hamed golmohammadzadeh

Splenic cysts are known as rare clinical encounter. Classifying into primary (true) and secondary cysts (pseudocysts), true cysts contain cellular epithelial lining and subdivided into parasitic and non-parasitic cysts. This study aimed to determine the outcome of treatment in patients with splenic cyst.
All patients with splenic cyst who had been treated in Department of General Surgery of Ghaem and Omid teaching hospitals over a 24-year period were identified. The medical records of these 16 patients were reviewed.
The study patients included 11 females (68.75%) and 5 males (31.25%) with average age of 39.8 years. Fifteen cases had true cyst including 11 parasitic cysts (hydatid) and only one pseudocyst. 37.5% of the splenic cysts had coexistent cysts in liver, pelvis, omentum and paracolic regions. Nine patients underwent total splenectomy and 5 cases partial splenectomy and 2 remaining cases received conservative medical treatment. The size of the cysts varied from 6 to 25 centimeter with average size of 14.3 centimeter. All patients with hydatid cysts received albendazole postoperative medical treatment with albendazole for 6 months. All patients recovered after treatment.
Open splenectomy whether total or partial is effective and safe in patients with splenec cysts with or without hydatidosis. The outcome of treatment is good without recurrences.

Pancreatic diseases are known to be associated with complications such as pseudocyst and abscess. A pseudoaneurysm associated with pancreatitis may develop as well. The pseudoaneurysm may rupture into various parts of the gastrointestinal tract; the peritoneal cavity, or the retroperitoneum. We report two cases of Hemosuccus pancreaticus admitted to our center in the past five years. One case was associated with acute pancreatitis, and another case was associated with chronic pancreatitis. A pseudocyst was found in two cases. Both were successfully managed by emergency surgery. So, Hemosuccus pancreaticus is a rare cause of gastrointestinal bleeding with difficult diagnosis, and surgery is the effective treatment for the patient with severe bleeding. However in cases with no life-threatening bleeding angiography and embolization can be performed.

Rheumatismal mitral stenosis is less common today than it was several decades ago, but it is a common cause of mitral  stenosis (MS) in the developing world. Mitral valve stenosis symptoms include fatigue, palpitations, and Shortness of breath especially  with exertion.

The purpose of this prospective study was to determine the incidence of left atrial (LA) thrombus and the predisposing  factors predicting its developments in patients with symptomatic rheumatismal mitral stenosis who underwent transesophageal  echocardiography (TEE) planed for percutaneous transvenous mitral commissurotomy (PTMC).Patients and

Patients who were referred to perform TEE before mitral balloon valvuloplasty enrolled the study. Data were analyzed by SPSS.

Out of 92 patients, females were 68 (73.91%). Mean age was 43.35 ± 13.94. They were classified into two groups based on the presence  or absence of LA thrombus. Group A consisted of 21 patients (seven men and 14 women) with LA thrombus (mean age of 53.00 ± 15.70 years). Group B consisted of 71 patients (17 men and 54 women) without LA thrombus. There were no statistically significant differences  between the two groups regarding age, sex, LA diameter, LA area, LA smoke, Trans-mitral mean pressure gradient, systolic pulmonary artery pressure, left ventricular ejection fraction and right ventricular function, but patients with LA clot had more LA appendage dysfunction,  more frequent atrial fibrillation rhythm, and smaller mitral valve area (P = 0.020, 0.005 and 0.020 respectively) and the prevalence of MR  was also lower in this group (P = 0.049). In our evaluation there was no statistically significant difference regarding the LA diameter or LA  area in patients with or without LA smoke.

The frequency of left atrial clots increased with the presence of LAA dysfunction, atrial fibrillation rhythm, and smaller  mitral valve area. Presence of MR had protective effects against LA clots.

Regarding the limited number of studies on the feasibility of resection and repair of the small intestine by ligasure, we performed this study to compare ligasure with linear stapler for the previously mentioned operation. This phase 1 clinical trial study was performed in Ghaem Hospital, an educational hospital affiliated to Mashhad University of Medical Sciences, from 2010 to 2011. After obtaining permission from the University's ethics committee and a written informed consent from each patient, we recruited 18 patients. The participants who had morbid obesity and were candidates for laparoscopic gastric bypass surgery were randomly allocated to two stapler and ligasure groups. The data were collected and analyzed by three statistical tests, including Mann-Whitney U test, by SPSS 16. All patients were female with the age range of 20-65 years. Cost in the stapler group ranged between 29,500,000 to 40,000,000 Rial (mean 31,830,000± 3,500,000 Rials) and in ligasure group it was between 24,000,000 to 35,000,000 Rials (mean 26,720,000± 3,290,000 Rials). There was a significant difference between the two groups in cost (P=0.004(. Duration of the operations were 200±3.4 and 240±10 minutes in the stapler and ligasure groups, respectively. The difference in duration was significant between the two groups (P=0.043). No significant differences were observed in complications. Application of ligasure in resection and reconstruction of small intestine is more cost-effective than stapler, although duration of surgery is longer.