Delayed Diagnosis of Compartment Syndrome After Transradial PCI, Leading to Long Term Disability

2021 ◽  
Author(s):  
Johanna Jones ◽  
Krishnaraj S. Rathod ◽  
Andrew Wragg ◽  
Daniel A. Jones
Keyword(s):  
Compartment Syndrome ◽  
Delayed Diagnosis ◽  
Transradial Pci

scholarly journals B Cell Activating Factor, Renal Allograft Antibody-Mediated Rejection, and Long-Term Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Haiyan Xu ◽  
Xiaozhou He ◽  
Renfang Xu
Keyword(s):  
B Cell ◽  
Renal Allograft ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Direct Proof ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Antibody Mediated Rejection ◽  
B Cell Activating Factor

Antibody-mediated rejection (ABMR) of renal allograft lacks typical phenotypes and clinical manifestations, always resulting in delayed diagnosis and treatment. It has been considered to be an elemental factor influencing the improvement of the long-term outcome of renal allograft. The B cell activating factor (BAFF) signal plays a fundamental function in the process of antibody-mediated immune response. Data from recipients and the nonhuman primate ABMR model suggest that the BAFF signal participates in the ABMR of renal allograft, while there are objections. The challenges in the diagnosis of ABMR, different study population, and details of research may explain the discrepancy. Large quantities of dynamic, credible data of BAFF ligands and their association with renal allograft pathological characteristics would constitute a direct proof of the role of BAFF in the progression of renal allograft ABMR.

scholarly journals Extensive skull base osteomyelitis, devastating complication of otitis externa: A case report and review of the literature

2021 ◽  
Vol 2 (3) ◽  
pp. 1-7
Author(s):  
Khadija El Bouhmadi ◽  
◽  
Myriam Loudghiri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Skull Base ◽  
Otitis Externa ◽  
Delayed Diagnosis ◽  
Petrous Bone ◽  
Term Treatment ◽  
Skull Base Osteomyelitis ◽  
Long Term Treatment ◽  
Orbital Wall ◽  
The Right

Skull base osteomyelitis (SBO), also referred to as malignant otitis externa (MOE) in its typical form, is usually a complication of otitis externa and severe uncommon and life-threatening condition requiring early diagnosis and long-term treatment in order to avoid its neurologic sequelae. We report the case of 69 years old female with a history of uncontrolled type 2 diabetes, who presented refractory and chronic right-sided purulent otorrhea with temporal headaches for 6 months, treated with no improvement by multiple attempts of ambulatory empiric therapy. After the appearance of grade III facial palsy and painful swelling in the right periorbital and zygomatic areas, the patient consulted in our department where a CT scan showed massive cortical and trabecular destruction of the right petrous bone and the mastoid extended to the lateral orbital wall, the zygomatic arch and the greater sphenoid wing realising extensive osteomyelitis of the skull base and the lateral face. The treatment was started immediately based on intravenous broad-spectrum antibiotics. Despite aggressive long-term treatment, the patient passed away, underlying the increased SBO morbidity and mortality secondary to delayed diagnosis.

scholarly journals Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

2019 ◽  
Vol 18 ◽  
Author(s):  
José Maciel Caldas dos Reis ◽  
Lauro José Mendes Queiroz ◽  
Pablo Ferreira Mello ◽  
Renan Kleber Costa Teixeira ◽  
Fábio de Azevedo Gonçalves
Keyword(s):  
Compartment Syndrome ◽  
Wound Closure ◽  
Early Recognition ◽  
Acute Compartment Syndrome ◽  
Lower Limbs ◽  
Lithotomy Position ◽  
Activity Levels ◽  
Urological Surgery ◽  
Baseline Activity

Abstract Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

scholarly journals Multimodality Surgical Approach in Management of Laryngotracheal Stenosis

2018 ◽  
Vol 2018 ◽  
pp. 1-11
Author(s):  
Ashfaque Ansari ◽  
Annju Thomas
Keyword(s):  
Primary Anastomosis ◽  
Delayed Diagnosis ◽  
Subglottic Stenosis ◽  
Long Term Results ◽  
Laryngotracheal Stenosis ◽  
Surgical Anastomosis ◽  
Suture Tension ◽  
Multiple Treatments ◽  
Almost All

