Annals of Medicine and Surgery最新文献

{"title":"\"Is sotagliflozin a 'wonder drug'? A review of its impact on cardiovascular, diabetic, renal, neuroprotective, and hepatic outcomes\".","authors":"Eeshal Fatima, Hamza Irfan, Faiza Fatima, Jyoti Jain, Obaid Ur Rehman, Ayesha Sehar, Bilal Ahmad, Sanjana Kumari, Aymar Akilimali","doi":"10.1097/MS9.0000000000003357","DOIUrl":"10.1097/MS9.0000000000003357","url":null,"abstract":"<p><p>Heart failure (HF) and diabetes mellitus frequently co-occur, with an incidence of HF among diabetics ranging from 9% to 22%. Clinical research underscores that shared pathophysiological pathways link these conditions, driving advancements in therapeutic strategies that target neuro-hormonal modulation and sodium-glucose co-transporter 2 (SGLT2) inhibition. The SOLOIST-WHF and SCORED trials highlighted the efficacy of sotagliflozin, a dual sodium-glucose co-transporters 1/2 (SGLT1/2) inhibitor, in patients with HF and chronic kidney disease (CKD), demonstrating reductions in cardiovascular mortality and HF-related hospitalizations. Trials with other SGLT2 inhibitors, like dapagliflozin and empagliflozin, in HF, diabetes, and renal disease also showed significant reductions in major adverse cardiovascular events, hospitalizations, and improved kidney function. Furthermore, SGLT2 inhibitors have shown neuroprotective effects, potentially benefiting patients with Alzheimer's and Parkinson's diseases. Dual SGLT1/2 inhibitors, by targeting glucose transport in the renal and intestinal systems, not only reduce blood glucose but also improve insulin sensitivity, weight loss, and cardiovascular health. Sotagliflozin specifically impacts postprandial glucose absorption, mitigating the risks of hypoglycemia and hyperglycemia-related complications. In diabetic CKD, SGLT inhibitors promote renal protection by reducing glucose reabsorption, diuresis, and systemic inflammation. Neuroprotective effects of these agents, including reduced oxidative stress and inflammatory markers, show promise in treating neurodegenerative diseases. While adverse effects like hypoglycemia and ketoacidosis remain concerns, tailored dosing, and monitoring strategies may mitigate these risks. Thus, SGLT inhibitors, especially dual inhibitors like sotagliflozin, offer broad therapeutic benefits in diabetes, HF, CKD, and potentially neurological conditions.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3700-3706"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors leading to the formation of intranasal synechiae (adhesions) in patients who underwent septo- and septoturbinoplasty (a retrospective cohort Study).","authors":"Mateusz J Stępiński, Jacek Banaszewski","doi":"10.1097/MS9.0000000000003223","DOIUrl":"10.1097/MS9.0000000000003223","url":null,"abstract":"<p><strong>Introduction: </strong>Intranasal adhesions (synechiae) are common complications of nasal surgery. This study aimed to analyze the factors influencing the development of synechiae, with particular emphasis on the use of nasal septal splints. We also propose a solution to reduce the incidence of this complication in the future.</p><p><strong>Methodology: </strong>This retrospective analysis of patients (<i>n</i> = 243) who underwent septoplasty and septoconchoplasty between 2017 and 2022.</p><p><strong>Results: </strong>Iatrogenic intranasal synechiae occurred in 26.75% (65/243) of patients. Among patients who received nasal septal splints, synechiae occurred in 13.1%. Synechiae complicated 46.9% of the surgeries in the group without separators (<i>P</i> < 0.001). There was no statistically significant relationship between increased risk of synechiae and concomitant conchoplasty (26% vs. 27.7%, <i>P</i> = 0.817). Patients with seton gauze dressings experienced synechiae significantly more often than those with nasal tampons or other gauze dressings (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>The use of nasal septal separators and tampons significantly reduces the risk of iatrogenic intranasal synechiae following septoplasty or septoconchoplasty, regardless of the degree of nasal septum deviation. Conversely, the use of seton gauze dressings is associated with a higher risk of developing synechiae.