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Liţescu M, Cristian DA, Coman VE, Erchid A, Pleşea IE, Bordianu A, Lupaşcu-Ursulescu CV, Florea CG, Coman IS, Grigorean VT. Right Transcephalic Ventriculo-Subclavian Shunt in the Surgical Treatment of Hydrocephalus-An Original Procedure for Drainage of Cerebrospinal Fluid into the Venous System. J Clin Med 2023; 12:4919. [PMID: 37568321 PMCID: PMC10419378 DOI: 10.3390/jcm12154919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/02/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
The objectives of this article are to present an original surgical procedure for the temporary or definitive resolution of hydrocephalus, in the case of repeated failure of standard treatment techniques, and to present a case that was resolved using this surgical technique. MATERIALS AND METHODS We present the case of a 20-year-old male patient with congenital hydrocephalus who underwent a number of 39 shunt revisions, given the repetitive dysfunctions of various techniques (ventriculo-peritoneal shunt, ventriculo-cardiac shunt). The patient was evaluated with the ventricular catheter externalized at the distal end and it was necessary to find an emergency surgical solution, considering the imminent risk of meningitis. The patient was also associated with the diagnosis of acute lithiasic cholecystitis. RESULTS AND DISCUSSIONS The final chosen solution, right ventriculo-venous drainage using the cephalic vein, was a temporary surgical solution, but there are signs that this procedure can provide long-term ventricular drainage. CONCLUSIONS Transcephalic ventriculo-subclavian drainage represents an alternative technical option, which can be used when established options become ineffective.
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Affiliation(s)
- Mircea Liţescu
- Discipline of Surgery and General Anesthesia—“Sf. Ioan” Clinical Emergency Hospital, 2nd Department, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- General Surgery Department, “Sf. Ioan” Clinical Emergency Hospital, 13 Vitan-Bârzeşti Road, 042122 Bucharest, Romania
| | - Daniel Alin Cristian
- Discipline of General Surgery—“Colţea” Clinical Hospital, 10th Department—General Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- General Surgery Department, “Colţea” Clinical Hospital, 1 Ion C. Brătianu Boulevard, 030167 Bucharest, Romania
| | - Violeta Elena Coman
- Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, 10th Department—General Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (A.E.); (C.G.F.)
| | - Anwar Erchid
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (A.E.); (C.G.F.)
| | - Iancu Emil Pleşea
- Pathology Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania;
| | - Anca Bordianu
- Discipline of Plastic and Reconstructive Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, 9th Department—Plastic and Reconstructive Surgery, Pediatric Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania;
- Plastic Surgery and Reconstructive Microsurgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania
| | - Corina Veronica Lupaşcu-Ursulescu
- Discipline of Radiology and Medical Imagistics, 2nd Surgery Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iaşi, Romania;
- Radiology and Medical Imagistics Department, “Sf. Spiridon” County Emergency Hospital, 1 Independenţei Boulevard, 700111 Iaşi, Romania
| | - Costin George Florea
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (A.E.); (C.G.F.)
| | - Ionuţ Simion Coman
- Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, 10th Department—General Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (A.E.); (C.G.F.)
| | - Valentin Titus Grigorean
- Discipline of General Surgery—“Bagdasar-Arseni” Clinical Emergency Hospital, 10th Department—General Surgery, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania; (V.E.C.); (V.T.G.)
- General Surgery Department, “Bagdasar-Arseni” Clinical Emergency Hospital, 12 Berceni Road, 041915 Bucharest, Romania; (A.E.); (C.G.F.)
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Liţescu M, Baboi ID, Paverman L, Vrabie CD, Iordache N, Coman IS, Lupaşcu-Ursulescu CV, Dina I, Grigorean VT. Incidental case of primary renal lymphoma (PRL) in a patient with chronic hepatitis C infection. Report of a rare case. Rom J Morphol Embryol 2021; 61:929-934. [PMID: 33817736 PMCID: PMC8112798 DOI: 10.47162/rjme.61.3.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Chronic viral hepatitis C (CHC) is a global health problem, being responsible for about 399 000 deaths worldwide, mostly from cirrhosis and hepatocellular carcinoma. Virus C infection has well known hepatic manifestations – cirrhosis and liver cancer – but the extrahepatic ones are responsible for up to 75% of morbidity in these patients. The well-known hepatitis C virus (HCV) lymphotropism is probably linked with the most frequent extrahepatic manifestations, mixed cryoglobulinemia and B-cell non-Hodgkin’s lymphoma (BCNHL). We report a very rare entity, the case of an 82-year-old female with Child–Pugh class A viral C cirrhosis associated with a primary renal lymphoma (PRL). PRL is a non-Hodgkin’s lymphoma (NHL) localized in the kidney, without any involvement of extrarenal lymphatic tissue. In addition to the case report, some relevant data from the literature were reviewed here.
