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Kaszczewski P, Kozubek H, Ostrowski T, Maciąg R, Chudziński W, Skórski M, Gałązka Z. Rapid Formation and Hybrid Treatment of a Large Superior Mesenteric Artery Aneurysm. Am J Case Rep 2023; 24:e939558. [PMID: 37898822 PMCID: PMC10624208 DOI: 10.12659/ajcr.939558] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 09/13/2023] [Accepted: 07/13/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Superior mesenteric artery (SMA) aneurysms account for about 5.5% of all visceral aneurysms, and are most commonly secondary to infectious causes or dissection. They tend to expand and rupture. Here, we present our successful diagnosis and treatment of a 41-year-old man with asymptomatic coeliac trunk stenosis, in whom the large aneurysm of the branch of the SMA developed in a very short time after conservative treatment of plastron appendicitis. CASE REPORT A 41-year-old man was diagnosed with plastron appendicitis during abdomen ultrasound (US) examination. Following 2 weeks of conservative treatment with intravenous antibiotic therapy, complete resolution of symptoms was obtained and confirmed in the computed tomography (CT) scan, and no other pathologies were diagnosed. Three weeks later, during the US examination, a 33-mm aneurysm of the branch of the SMA was diagnosed. The patient was admitted to the Vascular Surgery Department, where a critical stenosis of the coeliac trunk secondary to the compression by median arcuate ligament and a 33-mm true visceral aneurysm of one of the branches of the SMA were diagnosed. Successful treatment of the aneurysm was performed. Surgical decompression of the coeliac trunk and subsequent elective endovascular embolization of the SMA aneurysm with angioplasty of the coeliac trunk were performed. The postoperative period was uneventful and the patient was released from the hospital and remains asymptomatic. CONCLUSIONS Visceral artery aneurysm can form very quickly. In some of the aneurysms, a combination of open surgical and endovascular methods should be performed.
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Affiliation(s)
- Piotr Kaszczewski
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Herbert Kozubek
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Ostrowski
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Maciąg
- II Division of Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Witold Chudziński
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Skórski
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Gałązka
- Department of General, Endocrine and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
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Armatowicz P, Szostek M, Jakuczun W, Osęka M, Skórski M. Extra-anatomical bypass operation in patients with unilateral graft limb occlusion after endovascular aneurysm repair for abdominal aortic aneurysm. Kardiol Pol 2023; 82:72-74. [PMID: 37537912 DOI: 10.33963/kp.a2023.0166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 08/05/2023]
Affiliation(s)
- Paul Armatowicz
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warszawa, Poland.
| | - Małgorzata Szostek
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warszawa, Poland
| | - Wawrzyniec Jakuczun
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warszawa, Poland
| | - Marcin Osęka
- Department of Vascular Surgery, 1st Military Clinical Hospital with Outpatient Department SPZOZ in Lublin, Branch in Elk, Ełk, Poland
| | - Maciej Skórski
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warszawa, Poland
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Armatowicz P, Szostek M, Jakuczun W, Skórski M. Results Following Stent-Graft Coverage of the Hypogastric Artery in the Management of Aortoiliac Aneurysms in Endovascular Aneurysm Repair. Pol Przegl Chir 2023; 95:72-75. [PMID: 38084043 DOI: 10.5604/01.3001.0053.6870] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
<b><br>Aim:</b> The aim of our study was to assess the outcomes of stent-graft coverage of the hypogastric artery in the management of aortoiliac aneurysms with endovascular aneurysm repair (EVAR).</br> <b><br>Material and methods:</b> From January 2013 to March 2017, a total of 93 patients with aortoiliac aneurysms were treated with EVAR, which required occlusion of one or both of the hypogastric arteries. The patients of the Department of General, Vascular, Endocrine and Transplant Surgery were included in the study continuously and all procedures were elective.</br> <b><br>Results:</b> A total of 93 patients with aortoiliac aneurysms required a unilateral or bilateral procedure. Six patients were excluded from our study because they did not appear at their follow-up appointments. The study included 87 patients (80 men; mean age 71.9 (7.9) years, range 54-88), of which 30 had a unilateral procedure and 57 had a bilateral procedure. In 8 procedures (5.55%, n = 7) there was a type II endoleak that resolved during follow-up and required no surgical intervention. In 10 procedures (6.94%, n = 10) there was a type IB endoleak, with 8 procedures requiring surgical re-intervention in the form of an extension. In 12 procedures (8.33%, n = 9), the hypogastric artery thrombosed.</br> <b><br>Conclusion:</b> Coverage of the hypogastric artery by stent-graft has been proven to be a safe procedure, but there is still a risk of type II endoleak. Although 5.55% (n = 7) of the procedures in our study had a type II endoleak, none required surgical intervention.</br>.
