Appositional Choroidal Detachment Following XEN45 Gel Stent Requiring Surgical Drainage

Splenic abscess is a relatively uncommon condition, posing a diagnostic and therapeutic challenge for the treating physician. It occurs due to haematogenous spread from endocarditis or other septic foci, especially in immune-compromised individuals and diabetics. We describe an elderly male who presented with splenomegaly and low-grade fever with no predisposing factors. Examination revealed a tender splenomegaly. Ultrasonography (US) showed a hypoechoic area within the spleen from which guided aspiration of pus grew Staphylococcus aureus and Klebsiella pneumoniae. Percutaneous drainage and culture-based antibiotics failed to resolve the abscess, obligating surgical drainage. Intraoperative biopsy from the abscess wall was reported as splenic marginal lymphoma. This unusual presentation of lymphoma needs to be considered in splenic abscess without known risk factors.

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Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes, anatomic, and visual outcomes

Eye ◽

10.1038/s41433-021-01605-y ◽

2021 ◽

Author(s):

Ting Zhang ◽

Yantao Wei ◽

Zhaotian Zhang ◽

Wei Chi ◽

Lujia Feng ◽

...

Keyword(s):

Visual Acuity ◽

Medical Records ◽

Demographic Characteristics ◽

Choroidal Detachment ◽

Fluid Exchange ◽

Visual Outcomes ◽

Corrected Visual Acuity ◽

Ocular Hypotony ◽

Small Gauge ◽

Best Corrected Visual Acuity

Abstract Introduction To investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes. Methods We retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed. Results A total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery. Conclusion The incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.

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Pneumothorax and pneumomediastinum secondary to surgical drainage malposition after esophagectomy

Surgery ◽

10.1016/j.surg.2020.10.034 ◽

2020 ◽

Author(s):

Rocío Mato ◽

Teresa Rey ◽

Teresa Alonso ◽

Pablo Rama-Maceiras

Keyword(s):

Surgical Drainage

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Aggregatibacter aphrophilus spinal epidural abscess

BMJ Case Reports ◽

10.1136/bcr-2020-235320 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235320

Author(s):

Antoine Altdorfer ◽

Pierre Gavage ◽

Filip Moerman

Keyword(s):

Risk Factors ◽

Lower Limb ◽

Rare Case ◽

Epidural Abscess ◽

Spinal Epidural Abscess ◽

Surgical Drainage ◽

Eikenella Corrodens ◽

Aggregatibacter Aphrophilus ◽

Progressive Neurological Deficit ◽

Spinal Epidural

A 76-year-old woman with a rare case of spinal epidural abscess (SEA) that had no risk factors for such type of infection, presented symptoms of back pain, progressive neurological deficit of the lower limb and loss of sphincter control. A gadolinium-enhanced MRI confirmed the diagnosis of an SEA. The patient underwent laminectomy with surgical drainage, where cultures showed the presence of Aggregatibacter aphrophilus, a bacterium of the HACEK group (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species), rarely involved in SEA. Following surgery, the patient was treated with intravenous ceftriaxone for 6 weeks, and this gave excellent results.

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Bilateral choroidal detachment after cord blood stem cell transplantation in an adult patient with acute myeloid leukemia

International Ophthalmology ◽

10.1007/s10792-012-9539-z ◽

2012 ◽

Vol 32 (4) ◽

pp. 379-381

Author(s):

Tatsuya Mimura ◽

Takayuki Nakashizuka ◽

Junko Kami ◽

Morio Kohmura ◽

Shimpei Sato ◽

...

