Isaac Levy

Cystic metastases of the neck from occult thyroid adenocarcinoma

In 9 of 118 patients with differentiated thyroid carcinomas, a solitary cystic lateral cervical mass simulating a branchial cleft anomaly was the sole presenting sign of the disease. These masses were nodal metastases of occult papillary adenocarcinoma of the thyroid that underwent liquefaction necrosis. Sonographically, the masses presented a complex pattern. Accordingly, it is suggested that, in patients presenting with an asymptomatic solitary lateral cystic cervical mass, the possibility of metastasis from an occult thyroid malignancy should be considered, and consent for definitive surgery should be obtained. The ultrasonic pattern of the cystic mass is of importance in the differentiation of a cavitated lymph node from a branchial cleft cyst.

Giant cervical cyst: presenting symptom of an occult thyroid carcinoma.

A case of giant lateral cervical cystic metastasis from occult thyroid carcinoma mimicking branchial cleft cyst is reported. Lateral cervical cystic metastases arising from occult thyroid carcinoma and their ultrasonic differentiation from true cysts are discussed.

Postoperative complications of laparoscopic adjustable gastric banding

Background:  The primary aim was to determine the rate and nature of late postoperative complications in relation to the type of band used and the route through which it encircled the stomach in a retrospective review of postoperative complications that necessitated reoperation in 500 consecutive cases of laparoscopic adjustable gastric banding (LAGB) conducted over the past 48 months.

An unusual presentation of a huge seroma following ventral hernia repair

Background:  Seroma is a well‐known complication of postoperative ventral hernia (POVH) repair. It occurs during the immediate postoperative period and usually resolves with or without drainage within 4–6 weeks. The case presented herein is interesting in that a huge seroma appeared 6 months postoperatively. Ten litres were evacuated in each of two consecutive hospitalisations. The final outcome was a complete recovery with no mesh infection and no residual seroma. Of interest are the diagnosis and treatment of this unusual clinical presentation of seroma after POVH repair.

Massive Hemoperitoneum Caused by Complete Transection of the Rectus Abdominis Muscle

AbstractThe introduction of restraint devices in cars diminished tremendously the mortality caused by motor vehicle accidents. Hand-in-hand with the decline in mortality, a wide spectrum of injuries associated with the use of seat belts has been documented. In this case report we describe a patient who presented with massive hemoperitoneum caused by complete transection of the rectus abdominis muscle due to seat belt injury. To our knowledge, this complex of injury has never been reported before. However, the lesson should be that although such injury of the rectus abdominis muscle can lead to hemoperitoneum and is possible to be diagnosed by computerized tomographic scan, it should be referred to as a warning sign, which requires searching further for other severe intraabdominal injuries.