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Affiliation(s)
- Paul Armatowicz
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Szostek
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Wawrzyniec Jakuczun
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Skórski
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
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Ostrowski T, Kaszczewski P, Skórski M, Maciąg R, Wojtaszek M, Rowiński O, Gałązka Z. Treatment of Congenital Vascular Malformations - a Single Centre Experience. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.06.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Wołoszko T, Skórski M, Kwasiborski P, Kmin E, Gałązka Z, Pogorzelski R. Influence of Selective Biochemical and Morphological Agents on Natural History of Aneurysm of Abdominal Aorta Development. Med Sci Monit 2016; 22:431-7. [PMID: 26859744 PMCID: PMC4750727 DOI: 10.12659/msm.893639] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The development of abdominal aortic aneurysm (AAA) is probably influenced by many factors. The role of some of these factors, such as intraluminal thrombus (ILT) or cystatin C serum levels, remains controversial. Proving their influence could have therapeutic implications for some patients with AAA. Associations between the rate of increase in diameter of an aneurysm and ILT, as well as other factors, including biochemical factors (C-Reactive Protein - CRP, cystatin C), age, sex, and comorbidities, could predict disease progression in individual patients. MATERIAL AND METHODS Seventy patients with small AAA were included into the study. The patients were followed using ultrasound and CT imaging. We evaluated aneurysm dimensions and aneurysm wall thickness, as well as ILT and its dimensions, aneurysm wall morphology, CRP, and cystatin C. RESULTS We observed significant growth of AAA and thinning of aneurysmal wall. Aneurysms over 4 cm grew significantly faster in the second year of observation. ILT grew together with AAA size. Age, sex, smoking, dyslipidemias, or controlled arterial hypertension had no influence on aneurysm progression rate. Changes in serum of CRP concentration did not reach statistical significance, but cystatin C levels did. CONCLUSIONS Presence and size of ILT, wall thickness, and cystatin C levels may be considered in prediction of AAA progression. ILT might exert a protective influence on the risk of aneurysm rupture. However, larger aneurysms containing larger thrombi grow faster and their walls undergo more rapid degradation, which in turn increases the risk of rupture. This matter requires further studies.
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Affiliation(s)
- Tomasz Wołoszko
- Department of Endocrynology and General Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Skórski
- Department of Endocrynology and General Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Kwasiborski
- Department of Cardiology and Angiology, Miedzyleski Regional Hospital Warsaw, Warsaw, Poland
| | - Ewelina Kmin
- Department of Laboratory Diagnostics, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Gałązka
- Department of Endocrynology and General Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ryszard Pogorzelski
- Department of Endocrynology and General Surgery, Medical University of Warsaw, Warsaw, Poland
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Szostek MM, Jakuczun W, Alagbari A, Pogorzelski R, Szostek M, Osęka M, Skórski M, Kącka A, Piotrowski M. Chronic traumatic thoracic aortic aneurysms-results of endovascular treatment. Fourteen-year single-center experience. INT ANGIOL 2015; 34:506-513. [PMID: 25394957] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Chronic traumatic thoracic aneurysms are results of blunt trauma of the chest during motorcar accident. Treatment of choice is the endovascular procedure with stent-graft. METHODS Between 2000-2012 in General and Thoracic Surgery Department 30 patients with post-traumatic aneurysms were operated. In all cases aneurysm was located below left subclavian artery and in 63% developed during road traffic accident. RESULTS All patients were operated on with 100% technical success and no device failure was noticed. None of patients died during the endovascular procedure and no serious complications like spinal cord ischemia was observed. In one (3%) case, where left subclavian artery was covered, stroke was diagnosed treated conservatively. CONCLUSION At long-term follow-up, one endoleak type IA was found, solved with balloon-plasty. Two patients died due to cardiac diseases.
