scholarly journals 586 Peri-Pancreatic Migration of Lost Intra Uterine Device: Case Report and Review of Literature

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Bhattacharya ◽  
H Amada ◽  
A George
Keyword(s):  
General Practitioner ◽  
Rare Complication ◽  
Uterine Perforation ◽  
Abdominal Symptoms ◽  
Abdominal Organs ◽  
Effective Form ◽  
Upper Abdomen ◽  
Laparoscopic Removal ◽  
Multiple Episodes

Abstract Intra uterine devices (IUDs) is one of the most effective form of contraception available today. Uterine perforation and IUD migration is a rare but serious complication and is reported to occur in 0.05 to 13 cases out of 1000 IUCD placements. Migration of IUD to pelvis and lower abdominal organs following uterine perforation has been reported widely in literature. However far migration into the upper abdomen in very rare. Here we report a case asymptomatic peri-pancreatic migration of IUD. A 65-year-old lady being investigated for pneumonia was picked up to have an asymptomatic IUD lying in front of the pancreas. The patient recalled having a hormonal Mirena coil placed 12 years previously for menopausal symptoms. Routine 3-year general practitioner follow-up failed to detect the IUD on vaginal examination. The patient denied spontaneous IUD discharge. However, three subsequent pelvic ultrasound scans did not detect any retained IUD and she was discharged as unrecognized IUD expulsion. She remained asymptomatic for the next 12 years with no abdominal symptoms though she did report to the General Practitioner, multiple episodes of new onset hot flushes when opening bowels - which was managed conservatively with reassurance. It was decided to surgically remove the IUD. Intraoperatively, the IUD was found densely adherent to the lesser omentum close to the pancreas and stomach and was removed safely laparoscopically. The patient made a good postoperative overnight recovery and was discharged. Intra-abdominal migration of IUDs is a very rare complication of IUD insertion and when detected should be promptly treated with Laparoscopic removal.

scholarly journals Successful Conservative Management of a Dislocated IUD

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Hasan Ali Inal ◽  
Zeynep Ozturk Inal ◽  
Ender Alkan
Keyword(s):  
Conservative Management ◽  
Low Cost ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Surgical Removal ◽  
Uterine Perforation ◽  
Contraceptive Devices ◽  
Asymptomatic Patients ◽  
Intrauterine Contraceptive

Background. Intrauterine contraceptive devices (IUDs) are widely utilized all over the world owing to their low cost and high efficacy. Uterine perforation is a rare complication that may occur at IUD insertion resulting in extrauterine location of the IUD. Traditionally, surgical removal of dislocated IUDs has been recommended.Case. A 68-year-old patient who had an IUD (Lippes loop) inserted 32 years ago and whose routine examination incidentally revealed a dislocated IUD in the abdominal cavity. The patient remained asymptomatic during three years of follow-up and the IUD was left in place.Conclusion. Asymptomatic patients, whose vaginal examinations and ultrasonography or X-ray results reveal a dislocated IUD, may benefit from conservative management.

scholarly journals Routine clinical care data from thirteen cardiac outpatient clinics: design of the Cardiology Centers of the Netherlands (CCN) database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie H. Bots ◽  
Klaske R. Siegersma ◽  
N. Charlotte Onland-Moret ◽  
Folkert W. Asselbergs ◽  
G. Aernout Somsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Practitioner ◽  
Data Collection ◽  
The Netherlands ◽  
Strong Base ◽  
Daily Care ◽  
Cardiac Symptoms ◽  
Number Of Patients ◽  
Patient Groups

