Search Results

Now showing 1 - 2 of 2

Some of the metrics are blocked by your
consent settings
ACUTE APPENDICITIS ASSOCIATED WITH ENTEROBIUS VERMICULARIS –CASE REPORT
(Македонско лекарско друштво = Macedonian medical association, 2020)
Radomir Gelevski
;
;
;
;
Marija Toleska
Enterobius vermicularis, typically found in cecum, appendix or terminal ileum, is the cause of the most common helminthic infestation in humans. A 19-year-old female patient, with normal laboratory results, was admitted for urgent appendectomy via McBurney inci-sion. After ligation and division of the inflamed appendixfrom the cecal basis, several viable and mobile enterobiusvermiculareswere identified. A short course of alben-dazole treatment was initiated and was interrupted on the second day as a result of the strong anaphylactic reaction. Contrast enhanced CT of the abdomen iden-tified infundibulum of the gallbladder filled with iregu-larhyperdense liquid indicative for parasitic infestation. One month later, elective laparoscopic cholecystectomywas performed, and the removed gallbladder was sentfor parasitological evaluation confirming non-viable worms. Infestation with Enterobius vermicularisobstructsthe lumen of the appendix, causing contraction of the wall and results in appendicitis-like symptoms without signs of acute inflammation. In minority of cases, with pure pathological signs of inflammation a finding of Eneterobius vermicularisis incidental. There are two possible hypotheses regarding the exact mechanism of gallbladder involvement: hematogenous spread or directmigration through unhealthy intestinal tissue. It is recommended to thoroughly examine all appendiceal specimens for presence of this worm, in order to provideadequate anthelminthic therapy in case of infestation.
Some of the metrics are blocked by your
consent settings
DOUBLE, VERY SHORT CYSTIC ARTERY: ANATOMIC VARIATION REVEALED DURING LAPAROSCOPIC CHOLECYSTECTOMY: A CASE REPORT
(Македонско лекарско друштво = Macedonian Medical Association, 2020)
;
;
;
Marija Toleska
;
Introduction. The cystic artery (CA) is the key struc-ture sought to be clipped or ligated during laparoscopicor conventional cholecystectomy.In up to 25% of sub-jects, the superficial and deep branches of the CA have separate origins and Michels called them double CA. Case report. We are presenting a 38-year-old female with one-year history of chronic gallbladder inflamma-tion. During the laparoscopy dissection in the region of the Calot’striangle, we revealed an anatomic va-riation of the cystic artery-a double cystic artery. The more important thing was that both branches were ex-tremely short, or at the lower limit of the publishedlengths of this blood vessel-approximately 3mm each. Bydoing so, the surgicalcourse further took the standardcourse-laparoscopic clips were placed on both branches. Conclusion. The incidence of double CA ranges from 15 to 25%. Such arteries usually arise from RHA and frequently replace the deep branch of the CA. Anatomicvariations in and around Calot’s triangle are frequent. Therefore, careful dissection of Calot’s triangle is ne-cessary for both conventional and laparoscopic chole-cystectomy. Hemorrhage could be a problem during search of the CA if these variations are overlooked and that increases the rate of conversion to open surgery. It also hasto be kept in mind that during laparoscopic visualization anatomical relations are seen differently compared to conventional cholecystectomy

Faculty of Medicine

Browse

Filters

Settings

Sort By

Results per page

Search Results