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Affiliation(s)
- M M Szostek
- Department of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland -
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7
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Pogorzelski R, Toutounchi S, Krajewska E, Fiszer P, Pachucki J, Bednarczuk T, Łoń I, Gaciong Z, Marek B, Skórski M. Laparoscopic treatment of adrenal cysts--own research and literature review. Endokrynol Pol 2015; 66:469-72. [PMID: 26457502 DOI: 10.5603/ep.2015.0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/31/2014] [Indexed: 11/25/2022]
Abstract
MATERIAL AND METHODS Over the last 18 months we operated on six patients with large adrenal gland cysts in our centre. This consisted of 8.2% of all patients treated in said period due to adrenal gland pathologies. On ruling out malignancy or parasitic nature of the lesions, all patients were surgically treated in order to excise the cysts while leaving the gland untouched. In five patients the cysts were resected but the adrenal gland was spared. However, in one patient the adrenal gland coated the entire cystic mass, which imposed performance of adrenalectomy in addition to cystectomy. During surgeries we tried not to clip the suprarenal vein, which we managed to do in four out of six cases. RESULTS A one-year remote follow-up period revealed no cyst recurrence in ultrasound or CT, and it was possible to visualise the remaining part of the adrenal gland in all cases. CONCLUSION Thus, in our opinion resection of benign cysts is well justified and recommendable.
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Affiliation(s)
| | | | | | - Patryk Fiszer
- Department of General and Endocrine Surgery, Medical University of Warsaw, Poland.
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Pogorzelski R, Toutounchi S, Fiszer P, Krajewska E, Łoń I, Zapała Ł, Skórski M. The local spread of pheochromocytoma after adrenalectomy with a rupture of the tumor capsule at the time of the surgery. Open Med (Wars) 2015; 10:335-337. [PMID: 28352715 PMCID: PMC5152986 DOI: 10.1515/med-2015-0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 06/17/2015] [Indexed: 11/15/2022] Open
Abstract
Introduction We present a case of a 29-year-old patient treated due to fully symptomatic pheochromocytoma of the right adrenal gland. Case presentation Patient was operated on and an open right-sided adrenalectomy was performed. At the time of the surgery, a rupture of the tumor capsule occurred. Five years post-operatively, a recurrence of the symptoms of chromaffin-cell tumor was noted. After the exact localization of the multiple recurrences, the patient was reoperated on. Conclusion The case of pheochromocytoma is presented due to the possibility of chromaffin-cell seeding into the peritoneum, with no signs of distal metastases so far.
