Right lumbar abscess containing a gallstone—an unexpected late complication of laparoscopic cholecystectomy

Abstract During laparoscopic cholecystectomy, gallbladder perforation may occur leading to gallstone spillage and despite being rare, early or late complications may therefore develop. We report a case of a 79-year-old female, with a past medical history of a laparoscopic cholecystectomy 3 years earlier for symptomatic gallstones, admitted in the emergency department with a subcutaneous right lumbar abscess confirmed by computed tomography. Emergent abscess surgical drainage was performed and a gallstone was identified during saline lavage. Postoperative evolution was unremarkable and follow-up within a year was uneventful. Split gallstones due to gallbladder perforation during laparoscopic cholecystectomy should be retrieved in order to reduce future complications.

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Abdominal Wall Sinus: A Late Complication of Gallstone Spillage During Laparoscopic Cholecystectomy

HPB Surgery ◽

10.1155/1997/57313 ◽

1997 ◽

Vol 10 (3) ◽

pp. 163-164 ◽

Cited By ~ 6

Author(s):

Michael D. Graham ◽

Paul G. Anderson ◽

James Toouli

Keyword(s):

Laparoscopic Cholecystectomy ◽

Abdominal Wall ◽

Late Complication ◽

Biliary Complication ◽

Gallbladder Perforation ◽

Sinus Formation ◽

Complications Of Laparoscopic Cholecystectomy ◽

Gallstone Spillage

Long term complications of laparoscopic cholecystectomy are uncommon. However, as experience with this procedure accumulates, sporadic reports of non-biliary complication have been published. We report a case of abdominal wall sinus formation secondary to gallbladder perforation and stone spillage occurring during laparoscopic cholecystectomy.

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Late complications of carotid ligation in the treatment of intracranial aneurysms

Journal of Neurosurgery ◽

10.3171/jns.1981.54.5.0583 ◽

1981 ◽

Vol 54 (5) ◽

pp. 583-587 ◽

Cited By ~ 127

Author(s):

Richard A. Roski ◽

Robert F. Spetzler ◽

Frank E. Nulsen

Keyword(s):

Carotid Artery ◽

Internal Carotid ◽

Late Complication ◽

Late Complications ◽

Content Type ◽

Carotid Ligation ◽

History Of ◽

Ischemic Attack ◽

Fine Print

✓ The results in 57 consecutive patients treated with carotid ligation for an intracranial aneurysm were analyzed to define the risks of late complications. The average age for the group was 46 years. Eighty percent of the aneurysms were located on the internal carotid artery (ICA). The acute morbidity and mortality of the treatment and the natural history of the disease was 29%. Twenty-four patients were discharged with a common carotid artery (CCA) ligation, and 21 patients with an ICA ligation. Three patients from each ligation group could not be located for review. The follow-up period for the 21 patients with CCA ligation ranged from 1 to 15 years, with an average of 8.4 years, and for the 18 patients with ICA ligation it ranged from 2 to 19.5 years, with an average of 12.5 years. Excluding deaths from unrelated causes, five of the 21 patients with CCA ligation developed a late complication. Two patients had a transient ischemic attack (TIA). Two patients had a subarachnoid hemorrhage (SAH), one of which was fatal and was preceded by a TIA. Two patients developed monocular blindness. None of the patients had a stroke. Excluding deaths from unrelated causes, five of the 18 patients with ICA ligation developed a late complication. One patient had a fatal SAH. Three patients had a TIA, two of which were followed by a stroke. One patient had a stroke in the cerebral hemisphere contralateral to the side of the carotid ligation.

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Alternative pulmonary artery reconstruction technique in the arterial switch operation

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezab049 ◽

2021 ◽

Author(s):

Hisayuki Hongu ◽

Masaaki Yamagishi ◽

Yoshinobu Maeda ◽

Keiichi Itatani ◽

Masatoshi Shimada ◽

...

