Intestinal duplication cyst associated with intestinal malrotation anomaly: report of a case

Duplications of the alimentary tract are rare congenital malformations and may occur anywhere in the intestinal tract. Intestinal duplication cysts have been rarely found with intestinal malrotation anomaly. We present a 2-year old boy who had intestinal duplication cyst, associated with intestinal malrotation anomaly.     

Cardiac hemangioma of the right ventricle —Report of a case—

A 74-year-old male was admitted to our hospital with a diagnosis of intra-cardiac tumor on echochardiography, CT, and MRI. The tumor was located on the free wall of the right ventricle and protruded into the outflow tract. The surgical excision of the tumor was performed under cardiopulmonary bypass. The size of the tumor was 5 × 5 × 4 cm. Histological examination disclosed cavenous hemangioma. The post opertive course1 was uneventful. This is the forth case reported in Japan and the fifteenth case in the world.     

Myxoma of the free wall of the right ventricle: a case report

We present a 30-year-old female patient with a myxoma of the right ventricle, which was attached to the free wall of the right ventricle and was moving in and out the pulmonary valve causing right ventricular outflow tract obstruction. Myxomas of the right ventricle are rare and their surgical excision can be challenging especially if they infiltrate into important structures of the myocardium. They can be part of a broader category of diseases known as Carney complex with a familial predisposition.     

Intraparenchymal epidermoid cyst of the right frontal lobe: a case report

Epidermoid cysts are most likely to occur at the cerebellopontine angle or in the suprasellar region. Intracerebral epidermoid cysts are rare and only 18 cases have been reported in the literature. This report presents a case of epidermoid cyst which developed in the right frontal lobe. A 24-year-old woman was admitted to our clinic on April 24, 1983 because of generalized convulsions. On admission no neurological abnormalities were found except for absence of the venous pulsation in an ophthalmoscopic study. A plain roentgenogram revealed a crescent shaped calcification in the right frontal lobe. An X-ray CT scan showed a round low density area (Hounsfield units + 12) surrounded by irregular ring-like high density spots in the right frontal lobe. Right carotid angiography showed round shift of the anterior cerebral artery to the left. The horizontal portion of the middle cerebral artery was stretched and lenticulostriate arteries were shifted laterally. Abnormal vascularization was not found. On May 11th 1983 a right fronto-temporal craniotomy was performed. Partial corticotomy was done along the cortical sulcus and the tumor was resected. The histological diagnosis was epidermoid cyst. In general an X-ray CT scan shows a low density area with irregular margin. Usually the low density area revealed -8 approximately +30 of Hounsfield units. Neither perifocal low density area nor enhancement by contrast medium is observed.     

腹膜后腹腔镜手术治疗右肾囊肿及右肝囊肿1例报告并文献复习

目的:探讨腹膜后腹腔镜手术治疗右肾囊肿合并右肝囊肿的可行性及安全性。方法:分析腹膜后腹腔镜手术治疗右肾囊肿合并右肝囊肿1例患者的临床资料,并结合国内外文献进行分析。结果:患者顺利完成腹膜后腹腔镜右肾囊肿去顶术及右肝囊肿开窗术,手术时间约60 min。结论:腹膜后腹腔镜右肾囊肿去顶术可同时行右肝囊肿开窗术,手术操作方便、安全、有效。     

Cardiac reoperation in a patient with osteogenesis imperfecta: a case report.

A case of a 40-year-old man with dehiscence of the prosthetic aortic valve and recurrence of mycotic aneurysm of the left ventricular outflow tract with osteogenesis imperfecta is presented. He had an operation of aortic valve replacement and direct closure of the mycotic aneurysm for infective endocarditis twenty-one months ago. We performed reoperation of prosthetic aortic valve, patch closure of the mycotic aneurysm and graft replacement of the ascending aorta. He was complicated with multiple fractures of bilateral scapla and dislocation of left shoulder one postoperative day. Fortunately, cardiac reoperation was performed successfully in this patient despite anticipated difficulties with tissue friability with osteogenesis imperfecta.     

Single ventricle strategy for Uhl's anomaly of the right ventricle

Uhl's anomaly is a rare condition and surgical techniques are few and have had variable success. We present a novel and successful surgical technique to treat this difficult condition.     

Oblique plication for repair of the atrialized ventricle and tricuspid incompetence of Ebstein's anomaly.