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Affiliation(s)
- Ryszard Pogorzelski
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
| | - Sadegh Toutounchi
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
| | - Patryk Fiszer
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
| | - Ewa Krajewska
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
| | - Izabela Łoń
- Clinic of Internal Medicine, Hypertensiology and Angiology, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
| | - Łukasz Zapała
- Multidisciplinary Hospital Warsaw-Miedzylesie, Warsaw, Poland
| | - Maciej Skórski
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Banacha 1a St. 02-097 Warsaw, Poland
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9
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Ambroziak U, Zieliński G, Toutounchi S, Pogorzelski R, Skórski M, Cieszanowski A, Miśkiewicz P, Popow M, Bednarczuk T. Jednostronna laparoskopowa adrenalektomia w połączeniu z częściowym przezklinowym usunięciem gruczolaka przysadki wydzielającego ACTH- operacją ratującą życie pacjentce z chorobą Cushinga. Endokrynologia Polska 2015; 66:68-72. [DOI: 10.5603/ep.2015.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/02/2015] [Indexed: 11/25/2022]
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10
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Pogorzelski R, Toutounchi S, Krajewska E, Fiszer P, Łykowski M, Zapała Ł, Szostek M, Jakuczun W, Pachucki J, Skórski M. The effect of surgical treatment of phaeochromocytoma on concomitant arterial hypertension and diabetes mellitus in a single-centre retrospective study. Cent European J Urol 2014; 67:361-5. [PMID: 25667755 PMCID: PMC4310896 DOI: 10.5173/ceju.2014.04.art9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 08/26/2014] [Accepted: 09/01/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Phaeochromocytoma is one of the numerous causes of secondary hypertension. Furthermore, phaeochromocytoma may first present with type 2 diabetes mellitus. The objective of our study was to evaluate the effects of adrenalectomy on patient recovery with regards to normotension and well-controlled glycaemia. MATERIAL AND METHODS The retrospective analysis involved 67 patients with phaeochromocytoma operated between 2006 and mid-2012. The pre-operative diagnoses were made in the departments of internal medicine and endocrinology. Based on laboratory tests and diagnostic imaging, we were able to confirm the diagnosis of phaeochromocytoma in 42 (62.7%) patients. We verified the influence of adrenalectomy on the level of patient recovery, with regards to normotension and glycaemic control: arterial pressure and fasting glycaemia levels were obtained on the day of hospital discharge, at follow-up 3 months post-operatively and 1 year after surgical intervention. RESULTS Of the 67 patients operated for phaeochromocytoma, 48 (71.6%) were treated laparoscopically, whereas 19 (28.4%) underwent open adrenalectomy. Arterial hypertension was recorded in 53 (79.1%) cases. Furthermore, among this group, diabetes mellitus coexisted in 21 (31.3%) cases. Postoperatively, 70% of cases of arterial hypertension and 90% of type 2 diabetes mellitus were cured. Additionally, a high rate of patients reported a quantitative reduced use of antihypertensive medicines. CONCLUSIONS In the majority of patients, surgical treatment of symptomatic phaeochromocytoma leads to a regression of arterial hypertension, or a reduction of the number or doses of medicines taken in one's treatment, and glucose-intolerance symptoms.
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Affiliation(s)
- Ryszard Pogorzelski
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Sadegh Toutounchi
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Ewa Krajewska
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Patryk Fiszer
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Marcin Łykowski
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Łukasz Zapała
- Department of Urology, Multidisciplinary Hospital Warsaw–Międzylesie, Poland
| | - Małgorzata Szostek
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Wawrzyniec Jakuczun
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
| | - Janusz Pachucki
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Poland
| | - Maciej Skórski
- Department of General and Thoracic Surgery, Medical University of Warsaw, Poland
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11
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Pogorzelski R, Fiszer P, Kurnicki J, Toutounchi S, Skórski M. [Pseudoaneurysm of the radial and brachial artery as a complication of cardiac endovascular procedures]. Kardiol Pol 2014; 72:756. [PMID: 25155850 DOI: 10.5603/kp.2014.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 02/19/2014] [Indexed: 11/25/2022]
Affiliation(s)
| | - Patryk Fiszer
- Klinika Chirurgii Ogólnej i Chorób Klatki Piersiowej, Warszawski Uniwersytet Medyczny, Warszawa.