Keyword(s):

Pulmonary Artery ◽

Arterial Switch Operation ◽

Late Complication ◽

Late Complications ◽

Reconstruction Technique ◽

Reconstruction Method ◽

Arterial Switch ◽

Switch Operation ◽

Longitudinal Extension

Abstract OBJECTIVES Late complications of arterial switch operations (ASO) for transposition of the great arteries, such as neo-pulmonary artery (PA) stenosis and/or neoaortic regurgitation, have been reported. We developed an alternative reconstruction method called the longitudinal extension (LE) method to prevent PA bifurcation stenosis (PABS). METHODS We identified 48 patients diagnosed with transposition of the great arteries and performed ASO using the Lecompte manoeuvre for neo-PA reconstruction. In 9 consecutive patients (from 2014), the LE method was performed (LE). Before 2014, conventional techniques were performed in 39 patients (C). The median body weight and age in the LE and C groups were 3.0 and 3.1 kg and 12 and 26 days, respectively. In the LE group, 1 patient underwent bilateral PA banding before ASO. In C, PA banding and arch repair were performed in 1 patient each. Patients who received concomitant procedures were included. RESULTS The median follow-up in LE and C groups was 1.9 and 10.1 years, respectively. Early mortality/late death was not found in group LE and in 1 patient in group C. Only 1 case required ascending aorta sliding plasty in LE, and 8 patients needed PA augmentation for PABS in C. The median velocity of right/left PA was measured as 1.6/1.9 m/s in LE and 2.1/2.3 m/s in C, so it showed a lower value in LE. CONCLUSIONS Excellent mid-term results were obtained with the LE method. It was considered a useful procedure in preventing PABS, which is a primary late complication of ASO. Further follow-up and investigations are needed.

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Left Ventricular Aneurysm Presenting as a Late Complication of Childhood Chemotherapy

Case Reports in Cardiology ◽

10.1155/2015/625451 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Braghadheeswar Thyagarajan ◽

Lubna Bashir Munshi ◽

Martin Miguel Amor

Keyword(s):

Myocardial Infarction ◽

Acute Lymphocytic Leukemia ◽

Late Complication ◽

Left Ventricular ◽

Lymphocytic Leukemia ◽

Left Ventricular Aneurysm ◽

Ventricular Aneurysm ◽

Past Medical History ◽

History Of ◽

High Index Of Suspicion

Cardiotoxicity is a well known adverse effect of chemotherapy. Multiple cardiac injuries have been reported including cardiomyopathy, pericarditis, myocarditis, angina, arrhythmias, and myocardial infarction. A left ventricular aneurysm due to chemotherapy is a rare and a dangerous complication which is particularly challenging in diagnosis requiring a high index of suspicion and periodic imaging. We present a case of a young Caucasian male with a past medical history of Acute Lymphocytic Leukemia status after chemotherapy during his childhood diagnosed with left ventricular aneurysm several years later.

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Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Advances in Urology ◽

10.1155/2015/457305 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Avinash Chennamsetty ◽

Jason Hafron ◽

Luke Edwards ◽

Scott Pew ◽

Behdod Poushanchi ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Incisional Hernia ◽

Operative Time ◽

Patient Counseling ◽

Incisional Hernias ◽

Prostate Weight ◽

History Of ◽

Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

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Massive stone burden in an ileocecal pouch: A preventable condition?

Canadian Urological Association Journal ◽

10.5489/cuaj.1537 ◽

2014 ◽

Vol 8 (5-6) ◽

pp. 358

Author(s):

Anne Sophie Valiquette ◽

Diego Barrieras ◽

Michael McCormack

Keyword(s):

Surgical Complications ◽

Late Complication ◽

Bladder Exstrophy ◽

Stone Burden ◽

History Of ◽

Lost To Follow Up ◽

Efficient Transfer

The challenges of transition from the pediatric to the adult setting have been reported. We describe a case of massive stone burden in the ileocecal pouch of a patient lost to follow-up after his transfer from a pediatric to an adult institution. Although we successfully managed the patient and retrieved the pouch stones without any complications, several surgical complications may occur in a patient with a history of extensive abdominal surgeryand bladder exstrophy. This patient’s late complication might have been prevented with a more efficient transfer from a pediatric to an adult institution.