An 8-year-old girl who weighed 42 kg presented Ebstein's anomaly with severe tricuspid incompetence, and mild systemic cyanosis during exercise. A new reconstructive procedure for this complex anomaly was used. Oblique transference of the displaced posterior leaflet was performed, which resulted in plication of the atrialized ventricle and reduction in the tricuspid annular diameter. This procedure requires neither detachment nor closure of the tricuspid valve.     

Resolution of a fourth ventricle epithelial cyst after ventriculoperitoneal shunting: case report

BACKGROUND: Symptomatic cysts of epithelial origin occurring in the fourth ventricle are very rare. When such a cyst is encountered, the treatment strategy includes surgical removal or fenestration of the cyst into subarachnoid space. CASE 1: A 23-year-old male was diagnosed as having a cyst located in the fourth ventricle causing hydrocephalus; the patient underwent cyst removal via craniotomy. The histopathologic diagnosis was neuroepithelial cyst. Because clinical and neuroradiological findings persisted, he underwent VP shunting. The cyst disappeared and did not recur. CASE 2: A 54-year-old woman was diagnosed as having a cystic mass in the fourth ventricle and dilatation of the ventricles. Magnetic resonance imaging showed the same findings as those of the first case. The patient refused craniotomy for total mass excision. Therefore, a VP shunt was applied. Postoperatively, the clinical findings and hydrocephalus improved, and complete disappearance of the cystic mass was observed unexpectedly. Both cases had 2 years of follow-up. CONCLUSION: There is no proven mechanism to explain resolution of fourth ventricle cysts after a supratentorial VP shunting. We hypothesize that disappearance of the cyst could result from rupture of its wall because of pressure gradient, which might be facilitated by a VP shunt. The current report should not be taken as an argument against cyst removal, which is the established way of treatment. However, considering that the pathogenesis and pathophysiology of these cysts are unclear, VP shunting should be considered especially for recurrent cases accompanied by hydrocephalus.     

Single left coronary artery with a fistula to the right ventricle: report of a case with successful closure

A 4-year-old boy of single left coronary artery associated with a fistula to the right ventricle was reported. Cardiac catheterization and selective coronary angiography revealed single left coronary artery with a fistula to the right ventricle. At operation, a single coronary artery arising from the left aortic sinus was present. A dilated and tortuous left circumflex branch passed to the right and anterior . This vessel terminated into the outflow tract of the right ventricle. The dilated vessel was doubly ligated at just distal portion of a acute marginal branch. The fistula to the right ventricle was directly sutured from arteriotomy. Then three small branches from the anterior descending artery terminating into the terminal portion of the dilated vessel were found and these were ligated respectively. After repair of arteriotomy, the remainder of the dilated and tortuous vessel was wrapped with a Dacron mesh for reinforcement. Postoperative course was uneventful and there were no complications.     

Giant adrenal cyst in a young female patient: A case report

Adrenal cysts are rare cystic masses that arise from the adrenal gland. They are usually non-functional, asymptomatic and less than 10 cm in diameter when discovered incidentally. However, giant adrenal cysts are cysts of the adrenal gland which are larger than 10 cm in diameter. They pose a diagnostic conundrum to the surgeon as localization of the origin of the cyst is very difficult. Indications for surgical intervention include a size exceeding 10 cm in diameter, the presence of symptoms, endocrine abnormalities, intracystic bleeding and suspicion of malignancy. The current treatment of choice is adrenalectomy, either open or laparoscopic. Ultrasound-guided percutaneous drainage is an alternative, especially when there is no doubt regarding the diagnosis. Following, we report on one of the rare cases of a giant adrenal cyst.     

Double chambered right ventricle in a 62-year-old female: a surgical case report]

A 62-year-old female was admitted with a chief complaint of transient syncope on exertion. Angiography in right ventricle revealed a defect caused by an anomalous muscle bundle and a pressure gradient of 151 mmHg was observed between the two chambers by cardiac catheterization. Resection of the anomalouse muscle bundle was undertaken using a lower median sternotomy starting at the 2nd intercostal space level and through the outflow tract right ventriculotomy. Patch plasty was also undertaken in the outflow tract. Post-operative course was uneventful and pressure gradient had disappeared at the post-operative catheterization. A rare case of DCRV in a 62-year-old patient with a pressure gradient of 151 mmHg in the right ventricle was reported.