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12
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Osęka M, Tworus R, Kabala P, Skórski M. Severity of chronic venous disease and anatomic distribution of valvular incompetence. INT ANGIOL 2014; 33:282-291. [PMID: 24936535] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of the study was to examine the association between anatomical patterns of valvular incompetence and the severity of venous insufficiency in patients with chronic venous disease. METHODS A total of 211 consecutive patients (70% females) were referred from the vascular clinic to undergo a Doppler ultrasound examination. The extent and anatomical pattern of valvular incompetence was noted using CEAP criteria. Clinical classes C1-6 for each patient were expressed as a string of binary digits and translated into a clinical ordinal score. In this way, higher grade signs were not obscuring lower grade signs and non-parametric analysis could include a wider range of clinical data. RESULTS Varicose veins were the main complaint in 33% of the patients. 54% had at least one incompetent deep vein, 80% had incompetent perforators. Clinical severity increased with age, but was not related with gender. The presence of deep venous incompetence did not account for significant increase in signs. Superficial incompetence, especially if involving two or more segments, was most commonly seen in patients with severe signs. A linear regression model for clinical ordinal score identified non-saphenous superficial reflux and small saphenous vein reflux as the strongest predictors of clinical severity. CONCLUSION CEAP clinical classes can be translated into a clinical ordinal score, which is useful for data analysis. In a group with chronic venous disorders, clinical status is associated mostly with the condition of superficial and calf perforating veins.
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Affiliation(s)
- M Osęka
- Department of General and Thoracic Surgery, Warsaw Medical University, Warsaw, Poland
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13
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Toutounchi S, Pogorzelski R, Siński M, Loń I, Zapała L, Fiszer P, Krajewska E, Skórski M. A spontaneous paraganglioma-pheochromocytoma syndrome. Cent European J Urol 2014; 66:437-9. [PMID: 24757537 PMCID: PMC3992452 DOI: 10.5173/ceju.2013.04.art12] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/06/2013] [Accepted: 11/14/2013] [Indexed: 11/26/2022] Open
Abstract
We present a case of a 40–year old woman diagnosed with a four–place spontaneous paraganglioma–pheochromocytoma syndrome, which was treated surgically. The presence of the succinate dehydrogenase complex subunit D (SDHD) mutation that causes the pheochromocytoma was confirmed but no mutations in the family members were found. After the excision of the paragangliomas located in the areas of the division of carotid arteries, and mediastinum, as well as a tumor on the left site of the celiac trunk, the patient remains asymptomatic and is regularly followed–up.
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Affiliation(s)
- Sadegh Toutounchi
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ryszard Pogorzelski
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Siński
- Clinic of Internal Medicine, Hypertensiology and Angiology, Medical University of Warsaw, Warsaw, Poland
| | - Izabela Loń
- Clinic of Internal Medicine, Hypertensiology and Angiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Zapała
- Department of Urology, Multidisciplinary Hospital Warsaw-Międzylesie, Warsaw, Poland
| | - Patryk Fiszer
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Krajewska
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Skórski
- Clinic of General and Thoracic Surgery, Medical University of Warsaw, Warsaw, Poland
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14
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Skórski M. [Comparison of different methods for treating patients with intermittent claudication]. Kardiol Pol 2012; 70:544-545. [PMID: 22623261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Maciej Skórski
- Klinika Chirurgii Ogólnej i Chorób Klatki Piersiowej, Warszawski Uniwersytet Medyczny, Warszawa
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15
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Kurnicki J, Swiątkiewicz J, Wrzesińska N, Skórski M. Laparoscopic treatment of a huge mesenteric pseudocyst - case report. Wideochir Inne Tech Maloinwazyjne 2011; 6:167-72. [PMID: 23255977 PMCID: PMC3516932 DOI: 10.5114/wiitm.2011.24696] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 02/20/2011] [Accepted: 06/29/2011] [Indexed: 11/25/2022] Open
Abstract
Intra-abdominal cysts and pseudocysts are rarely occurring lesions. Their incidence is reported to be 1 per 100 000-250 000 hospitalizations. The lesions' rarity and their mostly asymptomatic development causes troubles in early recognition and treatment. The patients' complaints are unspecific and mostly occur when the cysts are enlarged. Sometimes these entities may cause signs of peritoneal irritation and be the reason for immediate operation. It may happen in the event of cyst rupture, torsion, haemorrhages into the lesion or signs of compression of neighbouring structures. Many radiological methods are helpful in revealing intra-abdominal cysts. Unfortunately they cannot accurately distinguish the character of the lesion. The most common surgical procedure of treatment is excision during laparotomy. However, in some cases the laparoscopic approach can be equal to open surgery. This article presents a case of a young woman with a large intra-abdominal pseudocyst treated with laparoscopy.
