PubMed · 9482616
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J A van Heerden. 1998. Endocrine surgery.. https://doi.org/10.1016/s1072-7515(98)00066-0
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We report on a 64-year-old patient with a huge adrenal pseudocyst. These are rare cystic lesions of the adrenal gland with an unclear etiology. Recent studies suggest that the majority of adrenal pseudocysts are of vascular origin. All cystic masses in the epigastric region have to be considered in the differential diagnosis. The treatment of choice is surgical removal.
Nowadays, minimally invasive operating techniques are an essential part of adrenal gland surgery. Meanwhile four different methods are being used: laparoscopically in the supine or lateral position or retroperitoneoscopically as a prone or lateral method. Ideal indications for endoscopic adrenalectomy are adrenal hyperplasias and benign, hormonally active adrenal gland tumors up to 5 cm in diameter. In comparison to the conventional operating procedures, the endoscopic methods have the advantage of less blood loss and minimized postoperative pain as well as shortening of hospital stay. Yet in contrast, the operating time of these procedures is prolonged. To date, it is not evident whether laparoscopy or retroperitoneoscopy should be preferred. Laparoscopy offers a familiar anatomical exposure but requires 5-6 trocars. For the retroperitoneoscopic methods only 3 trocars are needed, but orientation in the operating field is more difficult. All endoscopic procedures on the adrenal gland are technically difficult. They require a extended experience in minimally invasive surgery as well as special knowledge in endocrine surgery.
UNLABELLED: The differentiation between neonatal neuroblastoma and adrenal haemorrhage may be very difficult in the individual case. We investigated eight neonates with adrenal haemorrhage and one patient with congenital neuroblastoma by colour coded Doppler sonography and power Doppler sonography. Six haemorrhages were cystic, whereas the neuroblastoma and four adrenal haemorrhages had a solid appearance. Colour coded Doppler sonography and power Doppler demonstrated vessels within the neuroblastoma. In none of the ten adrenal haemorrhages could flow be shown either with conventional colour coded Doppler sonography or power Doppler sonography. CONCLUSION: Conventional colour coded Doppler sonography and power Doppler sonography are useful to differentiate between neuroblastoma and adrenal haemorrhage.