anomaly

异常
  • 文章类型: Case Reports
    背景:交叉融合肾异位(CFRE)是一种常见的先天性异常,其中一个肾脏异常位于中线的另一侧,经常与另一个肾脏融合。然而,单个输尿管引流交叉融合肾异位是罕见的。
    方法:这里,我们报告了一例有结石病史的46岁尼泊尔男性患者的交叉融合性肾异位伴单个输尿管。计算机断层扫描显示左肾位于右侧并与右肾融合。两个肾脏的肾盂融合,和一个输尿管,位于右侧,将两个肾脏排入膀胱。建议患者定期随访。
    结论:单输尿管交叉融合肾异位是一种罕见的肾脏异常。无症状患者通常可以保守治疗。建议定期随访以监测肾功能,微积分形成,感染,和恶性变化。
    BACKGROUND: Crossed fused renal ectopia (CFRE) is a common congenital anomaly where one kidney is positioned abnormally on the opposite side of the midline, often fused with the other kidney. However, single ureter draining crossed fused renal ectopia is a rare occurrence.
    METHODS: Here, we report a case of crossed fused renal ectopia with a single ureter in a 46-year-old Nepali male who presented with history of lithuria. Computed tomography revealed that the left kidney was situated on the right side and fused with the right kidney. The renal pelvises of both kidneys were fused, and a single ureter, located on the right side, was draining both kidneys into the bladder. The patient was advised to have regular follow-ups.
    CONCLUSIONS: Crossed fused renal ectopia with a single ureter represents a rare renal anomaly. Asymptomatic patients can typically be managed conservatively. Regular follow-up is recommended to monitor renal function, calculus formation, infections, and malignant changes.
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  • 文章类型: Journal Article
    一名患者在妊娠26周(约6个月)时通过紧急剖腹产分娩。在出生后13天的超声心动图中发现了动脉导管未闭(PDA)和房间隔缺损(ASD)。患者基于导管封堵PDA和ASD。在常规超声心动图检查装置位置时,发现上腔静脉(SVC)扩张,怀疑有血栓。完成了计算机断层扫描血管造影(CTA)以更好地定义SVC解剖结构和血流加速度。CTA显示存在双无名静脉。
    A patient was delivered at 26 weeks (about 6 months) gestation via an emergency caesarian section. A patent ductus arteriosus (PDA) and atrial septal defect (ASD) were discovered during an echocardiogram 13 days after birth. The patient had catheter-based closure of the PDA and ASD. During a routine echocardiogram to check device placements, it was discovered that there was dilation of the superior vena cava (SVC), and it was suspected that a thrombus was present. Computed tomography angiography (CTA) was completed to better define SVC anatomy and flow acceleration. The CTA demonstrated that there was a double innominate vein.
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  • 文章类型: Case Reports
    我们遇到了一个结肠癌病例,其中结肠中动脉(MCA)起源于脾动脉(SA)。
    一名妇女因横结肠癌被转诊到我们医院。三维计算机断层扫描(3D-CT)血管造影显示异常的MCA起源于SA,而不是典型的肠系膜上动脉(SMA)。行腹腔镜左半结肠切除术并D3淋巴结清扫术。从尾部视图解剖SMA周围的淋巴结,确认没有典型的MCA。胰腺下方发现了一个异常的SA起源MCA,在那里被剪接和结扎;随后,实现了肠系膜全切除。
    由于横结肠癌的D3淋巴结清扫在技术上很困难,3D-CT血管造影可用于术前识别血管异常,从而避免术中损伤。这是与SA起源的MCA异常相关的腹腔镜结肠切除术的首例报告。
    UNASSIGNED: We encountered a colon cancer case with a very rare anomaly of the middle colic artery (MCA) originating from the splenic artery (SA).
    UNASSIGNED: A woman was referred to our hospital for transverse colon cancer. Three-dimensional computed tomography (3D-CT) angiography showed an anomalous MCA originating from the SA rather than from the superior mesenteric artery (SMA) as is typical. Laparoscopic left hemicolectomy with D3 lymph node dissection was performed. The lymph nodes around the SMA were dissected from the caudal view, confirming the absence of a typical MCA. An anomalous SA-originating MCA was identified just below the pancreas, where it was clipped and ligated; subsequently, total mesenteric excision was achieved.
