Atraumatic retroperitoneal haemorrhage in a hydronephrotic kidney secondary to transitional cell carcinoma

Retroperitoneal haemorrhage due to rupture of a hydronephrotic kidney has been described previously. There have only been two previous cases reporting retroperitoneal haemorrhage secondary to transitional cell carcinoma. We report two cases of spontaneous retroperitoneal haemorrhage in grossly hydronephrotic kidneys which had extensive transitional cell carcinoma present in the renal pelvis.     

原发性盆部腹膜外肿瘤84例的外科治疗

目的　探讨原发性盆部腹膜外肿瘤的外科治疗经验及技巧。方法　回顾性分析原发性盆部腹膜外肿瘤 84例临床资料 ,其中良性 33例 ,低度恶性 33例 ,高度恶性 18例。术前 6例行血管造影并髂内动脉栓塞。经腹、经骶及位腹骶入路切除者分别 5 8、16、10例。结果　 84例均进行手术治疗 ,其中 1例半年内 4次手术切除肿瘤。 6 8例达肿瘤全部切除 (81% ) ,其中良性肿瘤切除率为 94 %(31/33)。行盆腔脏器联合切除者 35例 ,其中全盆腔脏器切除 2例、前盆腔脏器切除 2例。行髂总、髂外血管切除共 5例 ,均行人造血管移植 ;髂内动脉结扎 10例。术中出血最多 15 0 0 0ml,平均 2 385ml。切除肿瘤最大 30cm× 30cm× 2 5cm ,无手术死亡 ,并发症发生率 7% (6 /84 )。术后 37例获随访 ,平均随访 5 4个月 ,仅 1例死亡 ,2 1例复发者再行 2 2例次手术 ,其中 1例术后多次复发共行 7次手术存活12年。结论　联合切口及联合脏器切除 ,必要时行髂血管移植 ,分次切除及复发后再切除 ,是原发性盆部腹膜外肿瘤治疗的有效手段     

Tumor-Forming Idiopathic Retroperitoneal Fibrosis: Report of a Case

Idiopathic retroperitoneal fibrosis (IRF) is characterized by the progressive proliferation of connective tissue, but it rarely results in the formation of a mass. Herein, we report a rare case of tumor-forming IRF. A 76-year-old woman was referred to our hospital after a tumor in the right retroperitoneum was found by ultrasonography and computed tomography. Magnetic resonance imaging showed a 5 × 8 × 5-cm irregularly shaped tumor, lying adjacent to the right kidney, with a high-intensity T1-weighted image and a high-intensity T2-weighted image. Hormonal levels were within normal limits. Surgery was performed because of the possibility of an adrenal cancer. The tumor was firm, measured 7 × 8 × 4cm, and weighed 115g. The pathological diagnosis was retroperitoneal fibrosis. It is very difficult to distinguish tumor-forming IRF from malignancy. Several examinations, including needle aspiration cytology and biopsy, are necessary for the diagnosis and treatment of this disease.     

A case of retroperitoneal abscess caused by Salmonella Oranienburg

The authors report a case of retroperitoneal abscess caused by Salmonella Oranienburg in an 8-year-old girl. This was one case in an epidemic of food poisoning from Salmonella Oranienburg or Salmonella Chester transmitted by many kinds of contaminated dried squid products. This is the first reported case of a retroperitoneal abscess by Salmonella Oranienburg.     

Presentation of idiopathic retroperitoneal fibrosis in the pediatric population

Idiopathic fibrosis of the retroperitoneum is rare in childhood. The authors describe an 11-year-old boy who presented with progressive renal failure, bilateral hydronephrosis, hypertension, and elevated erythrocyte sedimentation rate (ESR) owing to retroperitoneal fibrosis. Ureterolysis was performed with improvement in his creatinine level and blood pressure. The soft tissue mass consisted of dense collagenous fibers consistent with retroperitoneal fibrosis. Postoperatively, he received steroids and azathioprine. Retroperitoneal fibrosis in the pediatric population is rare with only 23 cases reported in the English-language literature. Treatment includes pulsed steroid regimens, ureteral catheterization, and retroperitoneal exploration with ureterolysis. If allowed to progress, renal failure can result and lead to death. The etiology of retroperitoneal fibrosis in the pediatric patient may include autoimmune diseases, infection, and neoplasm, but most cases are idiopathic. Retroperitoneal fibrosis should be considered in patients with an elevated ESR, hypertension, renal failure, and hydronephrosis. Evaluation also should include a search for autoimmune diseases and malignancy.     

