Faculty of Medicine

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Author: search.filters.author.Jovanovska, FrosinaHas files: Yes

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    GIANT LEFT HEPATIC CYST WITH GASTRIC OUTLET OBSTRUCTION
    (Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2025-04)
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    Mihajloska Blazhevska, Pandora
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    Jovanovska, Frosina
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    The prevalence of cystic hepatic lesions in the United States is estimated to be 15%-18% and simple hepatic cyst is the most common, found in 2.5%-18% of the population. Gastric outlet obstruction (GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with GOO will often have recurrent vomiting of food that has accumulated in the stomach, but cannot pass into the small intestine due to the obstruction. A 74-year-old patient was admitted to the emergency department due to diffuse abdominal pain, bloating and tenderness in the upper abdomen. In the last month, he had malaise, bloating (especially after a large meal), loss of appetite, regurgitation and a metallic taste in the mouth. Laboratory tests (WBC 12.000, CRP 10) and a CT scan of the abdomen with contrast were performed. We detected a multiple cystic formations on the right liver lobe and larger one on the left liver lobe that compresses the antro-pyloric part of the stomach and D-1 of the duodenum. We performed gastric emptying with a nasogastric tube, serological tests to exclude possible echinococcosis and tumor markers to exclude possible malignancy. Then, we performed a diagnostic gastroscopy and the findings were normal. An indication for laparoscopic intervention has been made and laparoscopic evacuation and excision-reduction of the simplex cyst was performed. The histopathological analysis revealed a simplex cyst. The patient had a normal postoperative course and was discharged home on the third postoperative day. At the examinations after 1 and 3 months, the findings were normal. Large cysts within the liver parenchyma are in contact with the vascular, biliary and digestive systems. The resulting compression may lead to inferior vena cava obstruction, Budd Chiari syndrome, obstructive jaundice, portal hypertension and Gastric Outlet Obstruction.
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    Cecum Volvulus, In Misdiagnosis of Acute Appendicitis: a case report
    (2021-11-30)
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    Jovanovska, Frosina
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    Mustafova, Alma
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    Dervisov, Kristijan
    Cecum Volvulus, In Misdiagnosis of Acute Appendicitis: a case report Şenol Tahir, Martina Ambardjieva, Frosina Jovanovska, Alma Mustafova, Kristijan Dervisov, Nimetula Limani, Petar Markov, Berat Dalipi University Clinic for Surgical Diseases, General and Abdominal Departemen – St.Naum Ohridski, Skopje, N. Macedonia Background: As a type of intestinal malrotation, colon volvulus is most common in the sigmoid, followed by the caecum and then the transverse and splenic flexure. The cause of volvulus may be due to embryologically incomplete rotation of the intestine, Ledd’s bands, long mesocolon, or dolichocolon. Methods/Results: Preoperative diagnosis of cecal volvulus is usually accidental and can be confirmed by CT of the abdomen, and it is an incidental intraoperative finding in most cases. We present a patient with an operative diagnosis for acute appendicitis, with Alvarado score of 8 and positive ultrasonographic signs for acute appendicitis. On laparoscopic exploration for appendectomy, an enormously dilated colon (bigger cystic formation) affects the entire pelvis. The conversion was performed with lower median laparotomy, cecal volvulus found with 360-degree rotation in the direction of the clock’s hands with more significant deterioration of the caecum. Right hemicolectomy was performed with ileum- transverse colon double GIA stapler anastomosis. On the 6th postoperative day, the patient was discharged home. Conclusions: Cecal volvulus although a rare acute surgical condition should be recognized and properly surgically treated.
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    Giant Retroperitoneal Liposarcomas with Involving Adjacent Abdominal Organs: Two case reports
    (2022-09-15)
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    Jovanovska, Frosina
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    Mustafova, Alma
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    Bundovska, Marija
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    Panic, K