Infradiaphragmatic extralobar pulmonary sequestration is an extremely rare congenital malformation. It is more frequently diagnosed in the antenatal period due to routine ultrasonic examination of the fetus or in the first 6 months of life, though on rare occasions it is discovered incidentally in adults. A 32-yr-old man presenting with epigastric discomfort and fever was referred. Computed tomographic scanning showed that a 16-cm, multiseptated, dumbbell-shaped, huge cystic tumor was located beneath the diaphragm. On the next day, 850 mL of thick yellowish pus was drained by sonography-guided fine needle aspiration for the purpose of infection control and diagnosis, but no microscopic organisms were found in repeated culture studies. Surgical removal of the cyst was performed through thoracoabdominal incision and most of these pathologic lesions were removed but we could not find the feeding arteries or any fistulous tract to surrounding structures. Histopathologic study revealed that it was extralobar pulmonary sequestration and culture study showed that many WBC and necrotic materials were found but there were no microorganisms in the cystic contents. We report the first case of an infected infradiaphragmatic retroperitoneal extralobar sequestration which was administered a staged management and achieved an excellent clinical course.
Adult ; Bronchopulmonary Sequestration/complications/*pathology/surgery ; Diaphragm/abnormalities ; Humans ; Infection/complications/pathology ; Male ; Retroperitoneal Space/abnormalities

Clinical features of 1 case of retroperitoneal parasitic fetus (PF) were retrospectively analyzed and Chinese literatures were reviewed. PF in China has 4 clinical features: 1) The incidence was extremely low and it was more common in infants and children. 2) The parasitic parts showed centrality. 3) The retroperitoneum and abdominal cavity were the most common parasite locations. 4) There was no gender difference in the incidence. Retroperitoneal PF should be distinguished from various benign and malignant abdominal tumors. Imaging was the optimal option for PF diagnosis and the axis bone system was its typical manifestation. Complete excision was the optimal treatment. Thick and large nutrient vessels may be found at where the placenta was attached, and should be ligated carefully. The outcome of this case was good because PF was completely excised.
Child, Preschool ; Congenital Abnormalities ; surgery ; Fetus ; abnormalities ; Humans ; Male ; Retroperitoneal Space ; surgery

OBJECTIVE: To discuss management of chylous leakage after retroperitoneoscopic upper-pole heminephrectomy for duplex kidney. METHODS: Between November 2004 and Februar y 2011, 39 patients underwent retroperitoneoscopic upper-pole heminephrectomy for duplex kidney, of these 5 patients had chylous leakage. The ages of the patients ranged from 32 to 60 years (mean 42). All the patients were treated conservatively, and the therapeutic effects were observed. RESULTS: Delayed chylous leakage in 5 patients occurred 5-31 days after surgery, and leakage occurred in 4 of the same 5 patients during the first 2 post-operative years. Chylous leakage after retroperitoneoscopic upper-pole heminephrectomy for duplex kidney preferentially occurred at the left side of duplex kidney. All the patients healed under conservative treatment. CONCLUSION Chylous leakage typically occurs after left retroperitoneoscopic upper-pole heminephrectomy for duplex kidney, and can be prevented by improving surgical technique; it can be completely relieved by conservative management with satisfactory results.
Adult ; Chylous Ascites ; etiology ; prevention & control ; therapy ; Female ; Humans ; Kidney ; abnormalities ; surgery ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged ; Nephrectomy ; adverse effects ; methods ; Retroperitoneal Space