Abstract Background Despite the increasing availability of clinical data due to the digitalisation of healthcare systems, data often remain inaccessible due to the diversity of data collection systems. In the Netherlands, Cardiology Centers of the Netherlands (CCN) introduced “one-stop shop” diagnostic clinics for patients suspected of cardiac disease by their general practitioner. All CCN clinics use the same data collection system and standardised protocol, creating a large regular care database. This database can be used to describe referral practices, evaluate risk factors for cardiovascular disease (CVD) in important patient subgroups, and develop prediction models for use in daily care. Construction and content The current database contains data on all patients who underwent a cardiac workup in one of the 13 CCN clinics between 2007 and February 2018 (n = 109,151, 51.9% women). Data were pseudonymised and contain information on anthropometrics, cardiac symptoms, risk factors, comorbidities, cardiovascular and family history, standard blood laboratory measurements, transthoracic echocardiography, electrocardiography in rest and during exercise, and medication use. Clinical follow-up is based on medical need and consisted of either a repeat visit at CCN (43.8%) or referral for an external procedure in a hospital (16.5%). Passive follow-up via linkage to national mortality registers is available for 95% of the database. Utility and discussion The CCN database provides a strong base for research into historically underrepresented patient groups due to the large number of patients and the lack of in- and exclusion criteria. It also enables the development of artificial intelligence-based decision support tools. Its contemporary nature allows for comparison of daily care with the current guidelines and protocols. Missing data is an inherent limitation, as the cardiologist could deviate from standardised protocols when clinically indicated. Conclusion The CCN database offers the opportunity to conduct research in a unique population referred from the general practitioner to the cardiologist for diagnostic workup. This, in combination with its large size, the representation of historically underrepresented patient groups and contemporary nature makes it a valuable tool for expanding our knowledge of cardiovascular diseases. Trial registration: Not applicable.

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

scholarly journals Laparoscopic Resection of Renal Capsular Endometriosis in a Woman with Menstrual-Related Flank Pain: Case Report

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abbas Basiri ◽  
Iman Ghanaat ◽  
Hamidreza Akbari Gilani
Keyword(s):  
Flank Pain ◽  
Pathological Examination ◽  
Histologic Evaluation ◽  
Normal Renal Parenchyma ◽  
Perinephric Space ◽  
Superior Portion ◽  
The Right ◽  
First Time ◽  
Laparoscopic Removal

Abstract Background Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety. Case presentation A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence. Conclusion Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.

scholarly journals Innovative method for Amplatzer device implantation in patients with bronchopleural fistulas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jisong Zhang ◽  
Huihui Hu ◽  
Li Xu ◽  
Shan Xu ◽  
Jihong Zhu ◽  
...  
Keyword(s):  
Present Report ◽  
Rare Complication ◽  
Bronchopleural Fistula ◽  
Rigid Bronchoscopy ◽  
New Approach ◽  
Device Implantation ◽  
Amplatzer Device ◽  
Field Of Vision ◽  
Duration Of Operation

Abstract Background Bronchopleural fistula (BPF) is a relatively rare complication after various types of pulmonary resection. The double-sided mushroom-shaped occluder (Amplatzer device, AD) has been gradually used for BPF blocking due to its reliable blocking effect. We have improved the existing AD implantation methods to facilitate clinical use and named the new approach Sheath-free method (SFM). The aim of the present report was to explore the reliability and advantages of the SFM in AD implantation. Methods We improved the existing implantation methods by abandoning the sheath of the AD and using the working channel of the bronchoscope to directly store or release the AD without general anesthesia, rigid bronchoscopy, fluoroscopy, or bronchography. A total of 6 patients (5 men and 1 woman, aged 66.67 ± 6.19 years [mean ± SD]) had BPF blocking and underwent the SFM in AD implantation. Results AD implantation was successfully performed in all 6 patients with the SFM, 4 persons had a successful closure of the fistula, one person died after few days and one person did not have a successful closure of the fistula. The average duration of operation was 16.17 min (16.17 ± 4.67 min [mean ± SD]). No patients died due to operation complications or BPF recurrence. The average follow-up time was 13.2 months (range 10–17 months). Conclusion We observed that the SFM for AD implantation—with accurate device positioning and a clear field of vision—is efficient and convenient. The AD is effective in BPF blocking, and could contribute to significantly improved symptoms of patients.

scholarly journals Pancreaticopleural Fistula: A Cause of Recurrent Pleural Effusions in Chronic Pancreatitis

2021 ◽  
Author(s):  
Ayah Megahed ◽  
Rahul Hegde ◽  
Pranav Sharma ◽  
Rahmat Ali ◽  
Anas Bamashmos
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Pleural Fluid ◽  
Rare Complication ◽  
Delayed Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pleural Effusions ◽  
Diagnostic Challenge ◽  
Abdominal Symptoms ◽  
Pancreatic Duct Stenting

AbstractPancreaticopleural fistula is a rare complication of chronic pancreatitis caused by disruption of the pancreatic duct and fistulous communication with the pleural cavity. It usually presents with respiratory symptoms from recurrent large volume pleural effusions. Paucity of abdominal symptoms makes it a diagnostic challenge, leading often to delayed diagnosis. Marked elevation of pleural fluid amylase, which is not a commonly performed test, is a sensitive marker in its detection. Imaging with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography can help delineate the fistula. In this report, we present the clinical features, imaging, and management of a 59-year-old male patient with pancreaticopleural fistula, wherein the diagnosis was suspected only after repeated pleural fluid drainages were performed for re-accumulating pleural effusions and it was eventually successfully treated with pancreatic duct stenting. We review the literature with regards to the incidence, presentation, diagnosis, and management of this rare entity.