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3082-3096"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of preoperative anxiety and anesthesia-related fears in a comprehensive hospital in Ethiopia.","authors":"Zekarias Markos, Addisu Mekuanint, Sintayehu Samuel Lorato, Yisehak Wolde Mekeso, Samson Yirga, Misganu Mugoro, Esubalew Muluneh Aligaz, Gediwon Gebrehiwot Soramo, Atsedu Endale Simegn","doi":"10.1097/MS9.0000000000003339","DOIUrl":"10.1097/MS9.0000000000003339","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anxiety has been identified as a health concern in perioperative care because prior research has shown that most patients undergoing surgery would experience some degree of anxiety.</p><p><strong>Objective: </strong>To evaluate preoperative anxiety and anesthesia-related fears adult patients undergoing surgery under anesthesia.</p><p><strong>Method: </strong>A cross-sectional study was conducted among 392 surgical patients who underwent under anesthesia. Preoperative anxiety was assessed by using STAIS. Binary regression was used to find out the factors affecting preoperative anxiety. SPSS 27 was used for analysis. A <i>P</i>-value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Prevalence of a preoperative high STAI (State and Trait Anxiety Inventory Scale) (52.6%), fear of death (40.5%), fear of unable to recover (54.8%), fear of intraoperative pain (53.8%), and fear of awareness (40.8%) are statistically significant anesthesia-related causes for preoperative anxiety.</p><p><strong>Conclusion: </strong>The prevalence of anxiety was considered to be high. Fear of death, fear of being unable to recover, fear of intraoperative pain, and fear of awareness are statistically significant anesthesia-related causes of preoperative anxiety. No prior exposure of anesthesia and surgery, female gender, emergency procedure, and pre-existing chronic diseases are significantly associated risk factors for preoperative anxiety.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3162-3170"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygen gradients in tumor tissues implications for breast cancer metastasis - a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003121","DOIUrl":"10.1097/MS9.0000000000003121","url":null,"abstract":"<p><p>Oxygen gradients within tumor tissues play a pivotal role in breast cancer metastasis, influencing critical biological processes that contribute to disease progression. Tumors often develop regions of hypoxia due to rapid growth and insufficient blood supply, which drives adaptation mechanisms that promote metastatic behavior. These low-oxygen areas trigger the activation of hypoxia-inducible factors (HIFs), which regulate genes involved in angiogenesis, epithelial-to-mesenchymal transition (EMT), and immune evasion. Such processes increase the capacity of cancer cells to migrate, invade distant organs, and survive under harsh conditions, contributing significantly to metastasis in breast cancer. The interaction between oxygen gradients and the tumor microenvironment (TME) is complex, with hypoxia inducing significant alterations in immune responses. Hypoxic regions of tumors often foster an immunosuppressive microenvironment by recruiting regulatory immune cells that inhibit the function of cytotoxic T cells and natural killer cells. This immune evasion not only allows the tumor to grow but also facilitates the spread of cancer cells to secondary sites. Furthermore, hypoxia-induced angiogenesis provides the necessary vasculature for metastatic cells to enter the bloodstream and seed distant organs, further enhancing the metastatic potential of breast cancer.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3372-3380"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid onset of neurological symptoms in an HIV-positive patient with progressive multifocal leukoencephalopathy: a case report.","authors":"Sameeka Waqas, Umer Iqbal, Laiba Khurram, Ahmed Saleem, Qurrat Ul Ain, Mujeeb-Ur-Rehman Abid Butt, Inibehe Ime Okon","doi":"10.1097/MS9.0000000000003351","DOIUrl":"10.1097/MS9.0000000000003351","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease of the central nervous system caused by substantial damage to oligodendrocytes. It clinically presents as movement impairment, cognitive disability, language aphasia, dysarthria, and visual impairments. It was first identified in 1958. It is commonly associated with either Hodgkin's lymphoma or chronic lymphocytic leukemia.