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Diagnosis and treatment of adrenal cyst (report of 11 cases and literature review)


Like, large cysts may compress the adjacent organs and a corresponding symptoms, as indicated in the abdomen or lower back pain or a sense of fullness, gastrointestinal symptoms, such as ipsilateral renal dysfunction. Large cysts can reach the upper abdomen. The patients in 5 patients without any symptoms, 4 patients had pain in the lower back and not quarter ribs. The group l patients with hypertension, decreased blood pressure after cyst excision, follow-up blood pressure was normal after six months. The reason to be further explored. 3.3 Diagnosis and differential diagnosis of atypical clinical symptoms of the disease, often misdiagnosed as liver cysts, pancreatic cysts, and adrenal tumors. Preoperative diagnosis of adrenal cysts is important for surgical planning. Inflated before use more retroperitoneal contrast, KUB + IVU and so on, diagnostic accuracy is lower. B-to determine the mass properties of more than 1cm in diameter, above the general performance of renal echo-free round or oval-shaped dark area, wall thin, smooth; intracystic hemorrhage or infection, can be expressed as low-echo; capsule or capsule When the wall calcification. Can be expressed as a small hyperechoic echo or wall. However, due to the kidney, adrenal gland, pancreas tail and other closely related, B-orientation of the cyst has been difficult. The group B ultrasonic examination in 9 cases, 2 cases were diagnosed, the correct rate of only 22.2%. CT examination in determining the tumor mass with the surrounding nature and to determine the relationship than the B-superior, CT showed a typical cyst wall edges smooth, wall thin, low density contents, CT values ​​similar to water; when there is bleeding within the cyst, CT value can be increased, cyst fluid is generally not strengthened, some may have mild enhancement cyst. The group of 10 patients with preoperative examination CT, 6 cases of confirmed, the correct rate was 60%. Cysts showed T1-weighted MR image showed homogeneous low signal and T2-weighted images as homogeneous high signal. The preoperative routine MR examination of 2, 2 confirmed cases. When combined with B-, CT, MR, preoperative diagnosis rate can be greatly enhanced. 3.4 Treatment of adrenal cysts are benign, and rarely have endocrine functions, the main basis for its treatment of symptoms, cyst size, and pathological changes may be. For the 5cm were. ② hydatid cysts, neoplastic cysts, once discovered, needs early surgical treatment. ③ asymptomatic, diameter <4cm of simple cyst can continue to observe the clinical, symptoms such as increase or further surgery. ④ a function of the adrenal cyst. ⑤ suspected malignant cyst. The group of 11 patients had surgical indications. Surgical pathology according to different types of cysts differ. ① simple cyst with complete capsule, just the cyst removed, retaining the normal adrenal gland. 6 cases in this group. ② tumor cyst, adrenal lesions extensive, the possible adrenal cyst en bloc. 4 patients in this group. ③ hydatid cyst in close to protect the surrounding tissue, the first puncture diagnosis, smoking after a certain amount of cyst fluid, injection of 4% formaldehyde solution, the first capsule to be killed after the holiday,[link widoczny dla zalogowanych], cut outside the capsule, clear ascospores, Sun Capsule, and then formaldehyde solution to clean gauze ball outside wall of the capsule, and then cut off most of the outside wall, layer by layer from the bottom seam closed out cysts. There were no such cases. ④ hemorrhagic pseudocyst many large, first stripped to its surroundings can not be separated, it will be free of the wall most of the resection margin of the residual intestinal wall suture line catcher. The group 1 patients. Of the old and feeble, or determination, cerebral vascular disease patients can not tolerate surgery, or CT in the B-puncture fluid under the surveillance of the purposes of treatment. Cyst fluid out for testing. Net cyst fluid pumping after the injection of contrast agents, such as wall smooth, remove tumor cyst, it can into the amount of hardener. After the puncture fluid should be long-term follow-up observation. There were no such patients. 【
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