Renal cell carcinoma in a horseshoe kidney with abdominal aortic aneurysm: a case report

We herein report a case of renal cell carcinoma in a horseshoe kidney with an abdominal aortic aneurysm in a 69-year-old man. Radiological examinations showed a left renal tumor, horseshoe kidney and abdominal aortic aneurysm. We performed a left radical nephrectomy with the division of the isthmus and artificial graft through an abdominal transperitoneal approach. Histological findings revealed clear cell type renal cell carcinoma without invasion of the capsule or renal pelvis. Only 31 cases of renal cell carcinoma in a horseshoe kidney have been reported in Japan, and our case is the 32nd. No case with abdominal aortic aneurysm has been reported previously. We assume that abdominal aortic aneurysm was associated with renal cell carcinoma by chance in the horseshoe kidney in this case. The arterial and venous supplies vary from case to case. We emphasize that arteriography and venography are very important preoperative procedures.     

Right atrial rupture following a hoof kick to the chest wall

We report a case of right atrial rupture due to blunt trauma by a hoof kick to the anterior chest wall. We describe our successful management of this case. We suggest that a diagnosis of cardiac chamber rupture should be considered in all cases of blunt thoracic trauma.     

A Pancreatic Tumour Presenting as a Ruptured Spleen

We report a case of spontaneous rupture of the spleen due to invasion from a pancreatic tumour. We are unaware of any similar case having been reported in the literature.     

A case of ipsilateral pelvic transitional cell carcinoma and renal cell carcinoma

A case of ipsilateral pelvic transitional cell carcinoma and renal cell carcinoma (RCC), in an 82-year-old male is presented. We diagnosed this case as pelvic tumor preoperatively with retrograde pyelography and computed tomography. Operatively renal tumor was found and diagnosed as RCC. We thought it difficult to diagnose as RCC preoperatively. To date, this case is the 13th reported case diagnosed clinically.     

Symptomatic intraspinal pneumocoele resulting from closed head injury

Intraspinal pneumocoele is rarely associated with closed head injury. We describe a case of intra-spinal pneumocoele following a closed head injury. We believe this to be the first case presenting with radicular symptoms.     

Lateral Meniscal Cyst Causing Irreversible Peroneal Nerve Palsy

We report an unusual case of irreversible foot drop occurring secondary to a large lateral meniscal cyst. We discuss the presentation and management of this rare case and highlight some of the less common causes of foot drop.     

Mycosis fungoides causing ureteral obstruction

Ureteral obstruction due to malignant disease is an entity which is commonly encountered. We present a case of ureteral obstruction secondary to mycosis fungoides, a rare T-cell lymphoma. We believe this is the first case of this entity to be reported.     

Hypernephroma with contralateral renal artery stenosis. Therapeutic choices

We report a case of renal adenocarcinoma with contralateral stenosis of the renal artery. We describe the causes of hypertension in renal cancer and investigative techniques leading to the discover of a vascular implication in hypertension. We debate of the different surgical techniques for renal revascularisation with special regard to splenorenal anastomose. This is the method of revascularisation used in this case.     

Aneurysm of the internal jugular vein manifesting after prolonged positive pressure ventilation

True internal jugular vein aneurysms are exceedingly rare anomalies. To date very few case reports have appeared regarding this entity. We present a case of a congenital internal jugular venous aneurysm which manifested itself after abdominal surgery and prolonged positive pressure ventilation. A theory regarding its manifestation is presented. We believe this case to be unique in its presentation.     

Management of iatrogenic full thickness electrical burn in a preterm neonate using W-plasty technique combined with a median sternotomy incision

Burns in the neonatal period are rare and most commonly due to iatrogenic causes. We report a case of a preterm neonate who sustained a full thickness electrical burn following the use of a temporary pacing pad. The case was complicated by significant co-morbidities and the need for cardiac surgery. We describe the surgical management of the case, using excision and closure in the form of a W-plasty. We discuss the reasons for this surgical decision and the importance of managing complex cases such as this on an individual basis.     

Congenital lumbar hernia and bilateral renal agenesis

We report a new case of congenital lumbar hernia. This is first case reported of congenital lumbar hernia and bilateral renal agenesis. We review literature and describe associated malformations reported that would be role out in every case of congenital lumbar hernia.     