    UNASSIGNED: As D3 lymph node dissection for transverse colon cancer is technically difficult, 3D-CT angiography is useful for identifying vascular anomalies preoperatively, thereby avoiding intraoperative injury. This is the first case report of laparoscopic colectomy associated with a SA-originating MCA anomaly.
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  • 文章类型: Case Reports
    异位肝叶是一种罕见的异常,最常报告为孤立性肿块。在这里,我们报告一例尸检时发现多(两)异位肝叶。一名70多岁的日本男子死于与获得性免疫缺陷综合症(AIDS)相关的传染病。尸检显示偶然发现了两个1厘米的肿块,位于下腔静脉前方。两个肿块均由肝组织组成,内部微观结构类似肝门,由流出胆管和血管组成。流出胆管似乎与胆总管相连,但是流出血管的连接点不清楚。肝组织表现为中央静脉纤维性增厚和门静脉病变,包括门静脉区域的纤维化以及门静脉的狭窄和丢失。没有拥堵的证据,纤维化,胆汁淤滞,或者肿瘤。异位肝叶肝细胞癌的发病率高于正常肝脏,可能是由于异常的循环和胆汁排泄途径。患者还出现门静脉病变;这表明存在异常的循环动力学。
    The ectopic liver lobe is a rare anomaly and is most frequently reported as a solitary mass. Herein, we report a case of multiple (two) ectopic liver lobes detected at an autopsy. A Japanese man in his 70s died of an infectious disease associated with acquired immunodeficiency syndrome (AIDS). Autopsy revealed the incidental finding of two 1-cm masses, located anterior to the inferior vena cava. Both masses were composed of liver tissue and had internal microscopic structures resembling the porta hepatis, consisting of an outflow bile duct and blood vessels. The outflow bile duct appeared to be continuous with the common bile duct, but the connection point of the outflow vessel was unclear. The liver tissue showed fibrous thickening of the central veins and portal venopathy, including fibrosis in the portal area as well as narrowing and loss of the portal veins. There was no evidence of congestion, fibrosis, biliary stasis, or neoplasm. The incidence of hepatocellular carcinoma is higher in the ectopic liver lobe than in the proper liver, presumably due to the abnormal circulation and bile excretion pathways. The patient also presented with portal venopathy; this suggests the presence of abnormal circulatory dynamics.
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  • 文章类型: Case Reports
    我们介绍了一名18岁女性的病例,该病例转诊为MRI骨盆,以通过超声评估可疑的子宫异常。MRI显示完整的纵隔子宫,此外,从左腹膜后区域/左结肠旁沟的左卵巢延伸到脾下表面的细长管状结构(与脾脏等强度)。CT腹部和骨盆显示,这是一个与脾脏相似的增强结构,并且表现为管状腹膜后结构,将左卵巢连接到脾脏,相关的脉管系统与颅侧脾静脉和尾卵巢血管相连,与脾侧融合一致。
    We present a case of an 18-year-old female referred for an MRI pelvis to evaluate suspected uterine anomaly by ultrasound. The MRI showed a complete septate uterus and in addition, an elongated tubular structure (isointense to the spleen) extending from the left ovary in the left retroperitoneal region/left paracolic gutter to the under-splenic surface. CT abdomen and pelvis revealed this to be a similarly enhancing structure as the spleen and appears as a tubular retroperitoneal structure connecting the left ovary to the spleen with associated vasculature joining the splenic vein cranially and the ovarian vessels caudally consistent with splenogonadal fusion.
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  • 文章类型: Journal Article
    背景:据报道,Twig样大脑中动脉(T-MCA)是一种罕见的血管异常,其特征是大脑中动脉(MCA)的M1段由丛状的小血管网络重建。尽管人们普遍认为T-MCA的病因是胚胎持续性,一些研究者认为T-MCA可能是次要后果.这里,作者报告了2例T-MCA从头形成病例,并重新考虑T-MCA与孤立性MCA疾病相关的概念.
    方法:40岁的男性脑部磁共振成像(MRI)检查显示左侧MCAM1段中度狭窄。计划每年的MRI随访,一年后表演时,显示左侧MCAM1段闭塞。脑血管造影显示M1段闭塞,动脉网络异常。该病例被诊断为从头T-MCA。患者已保持无症状2年。
    结论:从头T-MCA的报道表明,获得性因素可能参与了T-MCA的发病机制。我们建议应将T-MCA定义为具有新血管形成的各种孤立的MCA疾病。
    BACKGROUND: Twig-like middle cerebral artery (T-MCA) is reported as a rare vascular anomaly characterized by reconstitution of the M1 segment of the middle cerebral artery (MCA) by a plexiform network of small vessels. Although it is generally believed that the etiology of T-MCA is an embryological persistence, some investigators have suggested that T-MCA may be a secondary consequence. Here, the authors report a second case of de novo T-MCA formation and reconsider the concept of T-MCA in connection with isolated MCA disease.
