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M Koshy R, Chee RKW, Wilson MP, Singh R, Mathew RP, Tu W, Low G. Vascular compression syndromes in the abdomen and pelvis: a concise pictorial review. Abdom Radiol (NY) 2024; 49:1747-1761. [PMID: 38683215 DOI: 10.1007/s00261-024-04315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 05/01/2024]
Abstract
Vascular compression syndromes are a diverse group of pathologies that can manifest asymptomatically and incidentally in otherwise healthy individuals or symptomatically with a spectrum of presentations. Due to their relative rarity, these syndromes are often poorly understood and overlooked. Early identification of these syndromes can have a significant impact on subsequent clinical management. This pictorial review provides a concise summary of seven vascular compression syndromes within the abdomen and pelvis including median arcuate ligament (MAL) syndrome, superior mesenteric artery (SMA) syndrome, nutcracker syndrome (NCS), May-Thurner syndrome (MTS), ureteropelvic junction obstruction (UPJO), vascular compression of the ureter, and portal biliopathy. The demographics, pathophysiology, predisposing factors, and expected treatment for each compression syndrome are reviewed. Salient imaging features of each entity are illustrated through imaging examples using multiple modalities including ultrasound, fluoroscopy, CT, and MRI.
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Affiliation(s)
- Reshma M Koshy
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada.
| | - Ryan K W Chee
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
| | - Mitchell P Wilson
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
| | - Ranjit Singh
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
| | - Rishi P Mathew
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
| | - Wendy Tu
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
| | - Gavin Low
- Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton, AB, T6G2B7, Canada
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Wahyudi I, Tendi W, Rahman F, Situmorang GR, Rodjani A. Minimal Invasive Treatment in Pelvic-Ureteric Junction Obstruction: A Comprehensive Review. Res Rep Urol 2021; 13:573-580. [PMID: 34408990 PMCID: PMC8364382 DOI: 10.2147/rru.s268569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/27/2021] [Indexed: 12/22/2022] Open
Abstract
Pelvic-ureteric junction obstruction (PUJO) is a common condition, and one of the lead causes of hydronephrosis in children. Currently, the gold standard treatment of PUJO is open surgery using the Anderson–Hynes-modified dismembered pyeloplasty technique. However, with the advancement of medical technology, several minimal invasive approaches were developed, including endoscopic, laparoscopic, and robotic approach, from which the best choice of surgical technique was yet to be determined. Considering the advantages and disadvantages of these methods, the recommended option is to tailor the best surgical approach to each individual patient, and to the surgeons’ preference and experience. Considering these recent advances, a new algorithm is proposed to choose the best minimal invasive modalities invasive treatment to treat PUJO.
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Affiliation(s)
- Irfan Wahyudi
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - William Tendi
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Fakhri Rahman
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Gerhard Reinaldi Situmorang
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Arry Rodjani
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Panek W, Janczak D, Panek M, Szydełko U, Chrzan R, Chabowski M, Szydełko T. Quality of Life of Patients After Laparoscopic Pyeloplasty Due to Ureteropelvic Junction Obstruction: A Long-Term Observation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1335:45-51. [PMID: 33713327 DOI: 10.1007/5584_2020_616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study aims to define the quality of life (QoL) of patients who had undergone laparoscopic pyeloplasty due to ureteropelvic junction obstruction. The QoL was investigated in 26 patients after pyeloplasty, on average, at a 7.5-year follow-up. The operation was performed in a single center between 2002 and 2009 and its effectiveness was confirmed by diuretic renography. The QoL was assessed using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Additionally, we used an own questionnaire, created for this study, specifically assessing the health-related quality of life after pyeloplasty. Overall, 96% of patients were satisfied with the surgical procedure and all would agree to have another pyeloplasty procedure if needed. In one case, dissatisfaction was caused by persisting postoperative pain. All patients but one, dissatisfied due to persisting pain, reported that the postoperative pain intensity was not a problem that would impact the QoL or professional activity. We conclude that laparoscopic pyeloplasty did not adversely affect the patients' QoL, which might stem from beneficial functional outcomes making the patients satisfied with treatment results.
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Affiliation(s)
- Wojciech Panek
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Dawid Janczak
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Panek
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland
| | - Urszula Szydełko
- Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Chrzan
- Department of Pediatric Urology, Collegium Medicum of the Jagiellonian University, Cracow, Poland
| | - Mariusz Chabowski
- Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland. .,Department of Surgery, Fourth Military Teaching Hospital, Wroclaw, Poland.
| | - Tomasz Szydełko
- Department of Urology, Fourth Military Hospital, Wroclaw, Poland.,Division of Oncology and Palliative Care, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
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