Serum carbohydrate antigen (CA 19-9) is the most common tumor marker assessed in pancreatic cancer patients; nevertheless few articles have comprehensively evaluated evidence for its utility management.Literature search was performed using Medline with keywords "pancreatic cancer", "tumor markers", "CA 19-9", "diagnosis", "screening", "prognosis", "resectability" and "recurrence". All English language pertaining to role of CA 19-9 were critically analyzed determine as a biomarker...

Acute mesenteric ischemia is commonly treated by surgical exploration and open thrombectomy. Very few reports describe using newer, minimally invasive methods which utilize catheter-based mechanical pharmacological thrombolysis. Herein, we report a case of acute superior embolism successfully with AngioJet hydrodynamic thrombectomy EKOS catheter A 76-year-old man new onset atrial fibrillation presented abdominal pain 48 hours duration. Subsequent contrast computed tomography scan the abdomen...

Esophageal diverticula are uncommon lesions that usually classified according to their location (cervical, thoracic, or epiphrenic), underlying pathogenesis (pulsion traction), and morphology (true false).The majority of esophageal acquired occur predominantly in elderly adults. Pulsion, false, the most commonly encountered type noticed at level cricopharyngeus muscle, as a localized outpouchings lacks muscular coat, such wall is formed entirely by mucosa submucosa. True, traction,...

We report the first case of complete laparoscopic resection a duodenal duplication cyst (DDC) in an 8-mo-old patient. The was diagnosed by routine antenatal ultrasound performed at 3 mo gestational age. Although baby born asymptomatic without any congenital abnormalities, had continued to increase on serial sonographic examinations. Previous reports have described treatment DDC surgical (laparotomy) or endoscopic marsupialization; we describe here, approach resect pediatric patient with...

Background: Bronchogenic cysts are benign lesions derived from the primitive foregut. They frequently occur in mediastinum, most commonly at subcarinal level. Subdiaphragmatic location for bronchogenic is extremely rare. Methods: A 40-year-old woman presented with worsening dysphagia and was diagnosed as a cyst arising infradiaphragmatic esophagus by computed tomographic scan endoscopic ultrasound-guided aspiration. Total laparoscopic enucleation of cystic mass performed. Results: The...

Background: Long-term lithium use in psychiatric patients may lead to associated hyperparathyroidism (LAH). Although anecdotal case reports have appeared, an evidence based algorithm for management of LAH is lacking. Methods: A comprehensive literature search was performed (1973-2010) using PubMed with keywords; “lithium” “hypercalcemia” “hyperparathyroidism” “sestamibi” “intra-operative parathyroid hormone (IOPTH) monitoring” “parathyroidectomy” and “medical management”. All English...

We present a case of left upper extremity paresis secondary to acute brachial artery occlusion in an elderly female with active non-ST segment elevation myocardial ischemia (NSTEMI) the setting paroxysmal atrial fibrillation. The patient was initially suspected have cerebrovascular attack (CVA); however, computed tomography (CT) head negative for stroke. diagnosis confirmed by tomographic angiography (CTA) extremity, confirming occlusion. In evaluating concern stroke atypical presentation,...

<b>BACKGROUND</b> : In many patients with early breast cancer, the sentinel lymph node (SLN) is sole site of regional nodal metastasis. This subgroup may not benefit from completion axillary dissection (CALND).<br><b> AIMS:</b> pilot study evaluates status 2nd echelon (station) nodes in axilla as a predictor additional positive presence <b> SETTINGS AND DESIGN: </b> Cross-sectional 40 cancer patients. MATERIALS METHODS:</b> Forty invasive underwent SLN biopsy followed by same sitting....

Purpose: Single port appendectomy (SPA) offers a new paradigm to minimally invasive approach for in children. This study sought evaluate feasibility and assess its’ clinical effectiveness compared traditional 3-port (3PA). Methods: After an institutional review board approval, data from children with acute appendicitis, admitted single surgeon, who underwent SPA were prospectively collected 3 PA (2010-2012). Outcomes analyzed include operative duration, blood loss, time resume diet, duration...

Here, we describe nutcracker syndrome management using intravascular ultrasound (IVUS) during endovascular stent placement of the renal vein.A 60-year-old woman with a known Factor V Leiden mutation, long-standing smoking history, and family history pancreatic cancer presented 2 years intermittent left upper quadrant pain (LUQ) 15 lb unintentional weight loss. Work-up included abdominal (US) computerized tomography (CT) scan. Abdominal US Chest CT scan were negative while revealed severe...

Abstract Background: In breast cancer patients, axillary lymph node dissection (ALND) is recommended in the presence of sentinel metastasis (SLNM). However, 50-70% SLN only site affected by and thus majority these patients are exposed to risk morbidity ALND without any benefit. Z011 trial suggests avoiding early with isolated SLNM. this results not applicable women advanced T-stage, multiple SLNM, lympho-vascular or peri-capsular invasion. This prospective study aims analyze whether SLN-II...

Abstract Background: SLN biopsy (SLNB) can avoid reoperation for axillary staging in DCIS patients upstaged to invasive breast cancer (IBC) following resection. Intraoperative frozen section (IFS) examination of the is a widely accepted tool IBC order select candidates lymph node dissection (ALND), and reoperation. Until now, utility IFS has not been addressed. Methods: Data from undergoing resection with SLNB (2000-11) was analyzed determine cost exam its impact on management. A binomial...

1091 Background: Whether SLN biopsy (SLNB) should be performed in patients with DCIS is controversial. Many centers perform SLNB believing it obviates the need for re-operation axillary staging when invasive cancer (IC) discovered. Given low incidence of occult IC detected, whether intra-operative pathologic evaluation during provides value has not been addressed. Methods: Demographic and clinico-pathologic data was collected analyzed all undergoing surgical resection between 2004-2010 order...