The Pan African medical journal
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Review Case Reports
Soft-tissue metastasis revealing a pancreatic adenocarcinoma: one case report and a review of literature.
Soft tissue metastases from pancreatic adenocarcinoma are rare lesions and can be the source of diagnostic confusion both clinically and pathologically. To our knowledge, one patient has been reported on with soft tissue lesions that ultimately disclose a pancreatic adenocarcinoma. ⋯ Clinicians should be aware that metastatic soft tissue lesions could be the initial presenting sign for pancreatic cancer. Also, the immunohistochemical staining for CK 7 and 19 may be helpful for the diagnosis of metastatic pancreatic adenocarcinoma.
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The goal of this paper is to discuss how to ameliorate the management of penetrating cardiac injuries in general surgery department. An algorithm for the initial assessment of penetrating injuries in cardiac box, based on our own experience, is presented. This was a retrospective study of 19 patients undergoing thoracotomy for penetrating cardiac injuries, managed in the department of general surgery of Nabeul-Tunisia, between 1994 and 2010. ⋯ All patients had cardiac injury resulting from stab wounds inside of the pericardium. 42% of them were critically unstable, 21% had cardiac tamponnade. All these patients were quickly transferred to the operating room without any other investigations. 37% of patients were hemodynamically stable and underwent additional investigations. The management of penetrating cardiac injuries is possible in a general surgery department, but it requires a rapid prehospital transfer, a yet thorough physical examination along with efficient surgical management, all done in minimal time.