 on the II_POD. PTH_4 is related to I_POD (<i>p</i> < 0.001, <i>r</i> = 0.45) and II_POD (<i>p</i> < 0.001, <i>r</i> = 0.44) calcemia. PTH_4-cut-off predicting I_POD hypocalcemia was 10.50 pg/ml (sensitivity: 78.7%, specificity: 72.7%). A PTH_4 value of 11.5 pg/ml is able to predict hypocalcemia during II_POD (sensitivity: 76.5%, specificity: 69.2%). We set up a combined test to predict II_POD hypocalcemia, using PTH_4 and I_POD calcium (sensitivity: 77.8%, specificity: 89.9%).</p><p><strong>Conclusion: </strong>This research shows the association between PTH_4 and postoperative hypocalcemia. The PTH_4 cut-off to predict I_POD-hypocalcemia was 10.5 pg/ml. We analyzed the calcemia trend during the postoperative period and we realized a combined test using PTH_4 and I_POD-calcemia. This test improves the accuracy of the previous test. Further studies, in particular multicentric, with a larger sample are necessary to validate the combined model.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"455-465"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-07-29DOI: 10.1080/00015458.2024.2384796
Maud A S Schoenmakers, Anke H C Gielen, Kevin P Wevers, Jarno Melenhorst
{"title":"Sigmoidorectal intussusception caused by colon carcinoma.","authors":"Maud A S Schoenmakers, Anke H C Gielen, Kevin P Wevers, Jarno Melenhorst","doi":"10.1080/00015458.2024.2384796","DOIUrl":"10.1080/00015458.2024.2384796","url":null,"abstract":"<p><p>Intussusception, the invagination of a bowel segment into an adjacent segment, occurs in 5% of adult patients with an obstruction of the bowel. It is often seen as a result of obstructive defecation syndrome or malignancy. However, a sigmoidal malignancy as lead point is rare. Symptoms in adults are less specific than in children, which makes preoperative diagnosis challenging. An 85-year-old female presented with bright red anal blood loss. A large palpable mass was found during rectal examination. A computed tomography was performed during workup, which showed a 'target-sign' on the location of the lesion. An intussusception of the sigmoid into the rectum was seen over the length of 15 cm. This particular type of intussusception is extremely rare. When a neoplasm is suspected to be the lead point, an oncological resection is recommended. We performed a total mesorectal excision, after which the patient had an uneventful recovery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"504-507"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-08-27DOI: 10.1080/00015458.2024.2395136
Mohammad Hossein Asadi, Azam Khosravi, Robrecht Van Hee, Saeed Amini, Farshid Haghverdi, Saeed Changizi-Ashtiyani
{"title":"The history of medieval bladder stone surgery in Persia.","authors":"Mohammad Hossein Asadi, Azam Khosravi, Robrecht Van Hee, Saeed Amini, Farshid Haghverdi, Saeed Changizi-Ashtiyani","doi":"10.1080/00015458.2024.2395136","DOIUrl":"10.1080/00015458.2024.2395136","url":null,"abstract":"<p><strong>Introduction: </strong>People's understanding of bladder stones has a long history. Since around the sixth century BC, surgery has been selected as the most specialized and last treatment and has continuously evolved. Meanwhile, many missing links have sometimes been a turning point in bladder stone surgery. The efforts of Iranian medicine scholars in advancing this treatment method are part of the impressive ups and downs of this path, which is discussed in this research.</p><p><strong>Methods: </strong>This review research is based on Persian medicine sources, such as Al-Hawi fi al-Tabb, The Kitāb al-Taṣrīf, and Al-Qanun fi al-Tebb. It has also used reliable databases such as Pub Med, Scopus, and Elsevier, as well as search engines such as Google Scholar, with related keywords.</p><p><strong>Results: </strong>Surgery as the last treatment method for bladder stones was first proposed in the Golden Age (800-1300AD) of Persian traditional medicine by Ali ibn Rabben Tabari (810-895 AD) and Rhazes (865-925 AD), who discussed it in more detail. Then Hally Abbas, Albucasis, and Avicenna completed and enriched it. Albucasis's role is imposing due to his unique techniques in perineal cystolithotomy, forceps to extract bladder stones, and primary lithotrity until the nineteenth century.</p><p><strong>Conclusion: </strong>Examining the evolution and progress of bladder stone treatment shows the efforts of physicians in different medical schools. The brilliance of the sages of Persian Medicine, who invented seven different types of bladder stone surgery, improved the techniques of the predecessors and created a significant leap in the progress of this surgery.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"444-454"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-06-18DOI: 10.1080/00015458.2024.2365503