scholarly journals Therapeutic strategy of central vein perforation accompanied by a mediastinal lesion after catheterization

2019 ◽  
Vol 47 (6) ◽  
pp. 2702-2708
Author(s):  
Chi-Chang Li ◽  
Wei Zhang ◽  
Xing-Jie Wu ◽  
Yang Bu ◽  
Zhi-Peng Zheng
Keyword(s):  
Therapeutic Strategy ◽  
Rare Complication ◽  
Treatment Options ◽  
Central Vein ◽  
Computed Tomographic ◽  
Percutaneous Catheter ◽  
Multidisciplinary Consultation ◽  
Vein Injury ◽  
Double Channel

Central vein perforation associated with a mediastinal lesion is a rare complication of catheterization. A 50-year-old woman was diagnosed with chronic kidney disease and required hemodialysis treatment. The patient developed central vein injury during attempted placement of a double-channel catheter. A computed tomographic scan and venography showed that the catheter had punctured the mediastinum from the central vein. After comprehensive assessment and multidisciplinary consultation, percutaneous catheter thrombin injection with follow-up balloon dilatation under fluoroscopy guidance successfully fixed the perforation. We summarize the therapeutic strategy of this complication and other treatment options, and discuss the related literature of central vein injury.

scholarly journals Chemotherapy-Induced Oesophageal Stricture in a Child with Osteosarcoma: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3
Author(s):  
Daichi Ishimaru ◽  
Takatoshi Ohno ◽  
Masato Maeda ◽  
Yutaka Nishimoto ◽  
Katsuji Shimizu
Keyword(s):  
Case Report ◽  
Balloon Dilatation ◽  
Distal Femur ◽  
Rare Complication ◽  
Oesophageal Stricture ◽  
Solid Foods ◽  
Paediatric Case

Treatment with a combination of chemotherapy and radiotherapy is known to be associated with oesophageal stricture in both children and adults with malignancies. However, oesophageal stricture resulting from chemotherapy alone is a rare complication, with few reports on it. We experienced a rare paediatric case of oesophageal stricture caused by chemotherapy for osteosarcoma of the left distal femur. After completion of the chemotherapy course, the patient showed dysphagia caused by the oesophageal stricture and underwent balloon dilatation for the oesophageal stricture. After balloon dilatation, he was able to ingest solid foods, and the oesophagus was normal without any strictures at the last follow-up (20 months after ballooning). Therefore, oesophageal stricture should be considered as a complication of treatment with chemotherapy alone in children with malignancies.

Intra-Peritoneal Pseudocyst as a Rare Complication After Peritoneal Dialysis: The Use of a Staged Surgical Approach in Management

2021 ◽  
pp. 000313482110474
Author(s):  
Ahmad Kharsa ◽  
Kayla Colvill ◽  
Heather Stevenson ◽  
Jeffrey Fair ◽  
Rupak Kulkarni ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Surgical Approach ◽  
Rare Case ◽  
Diagnostic Laparoscopy ◽  
Rare Complication ◽  
Cyst Excision ◽  
Neoplastic Processes ◽  
Life Threatening ◽  
Pseudocyst Formation

Despite its numerous benefits, peritoneal dialysis (PD) can rarely result in dangerous and even life-threatening complications, including peritonitis, hernias, encapsulating peritoneal sclerosis (EPS), and rarely peritoneal pseudocysts. Herein, we present a rare case of a giant intra-peritoneal pseudocyst that presented four months following the discontinuation of a 5-year course of complicated PD. Despite the initially successful drainages, the patient’s symptoms continued to recur, and the imaging findings were concerning for underlying neoplastic processes. As such, a staged surgical approach was performed, starting with a diagnostic laparoscopy and was subsequently followed with cyst excision and marsupialization to the peritoneal cavity. While previous reports of such rare pseudocyst have been documented in the literature as a complication of PD, to our knowledge, this is the second case of pseudocyst formation to occur months after the discontinuation of PD therapy. This case emphasizes the importance of close follow-up in PD patients and showcases how a staged surgical approach can be utilized to accurately diagnose and manage such complicated cases.

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