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Affiliation(s)
- Mircea Liţescu
- Department of Internal Medicine, Sf. Ioan Emergency Clinical Hospital, Bucharest, Romania; ; Department of Radiology, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania;
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Pleşea IE, Anuşca DN, Procopie I, Huplea V, Niculescu M, Pleşea RM, Ghelase ŞM, Lupaşcu-Ursulescu CV. The clinical-morphological profile of bone and joints tuberculosis - our experience in relation to literature data. Rom J Morphol Embryol 2017; 58:887-907. [PMID: 29250669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIM The authors made a morphological assessment of musculoskeletal tissue samples from patients admitted in Surgical Departments of the Emergency County Hospital of Craiova, Romania, between 1990 and 2015, proved as presenting tuberculous lesions in the Department of Pathology of the same Hospital. MATERIALS AND METHODS The studied material consisted of bone, joint and sometimes muscle tissue fragments resulted from biopsies or surgical excisions from 54 cases coming out of 841 patients investigated in the above-mentioned period of time, where the established histological diagnosis was tuberculosis (TB). For diagnostic confirmation, Ziehl-Neelsen staining has been used as a rule but, in some cases, immunohistochemistry was also used. RESULTS TB lesions have prevailed in men and around the age of 50 despite the tissue involved (either bones or joints or both structures). Bone tissue, lower limb and right side of the body have been more frequently touched by the TB lesions. Axial bones (spine, ribs and hip bone) and knee joint have been the favorite sites. From morphological point of view, the inflammatory cellular population has been dominated by the epithelioid and giant Langhans cells that surrounded areas less or more extended of classical acidophilic fine granular necrosis. The fibrosis was observed more frequently around bone lesions, usually in an incipient phase. Overall, the granulomatous reaction was of reactive type but one should notice hyporeactive or areactive, disorganized reaction encountered quite often in bone or associated bone and joints lesions. CONCLUSIONS Osteoarticular tuberculosis (OATB) has a complex and dynamic clinical morphological picture, which is still partly known, described and understood especially in the field of morphological changes. Further detailed and integrative analysis of both clinical and morphological aspects is required so the suspicion of diagnosis at the admission becomes as soon as possible certitude.
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Affiliation(s)
- Iancu Emil Pleşea
- Department of Public Health and Management, University of Medicine and Pharmacy of Craiova, Romania;
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David OI, Lupaşcu-Ursulescu CV, Lupaşcu CD, Sandu AM, Strâmbu VDE, Cristian DA, Bedereag ŞI, Calangea IA, Radu EV, Coman IS, Porojan VA, Grigorean VT. Histopathological diagnosis and its correlations with anatomoclinical features, surgical approach and postoperative prognosis in sacral tumors. Rom J Morphol Embryol 2017; 58:393-408. [PMID: 28730223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Sacral tumors encompass numerous histopathological types. They represent an uncommon pathology and, when diagnosed, they are often in advanced stage of the disease, becoming a therapeutic challenge. The correct treatment of a sacral tumor should be established by a multidisciplinary team that will assess the exact anatomical, imagistic and histopathological characteristic of the tumors thus choosing an optimal surgical approach while taking into consideration the risk of recurrence. MATERIAL AND METHODS We conducted a retrospective analysis of both primitive and metastatic sacral tumors in "Bagdasar-Arseni" Emergency Hospital, Bucharest, Romania, for a period of 10 years, studying demographic data, clinical signs, anatomical and histopathological features as well as surgical approach and postoperative prognosis. RESULTS Sacral tumors were diagnosed with a peak incidence in the age group 60-69 years, being more frequent in women. Primitive sacral tumor was predominant and, in this subgroup, chordoma was the most frequent. Metastatic tumors appeared in older subjects. None of the histopathological types associated a preferred topography of the resection or increased resectability. Posterior surgical approach was chosen in most cases, total resection being a hard goal to accomplish due to the invasion of vascular and nervous structures. Bleeding was the most frequently reported incident, carcinomas recording the highest blood loss amongst primitive tumors. Overall prognosis was clearly favorable for subjects diagnosed with primitive sacral tumors. CONCLUSIONS Interpreting imaging data in a clinical context, paying attention to histopathological examination and knowing each histological type characteristics is mandatory in choosing the surgical approach thus obtaining the best postoperative outcome possible.
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Affiliation(s)
- Oana Ilona David
- Department of Radiology and Imaging Sciences, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania;
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