Showing papers by "Pankaj P. Dangle published in 2012"

Leiomyosarcoma of the spermatic cord: case report and literature review.

Abstract: A 51-year-old man presented with a 2-year history of painless lump in the lefthemiscrotum. Scrotal examination demonstrated a 3-cm, firm-to-hard massattached to the left spermatic cord. Scrotal ultrasound scan revealed a heterogeneousmass separate from the left testis and epididymis. An orchidectomywas recommended to the patient; however, he declined surgery andunderwent excision biopsy of the lesion with preservation of the left testis.Histology suggested a leiomyosarcoma of the spermatic cord and positivemargins. Following a normal staging CT scan, the patient was referred tothe regional sarcoma clinic. He was treated with an orchidectomy. Microscopicexaminations showed fibrosis in the spermatic cord and negative margins.The patient has been followed up for 12 months with CT scans and shows nosigns of recurrence.

Robot-Assisted Repair of Ureteroileal Anastomosis Strictures: Initial Cases and Literature Review

Abstract: Background and Purpose: Ureteroileal anastomosis strictures are well-known complications of ileal conduit urinary diversion that occur in 4% to 8% of patients. Open surgical repair is the standard definitive treatment with minimally invasive, endoscopic approaches developed to prevent the need for major surgery when possible. Robot-assisted surgery has been applied to most primary urologic procedures, but the role of this surgery in the management of complications is undefined. We report our experience with two cases of robotic repair of ureteroileal anastomotic strictures after robot-assisted cystectomy, the first such cases to our knowledge, and review the literature regarding management of these strictures. Patients and Methods: Two patients underwent robot-assisted ureteroileal anastomosis revision for left-sided strictures of 1 and 6 cm in length after failed endoscopic management. Three ports were used in the first and four in the second procedure. The diseased segment was identified, and t...

A modified surgical approach to the Al‐Ghorab shunt – an anatomical basis

Abstract: Priapism, although rare, is a well identifi ed entity seen in the Emergency Department. Its presentation, types and management are well discussed in the literature [ 1 ] . Acute management is stepwise; with surgical intervention required once more conservative approaches fail to correct the underlying cause. Surgical shunts, e.g. the Winter and the Ebbehoj, have variable success rates of 30 – 100% [ 2 ] . The success of these procedures is dependent on the cause, duration, previous episodes, and number of previous surgical interventions. In stuttering priapism, both the Winter and Ebbehoj shunts can occlude secondary to frequent clotting and fi brosis. A surgically established shunt, e.g. the Al-Ghorab, has a proven success rate shown by persistent detumescence [ 2,3 ] . The traditional surgical approach for the Al-Ghorab shunt is a dorsal sub-coronal incision, which can surgically incise the dorsal nerve of the penis (DNP) and thereby denervate the glans penis. Herein, we describe a modifi ed surgical approach to the Al-Ghorab shunt with the intention of avoiding surgical incision to the dorsal nerve bundle innervating the dorsal aspect of glans penis.

Idiopathic non-traumatic spontaneous renal hemorrhage/laceration: a case report and review of the literature

Abstract: Introduction The majority of patients presenting with renal and/or peri-renal hemorrhage are diagnosed with an underlying etiology. Non-traumatic spontaneous idiopathic renal hemorrhage is an infrequently reported entity. Management of these patients is critical; diagnosis is established only once any surgically correctable etiology is excluded. Case presentation A 57 year old Caucasian female with no significant past medical history presented to an outside emergency department with a one day history of right lower back pain and fatigue. An abdominal and pelvic computed tomography (CT) at the time revealed a grade IV right renal laceration. We present this unusual case of a previously healthy woman with a low probability for a spontaneous idiopathic non traumatic grade IV renal laceration with perirenal hemorrhage. Conclusion Though most renal and perirenal hemorrhages are associated with an underlying etiology, in rare circumstances idiopathic non traumatic spontaneous renal laceration manifests with insignificant symptomatology. It is critical for clinicians in the Emergency Department to be aware of this entity to avoid diagnostic error. Prior to categorizing an injury as idiopathic, appropriate evaluation to rule out rare etiologic basis is crucial.

Hemangioma of the scrotal septum: a rare entity in infants with review of the literature.

Abstract: Hemagiomas are most common tumors in infancy; however, scrotal septum hemangiomas are very rare with only 45 cases reported in the literature. We report a case of a 6-month-old child who presented with a scrotal mass at birth which had increased in size with age. A scrotal ultrasound with color doppler analysis, revealed a soft tissue mass with diffusely increased blood flow. Scrotal mass excision was performed and the pathology confirmed a capillary hemangioma.