</p><p><strong>Case presentation: </strong>A 40-year-old male Asian farmer presented with altered behavior, fever, and weakness on the right side of his body after suffering a widespread tonic-clonic seizure. His medical background included a tonsillectomy, treatment for pulmonary tuberculosis, and hepatitis C (negative polymerase chain reaction). On admission, he had asymmetric plantar responses, pallor, brisk deep tendon reflexes, an oral thrush, and decreased strength and tone in the muscles on his right side. The findings of the laboratory tests revealed elevated pH, red blood cells, lymphocytes, and protein in the cerebrospinal fluid, as well as an elevated erythrocyte sedimentation rate, abnormal liver function tests, and no bacterial growth. Magnetic resonance imaging (MRI) showed bilateral parietal, temporal, and frontal lobe high signal lesions (T2W, FLAIR sequences), with more severe lesions in the left lobe and no contrast enhancement, consistent with the imaging features of PML. According to the spinal tap, the patient was JC virus-positive. HIV testing indicated a significant viral load, and electroencephalogram recorded seizures.</p><p><strong>Clinical discussion: </strong>JC virus reactivation causes PML, a serious brain condition in patients with weak immune systems. HIV and immunosuppressive drugs are thought to be the potential risk factors behind the reactivation of the JC virus and the appearance of PML. Symptoms like seizures and fever are not usually associated with PML, but the presence of these symptoms hints toward the complexity of the diagnosis of this case. Doctors should focus on treating the root cause of the weakened immune system to help patients. PML was identified by combining the results of an MRI scan with the patient's HIV status and the results of a spinal tap. The patient's health deteriorated even after receiving corticosteroids, acyclovir, nutritional supplements, and palliative therapy. As time passed, he developed neurological complications, respiratory failure, and ultimately death.</p><p><strong>Conclusion: </strong>This case highlights the more aggressive and unique course of PML in HIV patients, it underscores the importance of assessment of the neurological symptoms in high-risk individuals. As PML carries high mortality risk it necessitates prompt diagnosis and treatment with antiretroviral drugs to slow the disease progression.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3994-3998"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the pharmacological mechanisms of Xiaoyao pill in breast cancer treatment.","authors":"Jie Chen, Xinyu Meng, Yanyan Shen, Adheesh Bhandari, Rutian Hao","doi":"10.1097/MS9.0000000000003276","DOIUrl":"10.1097/MS9.0000000000003276","url":null,"abstract":"<p><strong>Objective: </strong>The Xiaoyao pill, a Chinese patent medicine initially designed for treating breast hyperplasia, has emerged as a potential therapy for inhibiting breast cancer.</p><p><strong>Method: </strong>Research has delved into its mechanisms, utilizing Disease Oncology, Gene Oncology, and Kyoto Encyclopedia of Genes and Genomes analyses. Correlations between Xiaoyao pill's target genes and lipid metabolism were identified. Comparative gene set enrichment analysis between normal and breast cancer (BRCA) tissues showed down-regulation of lipid metabolism-related genes in BRCA, suggesting their role in cancer development. Weighted gene co-expression analysis revealed a gene module associated with both normal and malignant breast tissue, impacting lipid metabolism significantly.</p><p><strong>Result: </strong>Protein-protein interaction network analysis highlighted expression differences in 24 common genes shared between Xiaoyao pill and BRCA. Receiver operating characteristic curve analysis indicated Xiaoyao pill's potential diagnostic utility for BRCA. Target genes were detectable in immune cell types, particularly T cells, suggesting a role in tumor immunity modulation.