Hydatid disease is still endemic in Tunisia. It is mostly seen in young people less than 40 years and children are affected in one third of cases. The lungs are the predominant location in children. Our study aims to define the particularities of children PHC's (pulmonary hydatic cyst) management, the characteristics of giant cyst and to study predictive factors of complications. We included retrospectively 105 children with PHC followed between 1999 and 2019. Patients were aged less than 16 years with surgically confirmed diagnosis of PHC. Two groups of cysts were defined: giant cysts which were 10 cm across or more, and no giant cysts.The sex-ratio was 1.38 with a mean age of 10.5±3 years. The symptomatology was dominated by cough (59%), thoracic pain (51%) and hemoptysis (46%). Giant cysts were observed in 24 (22.9%) patients. Dyspnea (29% vs 5% p<0.001) and thoracic pain (88% vs 41% p<0.001) were significantly more frequently reported in giant cysts. Eighty-six patients had a single cyst (83%) and 19 had multiple cysts (17%). Giant cysts accounted for 22,9% (24 cases). Thoracic ultrasonography was diagnostic in 77.4%. The thoracic CT scan was performed in 27 children with inaccessible cysts in thoracic ultrasonography or in diagnostic doubt.Patients were all treated surgically. Surgical procedures consisted of cystectomy (59%), pericystectomy (18%) and pulmonary resection when parenchyma was destroyed (23%). Parenchymal resection was more often performed in complicated cysts (27% vs 20% p>0.05) and in giant cysts (41% vs 18% p<0.05). A two-stage thoracotomy was performed in the 4 patients with bilateral cysts. Thirteen patients presented immediate post-operative complications which occurred more frequently in complicated and giant cysts. Hospital stay was longer in complicated cysts (16±9 days vs 7±3 days; p<0.001) and in giant cysts (14±9 days vs 11±8 days; p>0.05). In endemic regions, the diagnosis of PHC in children should be based on the combination of thoracic radiography and ultrasonography which are effective, not costly, safe and accessible. Complicated and giant PHC cause lung damage leading to extensive parenchymal resection. They are more associated with post-operative complications prolonging hospital stay and increasing expenses.
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http://dx.doi.org/10.4081/monaldi.2021.1770 | DOI Listing |
Cureus
November 2024
Department of Ophthalmology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PRI.
Giant conjunctival cysts, though rare, can cause significant discomfort and functional impairment due to their size as well as their potential for rupture and recurrence. We report the case of a 51-year-old female who presented with a recurrent giant conjunctival cyst in her left eye, experiencing considerable discomfort and pain upon eye movement. The cyst, located in the left eye, had previously recurred after surgical excision, though visual acuity remained 20/20 bilaterally.
View Article and Find Full Text PDFPak J Med Sci
December 2024
Prof. Dr. Asif Bashir, Department of Neurosurgery, Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Aneurysmal bone cysts are locally invasive, benign lesions usually found in the spine or metaphysis of long bones. They can be primary (idiopathic) or secondary to other bone pathologies. Primary aneurysmal bone cyst usually occurs in the first two decades of life.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
December 2024
Department of Neurosurgery, Kyorin University School of Medicine, Tokyo, Japan.
Background: A ventriculoatrial (VA) shunt is an alternative to a ventriculoperitoneal (VP) shunt for managing hydrocephalus, especially when VP shunt insertion is not feasible. Despite its decline in use, the VA shunt remains vital for certain patients. This report highlights a rare complication of bilateral vocal cord paralysis following VA shunt insertion for hydrocephalus secondary to subarachnoid hemorrhage.
View Article and Find Full Text PDFEar Nose Throat J
December 2024
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Consensus on removing a part of the helical cartilage during preauricular sinus surgery is lacking. A thorough understanding of the histopathological characteristics can improve surgical decisions. We reviewed the histopathological characteristics of preauricular sinuses in 54 patients who underwent surgery between October 2020 and October 2021.
View Article and Find Full Text PDFIndian J Dermatol
October 2024
Department of Dermatology, Institute of Child Health, Kolkata, India.
Introduction: Deep mycoses acquired by penetrating trauma to the skin can have varied and sometimes atypical morphological presentations resulting in diagnostic dilemmas and delay in treatment onset. Histopathology can be a useful tool in not only diagnosing but also differentiating various deep mycoses.
Aims And Objectives: To observe various morphological presentations and histopathological features of deep fungal infections.
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