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EN
Authors present a rare case of isolated hyoid bone fractures as a result of a traffic accident. Ten hours before the exam, the patient injured his neck by hitting it against a metal pole which he did not notice while riding a bicycle. Immediately afterwards he felt the pain, and came for an examination due to pain with swallowing. ENT examination discovered no signs of trauma in the oral cavity, oropharynx, hypopharynx, larynx and visible part of trachea. Computed tomography discovered an isolated fracture of hyoid bone. After 24 hour observation, patient was discharged for home care, and was shown a swallowing technique which significantly reduces swallowing pain. At control ENT examination 10 days later patient had no complaints. Control CT examination was not performed, as patient refused it.
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Pancreatic cysts: etiology, diagnosis and management

63%
Open Medicine
|
2014
|
vol. 9
|
issue 1
92-107
EN
Pancreatic cysts involve a wide spectrum of pathologies from post-inflammatory cysts to malignant neoplasms. Pancreatic pseudocysts, serous cystadenomas, mucinous cystadenomas, intraductal papillary mucinous neoplasms (IPMNs) and solid pseudopapillary tumors occur most frequently. Differential diagnosis involves the following imaging investigations: transabdominal ultrasonography (TUS), contrast enhanced ultrasonography (CEUS) and endoscopic ultrasonography (EUS), computed tomography (CT), magnetic resonance (MR) and magnetic resonance cholangiopancretography (MRCP), endoscopic retrograde cholangiopancretography (ERCP). The cyst fluid cytology is performed in difficult differential diagnosis between pseudocysts and benign and potentially malignant or malignant tumors. Most frequently, viscosity, amylase, CEA and CA 19-9 levels are determined. Imaging findings should be correlated with cytology. The management depends on the cyst type and size. Small asymptomatic pseudocysts, serous cystadenomas and branchduct IPMNs should be carefully observed, whereas symptomatic large or uncertain serous cystadenomas and cystadenocarcinomas, mucinous cystadenomas and cystadenocarcinomas, main-duct IPMNs and large branch-duct IPMNs with malignant features, serous and mucinous cystadenocarcinomas, and solid pseudopapillary tumors require surgery. Pseudocysts are usually drained. Percutaneous / EUS-guided or surgical cyst drainage can be performed. Complicated and uncertain pseudocysts and cystic tumors need surgical resection. The type of surgery depends on cyst location and size and includes proximal, central, distal, total pancreatectomies and enucleation.
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