</p><p><strong>Conclusion: </strong>In conclusion, the Xiaoyao pill holds promise in treating BRCA by down-regulating lipid metabolism pathways and potentially influencing tumor immunity, presenting a multifaceted approach to breast cancer management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3201-3214"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extradural malignant melanotic nerve sheath tumor of the lumbosacral spine: a diagnostic and surgical challenge.","authors":"Naeem Ul Haq, Gulmeena Aziz Khan, Shehryar Haider, Ashan Fareed, Samim Noori, Sardar Noman Qayyum","doi":"10.1097/MS9.0000000000003327","DOIUrl":"10.1097/MS9.0000000000003327","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Malignant melanotic nerve sheath tumor (MMNST) is a rare and potentially aggressive variant of schwannoma that arises from Schwann cells containing melanin. These tumors most frequently occur in the spinal nerve roots and are often misdiagnosed due to their radiological and histopathological similarities with other pigmented lesions such as malignant melanoma or pigmented meningioma. Accurate diagnosis is crucial, as MMNST carries a higher risk of local recurrence and distant metastasis compared to conventional nerve sheath tumors.</p><p><strong>Case presentation: </strong>We report the case of a 30-year-old male who presented with a 6-month history of progressive left-sided leg pain, lower backache, and paresthesia. Neurological examination revealed decreased perineal sensations and tenderness in the lumbosacral region. MRI of the lumbosacral spine showed an extradural, well-circumscribed, T1 hyperintense lesion with mass effect on the left L5, S1, and S2 nerve roots. The patient underwent surgical resection, and the lesion was found to be encapsulated and pigmented. Histopathology confirmed the diagnosis of MMNST. Immunohistochemistry was positive for S-100 and HMB-45. Postoperative recovery was uneventful, and no recurrence was observed at 6-month follow-up.</p><p><strong>Clinical discussion: </strong>MMNST poses significant diagnostic and therapeutic challenges. While MRI may suggest a pigmented lesion, definitive diagnosis relies on histopathology and immunohistochemical markers. Given its malignant potential, complete surgical resection with long-term follow-up is the mainstay of management. In this case, the tumor's extradural location and involvement of the sacral nerve roots added to the surgical complexity. Multidisciplinary collaboration was pivotal in planning surgical excision and monitoring for recurrence.</p><p><strong>Conclusion: </strong>MMNST should be considered in the differential diagnosis of pigmented spinal lesions, especially in young adults with progressive neurological symptoms. Early recognition and complete surgical resection remain essential for optimal outcomes. This case highlights the importance of integrating imaging, histopathology, and immunohistochemistry to ensure accurate diagnosis and guide management.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3940-3944"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of platelet to lymphocyte ratio for in-hospital outcome of patients admitted with diagnosis of exacerbation of COPD with type II respiratory failure.","authors":"Anand Kumar Deo, Kirti Kala Kharel, Deepshikha Kharel, Santa Kumar Das","doi":"10.1097/MS9.0000000000003352","DOIUrl":"10.1097/MS9.0000000000003352","url":null,"abstract":"<p><strong>Introduction: </strong>Exacerbations of chronic obstructive pulmonary disease (COPD) are often associated with increased local and systemic inflammation. They tend to worsen the quality of life of sufferers and increase hospital admissions and mortality. Reliable and readily available biomarkers to identify the high-risk patients are necessary to facilitate early implementation of appropriate treatment strategies.</p><p><strong>Methods: </strong>This prospective cohort study, conducted on 110 patients, aimed to study the predictive value of platelet to lymphocyte ratio (P/L) at the time of admission for in-hospital outcome of patients admitted with a diagnosis of exacerbation of COPD with Type II respiratory failure. Patients were followed up during their entire stay at the hospital and their blood tests, clinical course and outcome were recorded. The data obtained were recorded in an Excel sheet and analyzed using Statistical Package for Social Science (SPSS) version 25. The work has been reported in line with the STROCSS criteria.</p><p><strong>Results: </strong>Among 110 patients, 11 (10%) died during hospitalization. Mean P/L at the time of admission was 214.56 ± 84.13 among the patients who eventually died at hospital and 152.53 ± 121.19 among those who were discharged (<i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>Our study shows that the mean P/L at the time of admission was significantly higher in COPD patients with type II respiratory failure who died during hospitalization compared to those who were discharged. These findings suggest that the P/L could serve as potential prognostic biomarker for in-hospital mortality risk in COPD exacerbations.