Purpose Although intussusception has been reported as quite a rare cause of je junoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of...Purpose Although intussusception has been reported as quite a rare cause of je junoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of this study was to inv estigate the contribution of intrauterine intussusception and volvulus to the de velopment of JIA. Methods In 48 newborns (24 boys and 24 girls) treated for JIA at our hospital between 1978 and 2004, the operative and pathologic findings wer e reviewed. Results Intussusceptionwas responsible for gap and cord type atresia in 12 cases (25%). The cord showed an atrophic intestinal lumen in 2 cases. Vo lvulus was observed in 13 cases. Volvulus and intussusception were simultaneousl y noted in 1 case. This suggested that intussusception was the cause of the atre sia, whereas volvulus was a secondary event. Neither intussusception nor volvulu s was observed in high jejunal, apple peel, or multiple atresia. Conclusions Int rauterine volvulus and intussusception were commonly observed in single mid-and low JIA. Thus, intrauterine intussusception may be a common cause of gap and co rd type JIA. Volvulus may not only cause JIA but also result from anatomic chang es after the development of JIA in some cases.展开更多
OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and ...OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS: Seventy-nine (4%) patients aged 41.2 ±.14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95%confidence interval [CI]-73%, 91%) had urethral diverticula, of which 4 (6%; 95%CI 2%, 14.8%) contained malignancies. Six patients (7%; 95%CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95%CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95%CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95%CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95%CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n= 32). CONCLUSION: Periurethral masses were encountered in less than 4%of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.展开更多
文摘Purpose Although intussusception has been reported as quite a rare cause of je junoileal atresia (JIA), pediatric surgeons have noted the frequent presence of intussusception as well as volvulus at surgery. The aim of this study was to inv estigate the contribution of intrauterine intussusception and volvulus to the de velopment of JIA. Methods In 48 newborns (24 boys and 24 girls) treated for JIA at our hospital between 1978 and 2004, the operative and pathologic findings wer e reviewed. Results Intussusceptionwas responsible for gap and cord type atresia in 12 cases (25%). The cord showed an atrophic intestinal lumen in 2 cases. Vo lvulus was observed in 13 cases. Volvulus and intussusception were simultaneousl y noted in 1 case. This suggested that intussusception was the cause of the atre sia, whereas volvulus was a secondary event. Neither intussusception nor volvulu s was observed in high jejunal, apple peel, or multiple atresia. Conclusions Int rauterine volvulus and intussusception were commonly observed in single mid-and low JIA. Thus, intrauterine intussusception may be a common cause of gap and co rd type JIA. Volvulus may not only cause JIA but also result from anatomic chang es after the development of JIA in some cases.
文摘OBJECTIVE: To describe the differential diagnosis of periurethral masses is a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS: A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS: Seventy-nine (4%) patients aged 41.2 ±.14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95%confidence interval [CI]-73%, 91%) had urethral diverticula, of which 4 (6%; 95%CI 2%, 14.8%) contained malignancies. Six patients (7%; 95%CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95%CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95%CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95%CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95%CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n= 32). CONCLUSION: Periurethral masses were encountered in less than 4%of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.