Introduction. Postintubation laryngotracheal stenosis requires a precise diagnosis and an experienced operator in both endoscopic and surgical treatment. This report presents surgically treated cases of laryngotracheal stenosis secondary to long-term intubation/tracheostomy with review of the literature. Materials and Methods. In this retrospective study, we present 5 cases (a 23-year-old male, 13-year-old male, 22-year-old male, 19-year-old male, and 33-year-old female) of postintubation/tracheostomy laryngotracheal (glottic/subglottic) stenosis in the years 2016 and 2017. Each patient was managed differently. Intubation characteristics, localization of stenosis, surgical technique and material, postoperative complications, and survival of patients were recorded. Results. The site of stenosis was in the subglottis in 4 patients and glottis in 1 patient. The mean length of the stenosis was greater in the postintubation group. Postintubation stenosis had a mean duration of intubation of 6.8 days, compared to 206.25 days of cannulation following tracheostomies. Each patient underwent an average of 2 procedures during their treatment course. One patient underwent open surgical anastomosis because of recurrent subglottic stenosis after multiple treatments. Phonation improved immediately in almost all except in the patient who underwent only endoscopic dilatation. Discussion. The reasons for laryngeal stenosis and its delayed diagnosis have been reviewed from the literature. Suture tension should be appropriate, and placement of the suture knot outside the trachea minimizes formation of granulation tissue. The published reports suggest that resection by endoscopy with laser and open technique resection and primary anastomosis are the best treatment modality so far as the long-term results are concerned. Conclusion. Resection of stenotic segment by open surgical anastomosis and laser-assisted resection is a safe option for the treatment of subglottic stenosis following intubation without the need for repeated dilation. Endoscopic dilation can be reserved for unfit patients.

Management of alcohol poisoning

2016 ◽  
Author(s):  
Knut Erik Hovda ◽  
Dag Jacobsen
Keyword(s):  
Metabolic Acidosis ◽  
Ethylene Glycol ◽  
Delayed Diagnosis ◽  
Unknown Origin ◽  
Symptomatic Treatment ◽  
Toxic Metabolite ◽  
Adequate Treatment ◽  
Alcohol Poisoning ◽  
Long Term Prognosis

Ethyl alcohol poisoning is by far the most common alcohol poisoning, and it can usually be handled by simple symptomatic treatment. Methanol and ethylene glycol poisonings share many characteristics, often presenting with a metabolic acidosis of unknown origin. Obtaining the diagnosis could be difficult, and assays for the toxic alcohol are seldom available at hand. The diagnosis should thus be supported by the use of the anion- and osmolal gaps, and/or a simple and specific formate enzymatic method measuring the toxic metabolite itself. A delayed diagnosis of poisonings will often have fatal consequences, in spite of effective treatment available. Treatment mainly consists of buffer, antidote, haemodialysis, and folinic acid (if methanol is suspected) in addition to supportive care. The long-term prognosis of cerebral (unless hypoxic damage)—and kidney function in ethylene glycol poisonings - is good given adequate treatment. Diethylene glycol is also highly toxic, but the knowledge on toxicity is limited. We recommend treatment similar to ethylene glycol poisonings. Other alcohol poisonings are less severe, and will usually present without pronounced metabolic acidosis.

Evaluation of Strength Recovery after Traumatic Acute Compartment Syndrome of the Thigh. A Case Study

2017 ◽  
Vol 19 (4) ◽  
pp. 0-0
Author(s):  
Alban Fouasson-Chailloux ◽  
Pierre Menu ◽  
Marc Dauty
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Intramuscular Pressure ◽  
Rehabilitation Care ◽  
Fracture Reduction And Fixation ◽  
Strength Recovery ◽  
Prompt Diagnosis

Acute compartment syndrome of the thigh is an underestimated serious pathology which can cause long term morbidities. The management, recovery and follow-up of the case of a 20-year-old Caucasian man, who presented an acute compartment syndrome of the thigh, are described. After femoral fracture reduction and fixation by nail, intramuscular pressure measurements confirmed the diagnosis before treatment by fasciotomies. 12-months’ follow-up showed the presence of neurological femoral complications and physical impairment in spite of rehabilitation care. Because compartment syndrome of the thigh after a trauma is rare but potentially devastating, prompt diagnosis is required for performing early fasciotomies.

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