    METHODS: A 40-year-old man\'s brain magnetic resonance imaging (MRI) checkup showed moderate stenosis of the M1 segment of the left MCA. Annual MRI follow-up was planned, and when performed 1 year later, it showed occlusion of the M1 segment of the left MCA. Cerebral angiography revealed occlusion of that M1 segment with abnormal arterial networks. This case was diagnosed as de novo T-MCA. The patient has remained asymptomatic for 2 years.
    CONCLUSIONS: The reports of de novo T-MCA indicate that acquired factors may be involved in the pathogenesis of T-MCA. We suggest that T-MCA should be defined as a variety of isolated MCA disease with new vessel formation.
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  • 文章类型: Journal Article
    背景:腰骶移行椎骨(LSTV)是发生在L5-S1脊柱节段的先天性异常。这些椎骨是由最下面的腰椎节段的骶化或最上面的骶骨节段的腰化引起的。当最低腰椎与骶骨融合或形成假关节(假关节)时,它可以引起疼痛并在临床上表现为Bertolotti综合征。
    方法:一名36岁女性出现严重的右侧下腰痛。除右侧CastellviIIA型LSTV外,计算机断层扫描无异常。疼痛被证明是物理治疗和腰椎硬膜外注射难以治疗的,但有针对性的类固醇和布比卡因注射假关节导致2周的完全缓解疼痛。她随后接受了假关节的微创切除术,并立即改善她的腰痛.在3年的随访中,患者继续无痛。
    结论:LSTV改变了腰骶脊柱的生物力学,这可能导致需要手术干预的医学难治性机械性疼痛。选择Bertolotti综合征患者可以从手术管理中受益,包括切除,聚变,或病理关节减压。
    BACKGROUND: Lumbosacral transitional vertebrae (LSTVs) are congenital anomalies that occur in the spinal segments of L5-S1. These vertebrae result from sacralization of the lowermost lumbar segment or lumbarization of the uppermost sacral segment. When the lowest lumbar vertebra fuses or forms a false joint with the sacrum (pseudoarticulation), it can cause pain and manifest clinically as Bertolotti syndrome.
    METHODS: A 36-year-old female presented with severe right-sided low-back pain. Computed tomography was unremarkable except for a right-sided Castellvi type IIA LSTV. The pain proved refractory to physical therapy and lumbar epidural spinal injections, but targeted steroid and bupivacaine injection of the pseudoarticulation led to 2 weeks of complete pain relief. She subsequently underwent minimally invasive resection of the pseudoarticulation, with immediate improvement in her low-back pain. The patient continued to be pain free at the 3-year follow-up.
    CONCLUSIONS: LSTVs alter the biomechanics of the lumbosacral spine, which can lead to medically refractory mechanical pain requiring surgical intervention. Select patients with Bertolotti syndrome can benefit from operative management, including resection, fusion, or decompression of the pathologic joint.
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  • 文章类型: Case Reports
    Dandy-Walker畸形或综合征是最常见的后颅窝畸形。它通常与其他先天性异常有关,如心脏缺陷;然而,与巨大的枕骨脑膜膨出的关联极为罕见,因为只描述了大约34例。
    我们报告一例2个月大的女婴出现中线,脑后巨大的肿块。它最初是在产前超声检查中发现的。测量的质量约为15×5厘米,延伸到中后卫,不会因哭泣而改变大小,没有附着在后面,并进行了积极的透照试验。在做了脑部计算机断层扫描后,诊断得到了证实,这显示了疣的发育不全,后颅窝扩大,以及两个脑室的囊性扩张,并通过骨缺损突出。
    我们的病例强调了巨大的枕骨脑膜膨出与Dandy-Walker综合征之间的罕见关联,在医学文献中很少讨论或报道。通过报道这种极为罕见的Dandy-Walker综合征与巨大的枕骨脑膜膨出有关,我们希望有助于为未来的研究建立一个数据库,以便建立一个管理方案,供临床医生和神经外科医生使用,从而更好地管理病情.