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Outbreak of Foodborne Botulism in Alexandria, Egypt: Modulating Indications for Administration of Heptavalent Botulinum Antitoxin

10.21203/rs.3.rs-267943/v1 ◽

2021 ◽

Author(s):

Sara A Ghitani ◽

Maha A Ghanem ◽

Eman A Sultan ◽

Maram Atef ◽

Maii F Henaidy

Keyword(s):

Prospective Study ◽

Clinical Characteristics ◽

Personal Data ◽

Poison Center ◽

Supportive Treatment ◽

Past Medical History ◽

Salted Fish ◽

History Of ◽

Foodborne Botulism

Abstract Background: In October 2019, 94 patients were admitted into Alexandria Poison Center (APC) with a history of ingestion of Feseekh (salted fish). As a trial to allocate the resources, not all patients were given Heptavalent botulinum antitoxin (HBAT) immediately.The current study aimed to portray the clinical characteristics of the cases, explore the possible relation between these characteristics and necessity of HBAT administration, explore the reliability of MLT, and to establish a clinical guide for management with preservation of resources.Subject and Method: the current prospective study included 94 patients who were admitted to Alexandria Poison Center (APC) in the period from 29 th September to 27 th October 2019. The patients' data was recorded using a checklist that includes: personal data, past medical history, clinical assessment, investigations, treatment and the outcome. The checklist was carried out to assess and follow up each patient. Hospitalized patients were categorized according to symptoms consistent with botulism. The equine HBAT, made by Emergent BioSolutions Canada Inc. (formerly Can gene Corporation) was used in the treatment.Results: HBAT was given to (36.2%) patients only out of the total admission. However, 87.2% of patients were completely cured, whereas 10.6% of patients were discharged with mild neurological sequelea and death occurred only in two cases (2.2%).Conclusion: 63.8% of cases with suspected foodborne botulism toxicity could be managed by supportive treatment only with no need for HBAT.

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Ischemic Colitis and Stricture After Hemolytic-Uremic Syndrome

PEDIATRICS ◽

10.1542/peds.61.2.315 ◽

1978 ◽

Vol 61 (2) ◽

pp. 315-317

Author(s):

Hadi Sawaf ◽

Marcia J. Sharp ◽

Kum J. Youn ◽

Patrick A. Jewell ◽

Ali Rabbani

Keyword(s):

Renal Failure ◽

Hemolytic Uremic Syndrome ◽

Sudden Onset ◽

Late Complications ◽

Surgical Removal ◽

Review Of The Literature ◽

Follow Up Studies ◽

History Of ◽

Uremic Syndrome

The hemolytic-uremic syndrome (HUS) was first described by Von Gasser et al.1 in 1955 as a syndrome of acute renal failure, hemolytic anemia, and thrombocytopenia in children. Follow-up studies on HUS have emphasized hypertension and uremia as late complications.2,3 A review of the literature has revealed no previously reported cases of persistent colitis and bowel stenosis after HUS. We present a child who continued to have intermittent intestinal obstruction and diarrhea until surgical removal of a segment of colon almost seven months after the onset of HUS. CASE REPORT A 26-month-old white boy who had no history of gastrointestinal disturbance had sudden onset of diarrhea with blood and mucus in the stool.

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Incarcerated Lumbar Hernia Complicated by Retroperitoneal Pseudoaneurysm 50 Years after Resection and Radiation Therapy of a Sarcoma

Case Reports in Surgery ◽

10.1155/2019/1072821 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Oluwatobi Onafowokan ◽

Dabanjan Bandyopadhyay ◽

Dale Johnson ◽

Hugo J. R. Bonatti

Keyword(s):