Follow-up of a case of retroperitoneal fibroses treated sequencially via right side autotransplant and left uterolysis with wrapper of posterior preperitoneal fat

We present a case of retroperitoneal fibrosis treated with a renal autotransplantation in a patient inicially treated with endourologic measures and corticotherapy without success. The extense ureteral affectation was the indication to carry out an autotransplant. The follow-up is of nine years, with the function of the renal unity still preserved. We checked the literature for the therapeutic possibilities, medical as much as surgical, of the retroperitoneal fibrosis with special attention to the usage of the refractory IRF to other treatments. This revised version was published online in June 2006 with corrections to the Cover Date.     

Gastrointestinal Stromal Tumors and Leiomyosarcoma of the Abdomen and Retroperitoneum: A Clinical Comparison

Introduction: The present study was undertaken to define the clinical differences between leiomyosarcomas (LMS) occurring within the abdomen and retroperitoneum and gastrointestinal stromal tumors (GIST).Methods: It was a retrospective, single-institution review of patients treated for intra-abdominal and retroperitoneal GIST and LMS from July 1, 1982 through August 1, 1999.Results: A total of 561 patients, 239 with GIST and 322 with LMS, were identified. Patients with GIST were older, with a median age of 58 years versus 54 years in the LMS group (P < .01). The majority of patients with GIST were male (58%), whereas 68% of LMS patients (excluding gender-specific sites) were female (P < .01). The 5-year disease-specific survival for GIST and LMS were 28% and 29%, respectively. The presentation status and ability to achieve a complete surgical resection were the main independent predictors of outcome for both GIST and LMS. Local and distant recurrence was common in both. The pattern of distant recurrence differed: 50% of all first-site GIST recurrences involved the liver, whereas 30% of all LMS first-site recurrences involved the lungs.Conclusions: Although the two patient populations appear to be distinct, their clinical courses are similar. The pattern of distant spread follows the known patterns of hematogenous dissemination. Complete surgical resection is the cornerstone of treatment for primary GIST and LMS and in selected patients with local and distant recurrence.     

腹膜后腹腔镜精索静脉高位结扎术的疗效分析

目的:评价腹膜后腹腔镜精索静脉高位结扎术的疗效及价值。方法:回顾性分析68例经腹膜后腹腔镜途径行精索静脉高位结扎术的治疗效果及恢复情况。结果:67例手术获得成功,1例中转开放手术,平均手术时间为30.5m in,术后平均住院3 d,随访3~9个月,2例复发。结论:经腹膜后腹腔镜途径行精索静脉曲张高位结扎术创伤小、恢复快、治疗效果好,适用于单侧精索静脉曲张和开放手术复发者。     

后腹腔镜手术中转开放手术原因分析

目的分析后腹腔镜手术中转开放手术的原因。方法对195例后腹腔镜手术中17例转开放手术的原因及过程进行回顾性分析。结果17例术中转开放手术，包括肾上肿瘤切除6例，肾囊肿4例，肾切除4例，肾癌根治性切除3例。结论严格掌握后腹腔镜手术适应证，熟练后腹腔镜操作技巧，是提高后腹腔镜手术成功率的关键。     

腹膜后恶性间叶瘤的CT诊断

目的:探讨腹膜后恶性间叶瘤的CT平扫和增强表现及鉴别诊断要点。方法:回顾3例经手术病理证实的腹膜后恶性间叶瘤的CT平扫和增强资料,3例均行CT平扫,2例加作增强。结果:3例均表现为腹膜后单发巨大混合密度肿块,均有点状及大块状钙化,3例瘤内均有脂肪密度,增强扫描所有瘤灶内软组织成分有轻度至中度强化。结论:肿瘤呈单发巨大混合密度肿块,内有脂肪密度区及点状及大块状钙化灶为腹膜后恶性间叶瘤的典型CT表现。肿瘤呈软组织密度时不能与其他间叶组织肿瘤区别。