    UNASSIGNED: Dandy-Walker malformation or syndrome is the most common posterior fossa malformation. It is commonly associated with other congenital anomalies such as cardiac defects; however, association with a giant occipital meningocele is extremely rare, as only around 34 cases have been described.
    UNASSIGNED: We report a case of a 2-month-old female infant who presented with a midline, gigantic mass in the back of the head. It was first discovered on a prenatal ultrasound. The mass measured about 15 × 5 cm, extending to the midback, not changing in size with crying, not attached to the back, and with a positive transillumination test. The diagnosis was confirmed after doing a brain computed tomography, which revealed hypoplasia of the vermis with an enlarged posterior fossa as well as cystic dilation of both ventricles with herniation through a bone defect.
    UNASSIGNED: Our case highlights a rare association between giant occipital meningocele and Dandy-Walker syndrome that is rarely discussed or reported in the medical literature. By reporting this extremely rare case of Dandy-Walker syndrome associated with a giant occipital meningocele, we hope to contribute to the creation of a database for future research so that a management protocol can be established for use by clinicians and neurosurgeons for better management of the condition.
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  • 文章类型: Case Reports
    肺隔离症(PS)是一种罕见的先天性异常,其特征是无功能的肺组织从异常来源接受血液供应。PS通常在年轻人中诊断,但在老年人中并不常见。本摘要描述了一名62岁男性患者反复发烧的PS病例,慢性咳嗽,呼吸困难.影像学显示异常的肺组织与支气管树断开,由降胸主动脉供血.手术干预成功治疗了该病症。该案例强调需要考虑PS作为一种可能的诊断,即使是老年患者,并建议进一步研究其可能的病因。
    Pulmonary sequestration (PS) is a rare congenital anomaly characterized by non-functional lung tissue receiving blood supply from an abnormal source. PS is typically diagnosed in young individuals but is uncommon in the elderly. This abstract describes a case of PS in a 62-year-old male patient presenting with recurrent fever, chronic cough, and difficulty breathing. Imaging revealed abnormal lung tissue disconnected from the bronchial tree, with blood supply from the descending thoracic aorta. Surgical intervention successfully treated the condition. The case emphasizes the need to consider PS as a possible diagnosis, even in older patients, and suggests further research into its possible etiologies.
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  • 文章类型: Case Reports
    Twig样大脑中动脉(T-MCA)是一种罕见的血管异常,其特征是大脑中动脉(MCA)的M1段被小血管的丛状动脉网络所取代。T-MCA通常被认为是胚胎学的持久性。相反,T-MCA也可能是继发性后遗症,但没有关于从头形成病例的报道。这里,我们报告了第一例描述T-MCA可能从头形成的病例。
    一名41岁的妇女因左半偏瘫而从附近的诊所转诊到我们医院。磁共振(MR)成像显示双侧MCA轻度狭窄。然后,患者每年接受一次MR成像随访。53岁时的MR成像显示右侧M1闭塞。脑血管造影显示右侧M1闭塞,并形成与闭塞部位一致的丛状网络,导致从头T-MCA的诊断。
    这是描述从头T-MCA可能形成的第一个病例报告。尽管详细的实验室检查没有确认病因,怀疑自身免疫性疾病导致了这种血管病变。
    UNASSIGNED: Twig-like middle cerebral artery (T-MCA) is a rare vascular abnormality characterized by the replacement of the M1 segment of the middle cerebral artery (MCA) with a plexiform arterial network of small vessels. T-MCA is generally regarded as an embryological persistence. Conversely, T-MCA may also be a secondary sequela but no reports of cases of de novo formation exist. Here, we report the first case describing possible de novo T-MCA formation.
    UNASSIGNED: A 41-year-old woman was referred to our hospital from a nearby clinic because of transient left hemiparesis. Magnetic resonance (MR) imaging revealed mild stenosis of the bilateral MCAs. The patient then underwent MR imaging follow-ups once a year. MR imaging at the age of 53 showed a right M1 occlusion. Cerebral angiography revealed a right M1 occlusion and formation of a plexiform network consistent with the occlusion site, leading to the diagnosis of de novo T-MCA.
    UNASSIGNED: This is the first case report describing possible de novo T-MCA formation. Although a detailed laboratory examination did not confirm the etiology, autoimmune disease was suspected to have precipitated this vascular lesion.
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