[Imaging of adrenal gland diseases].
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Clinical picture of psychiatric disturbances occurring in dysfunctions of thyroid or adrenal axes is presented.
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The aim of the study is presentation of own remarks, related to surgical treatment of 183 patients with adrenal glands pathology in the years 1976-1996. The diagnosis was based on typical clinical symptoms and hormonal studies. The localisation of lesion was determined initially by X-ray examinations, mostly arteriography, later by ultra-sound and computer tomography, recently also by nuclear magnetic resonance and scintigraphy. The paper discusses methods of preparing the patients for surgery, tactics of surgical treatment, intra- and postoperative complications (8.2%), problem of incidentalomas.
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Adrenal diseases are generally rare but of variable manifestation and high diagnostic expenditure for definitive conformation of the disease in the individual case; therefore, the definitive diagnosis is often made by the specialist. On the other hand the supposed diagnosis, based on the knowledge of clinical symptoms, is frequently made by the nonspecialist who also initiates the first diagnostic steps in order to confirm or exclude the diagnosis. It is the aim of this survey to discuss not only the clinical symptoms of the most important adrenal diseases, but also the essential diagnostic steps in order to at least narrow down the diagnosis with as little expenditure as possible and to avoid a diagnostic maze.
Diseases of the kidney and of the adrenal gland can be managed surgically by the laparoscopic approach. Laparoscopic nephrectomy, nephroureterectomy, renal cyst resection and adrenalectomy have been reported. This paper describes our early experience with the laparoscopic approach for the treatment of diseases of the kidney and of the adrenal gland. Since June we have performed 4 nephrectomies, 14 renal cyst excisions and one adrenalectomy. Postoperative recovery and need for pain medication were reduced. Complications have been rare. At the present time laparoscopic nephrectomy for benign renal diseases, laparoscopic excision of recurrent renal cysts and laparoscopic adrenalectomy for functioning renal tumours should be considered. The role of laparoscopic approach for treatment of malignant diseases of the kidney and of the adrenal gland is still debatable.
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The reader should have a better working knowledge of several rare adrenal diseases after reading this article. Although they are rare, these adrenal diseases may be seen in many nursing settings. Astute nursing assessment and monitoring of signs and symptoms of these diseases are essential during diagnosis and treatment. A detailed case study illustrates Cushing's syndrome and pheochromocytoma as well as adrenal insufficiency.