Abdominal Pain ◽

Small Bowel ◽

Ct Scan ◽

Late Complication ◽

Abdominal Hernia ◽

Emergency Laparotomy ◽

Incisional Hernias ◽

History Of ◽

The Right

Background. Lumbar hernias are rare abdominal hernias. Surgery is the only treatment option but remains challenging. Posterior incisional hernias are even rarer especially with incarceration of intra-abdominal contents.Case Presentation. A 68-year old female presented with a 3-day history of worsening acute abdominal pain and distension, with multiple episodes of emesis. A CT scan indicated a large incarcerated posterolateral abdominal hernia. The patient had a history of resection of a sarcoma on her back as a child and also received chemotherapy and radiation. During emergency laparoscopy, a hemorrhagic small bowel segment incarcerated in the hernia was reduced and resected, and the distended small bowel was decompressed. An elective hernia repair was scheduled. After temporary clinical improvement, the patient again developed abdominal pain, distention, and emesis. During emergency laparotomy, a large hematoma in the right flank was found and partially evacuated. The right colon was mobilized out of the hernia and the duodenum was kocherized. A20×20cm BIO-A mesh was placed on top of the Gerota fascia and cranially tucked under liver segment VI. Anteriorly, the mesh was fixated with absorbable tacks. The duodenum and colon were placed into the mesh pocket. A postoperative CT scan identified a 2 cm pseudoaneurysm of a side branch of a lumbar artery, and the bleeding source was embolized. The postoperative course was complicated byClostridium difficile-associated colitis, but ultimately, the patient recovered fully. At 6-month follow-up, there was no evidence for a recurrent hernia.Discussion. There is a paucity of literature concerning lumbar incisional hernias. Repair with bioabsorbable mesh seems feasible, but longer follow-up is necessary as the mesh was placed in an unusual fashion due to the retroperitoneal hematoma. The exact cause of the hemorrhage is unclear and may have been caused during the initial incarceration, during surgery, or may be a late complication of her previous radiation.

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Laparoscopic Cholecystectomy for Treatment of Biliary Dyskinesia is Safe and Effective in the Pediatric Population

The American Surgeon ◽

10.1177/000313480807401106 ◽

2008 ◽

Vol 74 (11) ◽

pp. 1069-1072 ◽

Cited By ~ 7

Author(s):

Matthew Hofeldt ◽

Bryan Richmond ◽

Kristy Huffman ◽

Jennings Nestor ◽

Damian Maxwell

Keyword(s):

Laparoscopic Cholecystectomy ◽

Ejection Fraction ◽

Perioperative Complications ◽

Pediatric Population ◽

Biliary Dyskinesia ◽

Quadrant Pain ◽

Gallbladder Ejection Fraction ◽

Patients Âgés ◽

History Of

Experience with laparoscopic cholecystectomy for biliary dyskinesia in children remains limited. The aim of this study was to examine the results of a single institution's experience with laparoscopic cholecystectomy for the treatment biliary dyskinesia in the pediatric population. Medical records were reviewed on all patients younger than age 18 who underwent laparoscopic cholecystectomy at our institution from July 2004 to December 2006. Patients undergoing surgery for biliary dyskinesia, as evidenced by a preoperative gallbladder ejection fraction of 40 per cent or less, comprised the study group. Of the 51 pediatric laparoscopic cholecystectomies, 30 (58.8%) were performed for biliary dyskinesia. The patients’ ages ranged from 7 to 17 (mean, 12.67 years; SD, 2.75). Symptoms consisted of chronic right upper quadrant pain (96.67%), nausea/vomiting (73.33%), back pain (30.0%), weight loss (13.33%), and a history of pancreatitis (6.66%). The amount of time between onset of symptoms and surgery was as follows: 1 to 3 months (34.62%), 4 to 6 months (30.77%), 7 to 12 months (7.69%), and greater than 1 year (26.92%). Gallbladder ejection fraction ranged from 1 to 36 per cent (mean, 14.7%). Seven of the 30 (26.67%) underwent endoscopic evaluation as part of their preoperative workup (six upper endoscopy, one colonoscopy), all of which were noncontributory. Pathology revealed chronic cholecystitis in 26 of 30 (93.3%), no abnormalities in three of 30 (10.0%), and unexpected cholelithiasis in one of 30 (3.33%). No perioperative complications were encountered. Twenty-nine of the 30 patients were available for follow up and all but one reported relief of symptoms (96.55%). This study supports the use of laparoscopic cholecystectomy as a safe and effective treatment for biliary dyskinesia in the pediatric population. The success rate in our study was substantially higher than that reported in previous series. Routine preoperative endoscopy was not used and was reserved for investigation of ambiguous or unrelated complaints.

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