Parkerbecker1534

MRCP is a good noninvasive investigation to diagnose the biliary injury. ERCP is considered as the most appropriate tool for the diagnosis as well as therapeutic stenting.

High degree of suspicion is most important in diagnosis of the distal common bile duct trauma as imaging studies like FAST and CT scan can miss the same. MRCP is good noninvasive imaging tool to diagnose the biliary trauma, while ERCP is the best diagnostic and therapeutic tool with minimal post-operative morbidity.

High degree of suspicion is most important in diagnosis of the distal common bile duct trauma as imaging studies like FAST and CT scan can miss the same. MRCP is good noninvasive imaging tool to diagnose the biliary trauma, while ERCP is the best diagnostic and therapeutic tool with minimal post-operative morbidity.

Brain abscess is a potentially fatal neurological infection, despite the development of new antimicrobial agents and modern neurosurgical techniques.

We present an uncommon case where a large brain abscess was treated successfully in a patient with Eisenmenger syndrome. He was underwent neurosurgical treatment and eventually recovered.

The etiology of a brain abscess in patients with congenital cyanotic heart disease has multiple aspects. In this patient population was high risk for developing perioperative complications.The preoperative evaluation, intraoperative management and postoperative care are important steps in the treatment of cardiac patients undergoing noncardiac surgery, and essential for patient's safe and fast recovery.

We highlight the importance of the diagnosis and management of Eisenmenger syndrome to help us further understand this rare and fatal disease.

We highlight the importance of the diagnosis and management of Eisenmenger syndrome to help us further understand this rare and fatal disease.

Spindle cell type undifferentiated carcinoma of the extrahepatic bile duct is extremely rare and has a poor prognosis. However, its pathology is not fully known, yet.

76-year-old man with abdominal pain and dark-colored urine was referred to our department. Pracinostat Contrast-enhanced computed tomography showed an enhanced tumor at the junction of the cystic duct and direct invasion of the portal vein. He was diagnosed as having resectable biliary cancer and underwent a subtotal stomach-preserving pancreaticoduodenectomy with a reconstruction of the portal vein. Histopathological findings demonstrated undifferentiated spindle cell carcinoma. Forty-two days post-surgery, he presented with peritoneal dissemination and local recurrence with ascites, and died sixty-five days after his operation.

Spindle cell type undifferentiated carcinoma has highly metastatic potentials and also easily invade adjacent organs. Therefore, the prognosis of an undifferentiated, spindle cell type cholangiocarcinoma was poor. Although only surgery ensures cure, multidisciplinary treatment, including chemotherapy and radiotherapy is required.

Although surgery for spindle cell type undifferentiated carcinoma may provide a cure, we must consider the induction of multidisciplinary treatment.

Although surgery for spindle cell type undifferentiated carcinoma may provide a cure, we must consider the induction of multidisciplinary treatment.

Teratoma is a rare clinical entity in adults and commonly arises from gonads. Being rare, retroperitoneal teratomas account for 4 % of all primary teratomas. A teratoma can be mature or immature, of which mature is more common in adults and immature is more common in neonates or children. It is labeled immature if at least one from the three germ layers lacks differentiation. To the best of our knowledge, this is the first case of primary retroperitoneal 'immature' teratoma in a male adult.

A 53-year-old male, following a road traffic accident, was investigated for the same and was incidentally detected with a retroperitoneal mass based on Chest X-ray, USG abdomen, and CT scan reports.

A painless palpable mass was identified on examination after the patient was referred to our tertiary care hospital for surgical benefit. AFP, HCG and LDH were tested and reported normal.

An exploratory laparotomy was done and the mass was surgically removed and sent for histopathological examination, which revealed an 'immature' retroperitoneal teratoma. After resection, a rent was identified in the IVC, following which the IVC was clamped. On follow-up, the patient has been compliant and the prognosis is good.

Retroperitoneal teratoma is a very rare clinical entity in adults. Being such massive, it can remain asymptomatic to be detected incidentally. Diagnosis is made with help of radiological findings and can be confirmed after surgical resection and histopathological examination. Surgery remains the mainstay of treatment.

Retroperitoneal teratoma is a very rare clinical entity in adults. Being such massive, it can remain asymptomatic to be detected incidentally. Diagnosis is made with help of radiological findings and can be confirmed after surgical resection and histopathological examination. Surgery remains the mainstay of treatment.BLK and BANK1 in primary Sjögren's syndrome (pSS) have scarcely been evaluated and the results are inconclusive. The aim of our study was to determine whether single nucleotide variants (SNVs) located within BLK or BANK1 are associated with susceptibility, clinical and serological features, and smoking in pSS. BLK rs13277113A/G, BANK1 rs10516487G/A and rs3733197G/A were genotyped in 203 cases and 424 controls using a TaqMan® SNP genotyping assay. The BLK rs13277113A allele showed association with pSS under the allelic (OR 1.35, p = 0.02), and recessive (OR 1.83, p = 0.003) model, while, BANK1 rs3733197G/A showed association under the dominant model (OR 2.90, p = 0.043). Interactions between BANK1 and BLK genotypes also showed association (OR 2.36, p less then 0.0001). In addition, BLK rs13277113A/G was associated with protection against arthritis and BANK1 rs10516487G/A with both arthritis and keratoconjunctivitis sicca, meanwhile, BANK1 rs3733197G/A was associated with smoking in patients with pSS. This is the first study to describe an association between BLK and susceptibility to pSS in a Latin-American population.