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3118-3122"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D bio-printed scaffolds and smart implants: evaluating functional performance in animal surgery models.","authors":"A S Vickram, Shofia Saghya Infant, S Manikandan, B Bhavani Sowndharya, G Gulothungan, Hitesh Chopra","doi":"10.1097/MS9.0000000000003333","DOIUrl":"10.1097/MS9.0000000000003333","url":null,"abstract":"<p><p>Surgical models with an application of 3D bio-printed scaffolds and smart implants in animal surgery and their further applicability in regenerative medicine and implantology. This review discusses the functional performance of these advanced biomaterials in terms of mechanical properties, biodegradation rates, cellular responses, and in vivo integration. These 3D bio-printed scaffolds from hydrogels, bioceramics, and polymer composites feature tunable porosity (50-90%), mechanical strengths (0.1-50 MPa) and degradation rates compatible with bone, cartilage, and soft tissue engineering. Smart implants combining biosensors, drug delivery systems, and electrical stimulation in real time facilitate island operation of tissue regeneration. According to animal studies, titanium-based smart implants with surface-modified coatings show 86% osseointegration enhancement. In a rabbit knee model, gelatin-methacryloyl (GelMA) scaffolds for cartilage repair restored over 75% of native tissue function within 12 weeks. In rodent sciatic nerve defects, electrostimulated bio-scaffolds have induced a 40% increase in the rate of nerve regeneration. Concerning challenges, such as immune rejection and vascularization limitation, in addition to the demand for long-term stability, still require further improvements, including enhanced resolution of bioprinting technology and bioactive material offer. This review provides a critical assessment of qualitative and quantitative evidence to drive preclinical and translational studies in the wider context of precision medicine and next-generation, implantable biomaterials.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3618-3634"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal cysts with congential, ipsilateral renal agenesis of left kidney: a case report.","authors":"Hardik Bhandari, Kabi Raj Bhusal, Sandhya Banjade, Bibhav Bashyal","doi":"10.1097/MS9.0000000000003347","DOIUrl":"10.1097/MS9.0000000000003347","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Unilateral renal agenesis is defined as the congenital absence of renal tissue of one side that results from a lack of induction of the metanephric blastema by the ureteral bud. Primary retroperitoneal cysts lying in the retroperitoneal fatty tissue have no apparent connections with any anatomical structure except by loose areolar tissue and are rare. They remain asymptomatic and are diagnosed incidentally.</p><p><strong>Case presentation: </strong>A 28-year female presented with complain of epigastric pain for 2 years. On examination, abdomen was soft and non-tender without any palpable masses. Abdominal ultrasonography revealed enlarged right kidney with left retroperitoneal cyst and absent left kidney. This finding was later confirmed by CT abdomen. The patient underwent ultrasound guided drainage of the lesion and a total of 300 ml of clear fluid was obtained. The fluid was examined to perform microbiological analysis and to exclude the presence of neoplastic cells. All tests were found to be negative.</p><p><strong>Clinical discussion: </strong>Unilateral renal agenesis is associated with other congenital anomalies of the kidney, urinary tract. Retroperitoneal cysts are rare intra-abdominal tumors. The urogenital cysts arise from the vestiges of the embryonic urogenital apparatus and can be classified into pronephric, mesonephric, metanephric, and mullerian. In view of the anatomical location of these embryonal organs, the position of the retroperitoneal cysts can determine from which of the 3 divisions of the primitive urinary apparatus it arose. CT is ideal for assessing retroperitoneal cysts.</p><p><strong>Conclusion: </strong>The occurrence of retroperitoneal cyst with congenital absence of ipsilateral kidney is a rare clinical phenomenon.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3969-3972"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}