Pre- and postoperative diagnostic of giant hepatic hydatid cyst: a case report and brief literature review
WJMI 2022; 2(1):1-6
Online publish date: 2022.06.30
Objectives. The presentation of case report of preoperative ultrasound and postoperative histological diagnostic of giant hydatid liver cyst. Material and methods. A 58-year-old female with a chronic right upper quadrant abdominal pain, nausea, vomiting and a history of contact with pets was admitted to hospital. Preoperative sonography, blood profile including serological testing were conducted. Pathomorphological studying was carried out after surgical treatment. Results. Abdomen ultrasonography revealed giant cyst (size: 143 x 160 x 145 mm; volume: 1728 cm3) in the right liver lobe, with presence of peripheral “daughter” cysts, intracavital echogenic linear septa and sharply defined outer borders containing the features of calcification. Postoperative gross examination of resected tissues showed: well-defined round parasitic cyst up to 18 cm in diameter with smooth yellowy-brown wall surface. Wall thickness was 4 mm. Microscopically the cyst wall consisted of rough fibrous connective tissue with chronic nonspecific inflammatory features. Conclusions. Our case presentation confirmed an important and key role of ultrasonography and ancillary role of serological testing for preoperative diagnostic of giant liver hydatid disease with following histologic study of postoperative biomaterial.
Pathomorphological features of the alveolar bone when applying osteoconductive materials on the background of generalized periodontitis
WJMI 2022; 2(1):7-13
Online publish date: 2022.08.14
Modern methods of surgical preparation for orthopedic treatment of patients with periodontal diseases need improvement. The problems of optimization of reparative osteogenesis, prevention of atrophy of the alveolar process which affects the quality of osseointegration, are considered separately. The aim of the study is to establish preimplantation morphological changes of the alveolar bone after surgery to increase the effectiveness of surgical preparation for orthopedic treatment of patients with periodontal disease by developing scientifically sound diagnostic, treatment and rehabilitation measures. To find out the histological compliance of the alveolar bone with clinical and radiological parameters and to determine the general characteristics of the restored bone tissue, histological examination of the alveolar process biopsy was performed during dental implantation in 80 patients: in 20 cases – from areas where osteoplastic mixtures were not applied; in 60 cases – where osteoplastic mixtures were applied. The proposed surgical approaches to tooth extraction applying osteotropic material based on β-TCF with fibrin gel enriched with growth factors, the use of osteoplastic material based on β-TCF and myelocollagen transplant in patients with generalized periodontitis are quite effective in the prevention of postextractive and postoperative atrophy of alveolar processes, which is statistically proven during the evaluation of clinical, radiological, anthropometric, densitometric and morphological results of the study. The applied methods allowed to achieve a significant reduction in the loss of height, width and optical density of the alveolar process long time after treatment compared with the loss of these parameters in patients treated by traditional methods.
Reconstructive surgery of the abdominal aorta coexistent with a horseshoe kidney
WJMI 2022; 2(1):14-19
Online publish date: 2022.09.27
Objectives. Improvement of surgical treatment of abdominal aortic diseases with concomitant horseshoe kidney. Material and methods. We present our experience of reconstructive abdominal aortic surgery associated with a horseshoe kidney. Three clinical observations with data of computed tomography angiography, intraoperative fotos were demonstrated with a discussion of different surgical techniques. Results. To date, due to the uniqueness of the pathology, reconstructive surgery of the abdominal aorta with concomitant horseshoe kidney in the literature is limited to small cohort studies or individual clinical cases, and the choice of treatment technique remains an active subject of discussion. Surgical methods of aortic reconstruction due to this rare anomaly determine the variety of operative strategies, from choosing surgical approach, crossing the renal isthmus, ligation or preservation additional renal arteries. Our clinical observations confirm the аdvаntаges оf оpеn surgіcаl tеchniquе, whіch nоt оnly prоvіdеd sufficiеnt еxpоsurе of the оpеrаting аrea, but also allowеd to pеrform оptimal reconstruction of the аbdоminаl аortа coexistent with a horseshoe kidney. Conclusions. Detailed preoperative diagnosis of renal anomalies determines the choice of optimal surgical strategy of abdominal aortic reconstruction. Open surgical treatment of abdominal aortic aneurysms and aorto-iliac occlusive diseases in combination with a horseshoe kidney is a safe and efficient method, which allows to provide satisfactory immediate and long-term results.