DELAYED SURGICAL EMPHYSEMA, PNEUMOMEDIASTINUM AND BILATERAL PNEUMOTHORACES AFTER POSTOPERATIVE VOMITING

We describe a case of surgical emphysema, pneumomediastinumand bilateral pneumothoraces which occurred some hours aftergeneral anaesthesia for a repeat laparoscopy and followed persistentnausea and vomiting. We report the case because of the unexpectedand delayed appearance, which led to delay in diagnosis andmanagement. We suggest that this intrathoracic air leak wasa consequence of postoperative vomiting rather than a complicationof laparoscopy.     

Recurrent malignant melanoma of the penis

We report the case of a 72-year-old man with arcal-lentiginous type melanoma of the penis who had undergone local excision and bilateral inguinal lymphadenectomy but developed recurrence at the subcoronal ridge of the glans penis. To our knowledge, this is the 10th reported case in English published studies. We believe this case demonstrates the importance of close follow-up postoperatively and to beware of the recurrence of penile melanoma in patients without total penectomy.     

Postoperative muscle weakness in a patient recently treated with infliximab

We present a case of profound postoperative muscle weakness in a patient who had been treated with infliximab, and whose weakness had not manifested pre-operatively. We believe this to be the first case report of infliximab-related muscle weakness manifesting immediately after anaesthesia.     

Diagnosis and successful management of calciphylaxis in a pancreas-kidney transplant patient.

Sir, We would like to refer to a case of fatal calciphylaxis developed2 years after kidney transplantation published in the December2004 issue of Nephrology Dialysis Transplantation [1]. We report a case of a 49-year-old woman     

An intra-articular vascular malformation with a ganglion in a knee

We report a case of an intra-articular vascular malformation occurring simultaneously with a ganglion in a knee joint. We believe this to be the first reported case of an intra-articular vascular malformation occurring simultaneously with a ganglion. The malformation was cauterized resulting in resolution of knee pain. We suggest that vascular malformations be considered in the differential diagnosis of knee pain.     

Appendix Carcinoid Found Incidentally During Excision of a Choledochal Cyst: Report of a Case

We report the case of a 13-year-old girl in whom an appendix carcinoid was found incidentally during excision of a choledochal cyst. Although incidental carcinoid tumors of the extrahepatic bile ducts have been reported, to the best of our knowledge this is the first published case of a choledochal cyst associated with an appendix carcinoid. We present this case to highlight the importance of conducting a thorough exploration of all quadrants of the abdomen before closure.     

Right atrial rupture following a hoof kick to the chest wall

Several myocardial lesions can be induced by thoracic blunt trauma. It varies from myocardial lesions to heart rupture. We report a case of right atrial rupture due to unusual blunt trauma: a hoof kick. We describe a successful management of this case. We suggest that a diagnosis of cardiac chamber rupture should be considered in all cases of blunt thoracic trauma.     

A strategy to decide whether to move the last case of the day in an operating room to another empty operating room to decrease overtime labor costs

We examined how to program an operating room (OR) information system to assist the OR manager in deciding whether to move the last case of the day in one OR to another OR that is empty to decrease overtime labor costs. We first developed a statistical strategy to predict whether moving the case would decrease overtime labor costs for first shift nurses and anesthesia providers. The strategy was based on using historical case duration data stored in a surgical services information system. Second, we estimated the incremental overtime labor costs achieved if our strategy was used for moving cases versus movement of cases by an OR manager who knew in advance exactly how long each case would last. We found that if our strategy was used to decide whether to move cases, then depending on parameter values, only 2.0 to 4.3 more min of overtime would be required per case than if the OR manager had perfect retrospective knowledge of case durations. The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved. Implications: The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays, can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved.     

Sacral fracture associated with small bowel entrapment: a case report

We report the third documented case of small bowel entrapment within a sacral fracture leading to small bowel obstruction. This important diagnosis is rare and difficult to make, even with current imaging methods. We report a case in which a segment of small bowel trapped in a Denis II fracture of the sacrum required laparotomy, small bowel resection, and an omental patch over the fracture site. In this case the outcome was favorable with no residual sequelae.