Dusan J Petrovic, Polina Pavicevic
{"title":"Pleuropulmonary blastoma (PPB) with central nervous system metastasis: case report, imaging findings, and review of literature.","authors":"Dusan J Petrovic, Polina Pavicevic","doi":"10.1080/00015458.2024.2365503","DOIUrl":"10.1080/00015458.2024.2365503","url":null,"abstract":"<p><p>Pleuropulmonary blastoma (PPB) is a very rare tumor of the chest seen predominantly in young children with great heterogeneity and clinical, biochemical, and biological complexity and recognized, described, and classified as distinct from the pulmonary blastoma typically encountered in adults. Unfortunately, it has a poor and dismal prognosis and is mainly classified as cystic (type 1), mixed type (type 2), and solid (type 3). Herein, we present one case of PPB type 2 presenting clinically with a right pulmonary abscess, a rare clinical presentation of PPB, which was initially treated with surgery, and after approximately 1 year of follow-up, pulmonary rest-recurrence and central nervous system secondary deposits were detected. When a large pleural-based mass is identified in a young child, PPB should also be considered, especially in a patient with a positive oncological family history. Suggestive findings include the absence of chest wall invasion, presence of pleural fluid, right-sided location, and heterogeneous native (NECT) low attenuation with variable postcontrast enhancement. The authors believe that a modern therapeutic approach should consider these results for a better understanding of the genetic nature and complex mechanism and process of PPB disease development (both clinical and preclinical data concerning PPB pathophysiology are still lacking and are not completely understood) so that it would be possible to establish new possible therapeutic options (i.e. nuclear medicine theranostics in PPB treatment, developments and innovation in FLASH radiotherapy and proton therapy) and approaches, and so that, given the severity of the disease, it would be possible to indicate the importance of genetic testing and counseling of close relatives. In line with the previous, the rapid development of artificial intelligence could potentially bring the development of a novel fusion of radio mics and semantic features and MRI-based machine learning in distinguishing PPB from similar pathology.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"499-503"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta Chirurgica BelgicaPub Date : 2024-12-01Epub Date: 2024-08-20DOI: 10.1080/00015458.2024.2392349
Thaïs De Witte, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke
{"title":"Neck paragangliomas: a case report and literature review.","authors":"Thaïs De Witte, Klaas Van Den Heede, Nele Brusselaers, Sam Van Slycke","doi":"10.1080/00015458.2024.2392349","DOIUrl":"10.1080/00015458.2024.2392349","url":null,"abstract":"<p><strong>Objective: </strong>Thyroid-originated paragangliomas are very uncommon, and there is a lack of established guidelines regarding their management.</p><p><strong>Methods: </strong>A case study was presented, and a review of the literature was conducted.</p><p><strong>Results: </strong>Diagnosing a paraganglioma requires multiple diagnostic methods, including a 24-h measurement of metanephrines or catecholamines, anatomical imaging using magnetic resonance or computed tomography (CT) scans, and functional imaging using metaiodobenzylguanidine or <sup>18</sup>F-DOPA PET/CT scans. Additionally, with the presence of somatostatin receptors on paragangliomas, the use of octreotide scans such as a <sup>68</sup>Ga DOTATATE PET/CT scan is expected to increase soon. The primary treatment for laryngeal paragangliomas is surgical intervention aimed at achieving optimal tumor removal while retaining the highest possible level of laryngeal function. One should not do elective neck dissection given the low risk of metastasis and recurrence. Although the rate of recurrence and metastasis for paragangliomas is low, continued monitoring through clinic visits, biochemical testing, and imaging is still necessary. Furthermore, follow-up efforts should also consider genetic testing of the critical genes associated with paragangliomas.</p><p><strong>Conclusion: </strong>Although there is still debate regarding the existence of thyroid paraganglioma, it can nonetheless be classified as a subtype of laryngeal paragangliomas. All hypervascular thyroid nodules require the consideration of thyroid-associated paragangliomas.</p>","PeriodicalId":6935,"journal":{"name":"Acta Chirurgica Belgica","volume":" ","pages":"508-513"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}