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Affiliation(s)
- Jacek Kurnicki
- Department of General and Thoracic Surgery, Public Central Teaching Hospital, Warsaw, Poland
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16
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Bednarczuk T, Bar-Andziak E, Hubalewska-Dydejczyk A, Waligórska A, Górska M, Myśliwiec J, Jarzab B, Karczmarzyk R, Zawadzka A, Garmol D, Kecik D, Królicki L, Plazińska MT, Krzeski A, Krzyzanowska-Swiniarska B, Lewiński A, Milewicz A, Daroszewski J, Placzkiewicz-Jankowska E, Pilarska K, Skórski M, Wiechno W, Sowiński J, Syrenicz A, Szafilk J, Wanyura H, Zgliczński W, Jastrzebska H, Nauman J. [Management of Graves' orbitopathy. Comments on the EUGOGO consensus statement]. Endokrynol Pol 2009; 60:312-330. [PMID: 19753546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Tomasz Bednarczuk
- Katedra i Klinika Chorób Wewnetrznych i Endokrynologii Warszawskigo Uniwesytetu Medycznego.
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Pogorzelski R, Wołoszko T, Szostek MM, Jakuczun W, Ziarkiewicz-Wróblewska B, Górnicka B, Małek AK, Skórski M. [Whipple's disease with generalized lymphadenopathy]. Pol Arch Med Wewn 2006; 116:1184-1187. [PMID: 18634529] [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: 05/26/2023]
Abstract
A case of Whipple's disease in 44 year-old man with generalized limphadenopathy of superficial and retroperitoneal lymph nodes was presented. Differential diagnostics with lymphatic neoplasm was necessary.
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Affiliation(s)
- Ryszard Pogorzelski
- Katedra i Klinika Chirurgii Ogólnej i Chorób Klatki Piersiowej Akademii Medycznej w Warszawie.
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18
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Madej A, Czarkowski M, Skórski M, Górnicka B, Cieszanowski A. [Low-symptomatic pheochromocytoma]. Pol Merkur Lekarski 2002; 12:61-4. [PMID: 11957807] [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: 02/24/2023]
Abstract
We present the patient with 1-month history of mild hypertension, who was admitted to our department with suspicion of coronary heart disease. He had family history of hypertension and coronary heart disease, hyperlipidaemia and he has been smoker for several years. During the diagnostic exertion test chest pain together with an unusual high blood pressure was found (240/140 mmHg). The results of catecholamines and their metabolites in 24-urine collection, abdominal ultrasonography and NMR revealed pheochromocytoma in the left adrenal gland, which was removed successfully. Particular clinical examination allowed to include the patient to the group with low-symptomatic pheochromocytoma. Abdominal USG, which had been done prior to the exertion test, didn't reveal any incidental tumor in the adrenal glands. The abnormal hypertensive reaction during exertion test was the main decision of the urine catecholamines and their metabolites determination. Pheochromocytoma should be included to the differential diagnosis in all patients with chest pain and high blood pressure during diagnostic exertion test.
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Góralewska A, Skórski M. [Diagnostic difficulties and threatening complications in arterial hypertension caused by combined vascular anomaly of the abdominal aorta]. Wiad Lek 1993; 46:66-70. [PMID: 8249384] [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: 01/29/2023]
Abstract
A case is described of hypertension in a boy aged 8 years, admitted for elucidation of its cause is described. Abdominal aortography demonstrated a combined vascular anomaly-stenosis of the abdominal aorta and renal arteries.
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Affiliation(s)
- A Góralewska
- Kliniki Pediatrii Centrum Medycznego Kształcenia Podyplomowego, Dziekanowie Leśnym
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