1.Atrial Blood Cyst: A Rare Tumor in an Adult
Takashi Ando ; Haruo Makuuchi ; Keita Kikuchi ; Hiroshi Murakami ; Makoto Oono ; Mamoru Tadokoro ; Masahiro Hoshikawa
Japanese Journal of Cardiovascular Surgery 2005;34(1):37-39
A regular check-up in a 69-year-old man showed normal blood chemistry values, except for elevated value of liver enzymes and inflammatory reactions. A computed tomography scan (CT) of the abdomen revealed a normal appearance of the liver, pancreas and spleen, but incidentally showed a tumor in the right atrium. The tumor (a blood cyst which contained white thrombus) was successfully excised. Blood cysts of the heart are extremely rare in adults. These tumors are incidently found at autopsy on cardiac valves in approximately 50% of infants under 2 months of age. The blood cyst in this case arose from the right atrial wall, which is also quite rare.
2.The feasibility of percutaneous transhepatic gallbladder aspiration for acute cholecystitis after self-expandable metallic stent placement for malignant biliary obstruction: a 10-year retrospective analysis in a single center
Akihisa OHNO ; Nao FUJIMORI ; Toyoma KAKU ; Masayuki HIJIOKA ; Ken KAWABE ; Naohiko HARADA ; Makoto NAKAMUTA ; Takamasa OONO ; Yoshihiro OGAWA
Clinical Endoscopy 2022;55(6):784-792
Background/Aims:
Patients with acute cholecystitis (AC) after metallic stent (MS) placement for malignant biliary obstruction (MBO) have a high surgical risk. We performed percutaneous transhepatic gallbladder aspiration (PTGBA) as the first treatment for AC. We aimed to identify the risk factors for AC after MS placement and the poor response factors of PTGBA.
Methods:
We enrolled 401 patients who underwent MS placement for MBO between April 2011 and March 2020. The incidence of AC was 10.7%. Of these 43 patients, 37 underwent PTGBA as the first treatment. The patients’ responses to PTGBA were divided into good and poor response groups.
Results:
There were 20 patients in good response group and 17 patients in poor response group. Risk factors for cholecystitis after MS placement included cystic duct obstruction (p<0.001) and covered MS (p<0.001). Cystic duct obstruction (p=0.003) and uncovered MS (p=0.011) demonstrated significantly poor responses to PTGBA. Cystic duct obstruction is a risk factor for cholecystitis and poor response factor for PTGBA, whereas covered MS is a risk factor for cholecystitis and an uncovered MS is a poor response factor of PTGBA for cholecystitis.
Conclusions
The onset and poor response factors of AC after MS placement were different between covered and uncovered MS. PTGBA can be a viable option for AC after MS placement, especially in patients with covered MS.
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