Keyword(s):

Acute Myeloid Leukemia ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Cord Blood ◽

Adult Patient ◽

Myeloid Leukemia ◽

Choroidal Detachment ◽

Cord Blood Stem Cell ◽

Blood Stem Cell Transplantation ◽

Acute Myeloid

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Petrous apex cholesterol granuloma: pictorial review of radiological considerations in diagnosis and surgical histopathology

The Journal of Laryngology & Otology ◽

10.1017/s0022215113000091 ◽

2013 ◽

Vol 127 (4) ◽

pp. 339-348 ◽

Cited By ~ 16

Author(s):

M Hoa ◽

J W House ◽

F H Linthicum ◽

J L Go

Keyword(s):

Differential Diagnosis ◽

Surgical Management ◽

Fibrous Tissue ◽

Tissue Reaction ◽

Petrous Apex ◽

Cholesterol Granuloma ◽

Surgical Drainage ◽

Radiological Features ◽

Pictorial Review ◽

Appropriate Treatment

AbstractBackground:Petrous apex cholesterol granulomas are expansile, cystic lesions containing cholesterol crystals surrounded by foreign body giant cells, fibrous tissue reaction and chronic inflammation. Appropriate treatment relies on an accurate radiological diagnosis and an understanding of the distinguishing radiological features of relevant entities in the differential diagnosis of this condition.Methods:Firstly, this paper presents a pictorial review of the relevant radiological features of petrous apex cholesterol granuloma, and highlights unique features relevant to the differential diagnosis. Secondly, it reviews the histopathological and radiological findings associated with surgical drainage of these lesions.Results:Radiological features relevant to the differential diagnosis of petrous apex cholesterol granuloma are reviewed, together with radiological and histopathological features relevant to surgical management. Following surgical management, histopathological and radiological evidence demonstrates that the patency of the surgical drainage pathway is maintained.Conclusion:Accurate diagnosis of petrous apex cholesterol granuloma is essential in order to instigate appropriate treatment. Placement of a stent in the drainage pathway may help to maintain patency and decrease the likelihood of symptomatic recurrence.

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Endoscopic versus Surgical Intervention for Painful Obstructive Chronic Pancreatitis: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10122636 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2636

Author(s):

Ka Wing Ma ◽

Hoonsub So ◽

Euisoo Shin ◽

Janice Hoi Man Mok ◽

Kim Ho Kam Yuen ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Pain Relief ◽

Meta Analysis ◽

Small Sample ◽

Cochrane Library ◽

Endoscopic Drainage ◽

Complication Rates ◽

Surgical Drainage ◽

Endocrine Insufficiency ◽

Significant Difference

There is limited evidence on the standard care for painful obstructive chronic pancreatitis (CP), while comparisons of endoscopic and surgical modes for pain relief have yielded conflicting results from small sample sizes. We aimed to obtain a clear picture of the matter by a meta-analysis of these results. We searched the Pubmed, Embase, and Cochrane Library databases to identify studies comparing endoscopic and surgical treatments for painful obstructive CP. Pooled effects were calculated by the random effect model. Primary outcomes were overall pain relief (complete and partial), and secondary outcomes were complete and partial pain relief, complication rate, hospitalization duration, and endocrine insufficiency. Seven studies with 570 patients were included in the final analysis. Surgical drainage was associated with superior overall pain relief [OR 0.33, 95% CI 0.23–0.47, p < 0.001, I2 = 4%] and lesser incidence of endocrine insufficiency [OR 2.10, 95% CI 1.20–3.67, p = 0.01, I2 = 0%], but no significant difference in the subgroup of complete [OR 0.57, 95% CI 0.32–1.01, p = 0.054, I2 = 0%] or partial [OR 0.67, 95% CI 0.37–1.22, p = 0.19, I2 = 0%] pain relief, complication rates [OR 1.00, 95% CI 0.41–2.46, p = 0.99, I2 = 49%], and hospital stay [OR −0.54, 95% CI −1.23–0.15, p = 0.13, I2 = 87%] was found. Surgery is associated with significantly better overall pain relief and lesser endocrine insufficiency in patients with painful obstructive CP. However, considering the invasiveness of surgery, no significant differences in complete or partial pain relief, and heterogeneity of a few parameters between two groups, endoscopic drainage may be firstly performed and surgical drainage may be considered when endoscopic drainage fails.

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