scholarly journals Ureteral Guidewire Looping and Entrapment above an Impacted Ureter Stone

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Aikaterini Tsionga ◽  
Anastasios Anastasiadis ◽  
Wilbert Fana Mutomba ◽  
Dimitrios Memmos ◽  
Ioannis Vakalopoulos ◽  
...  
Keyword(s):  
Rare Case ◽  
Rare Complication ◽  
Laser Lithotripsy ◽  
Stent Insertion ◽  
Ureter Stone ◽  
Double J Stent ◽  
One Step ◽  
Proximal Ureter ◽  
Impacted Stone

We present a rare case of a hydrophilic guidewire looping and entrapment in the ureter of a patient with an impacted stone in the proximal ureter during a simple double-J stent insertion. Looping of guidewire is a rare complication in urology and only few cases have been described. In that case, release and removal of the entrapped guidewire was possible only after one step fragmentation of the stone with laser lithotripsy.

scholarly journals Comparative Study Between Holmium Laser versus Pneumatic Ureteroscopic Lithotripsy for Proximal Ureteric Stones Close to Pelvi-ureteric Junction (PUJ) -A Prospective Trial

2020 ◽  
Vol 23 (2) ◽  
pp. 188-192
Author(s):  
Harun Or Rashid ◽  
Md Shahidul Islam ◽  
SM Shameem Waheed ◽  
Md Abdur Rakib ◽  
Md Ashif Chowdhury ◽  
...  
Keyword(s):  
Laser Lithotripsy ◽  
Stent Insertion ◽  
Stone Size ◽  
Ureteroscopic Lithotripsy ◽  
Secondary Intervention ◽  
Upward Migration ◽  
Ho:Yag Laser ◽  
Double J Stent ◽  
Stone Free Rate ◽  
Free Rate

Objective: To compare the outcomes of ureteroscopic lithotripsy with pneumatic lithotripter versus Holium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in the management of upper ureteric stones. Materials and methods: Patients who underwent ureteroscopic lithotripsy with pneumatic lithotripter or Ho:YAG laser for upper ureteric stones were reviewed. Patients with urinary tract infection, ,loss of follow-up, concurrent middle or lower third ureteral stones or acute renall failure were excluded. Patient age, stone size and burden (based on KUB or computerized tomography), stone upward migration, double J stent insertion rate, stone free rate and secondary intervention rate for residual stones were compared in both groups. Results: There were 70 patients with upper ureteric stones (35 in pneumatic group and 35 in laser group) meeting the study criteria. Patients’ age, gender, stone size and burden were similar in both groups. The Ho:YAG laser lithotripsy group had better stone free rate, less double J stent insertion rate and less upward migration and secondary intervention rate, sepsis as compared with pneumatic lithotripsy (94.2% vs. 60%; 85% vs. 100%; 5.7% vs 40%; 5.7% vs 34.2%; 2.8 vs 2.8 respectively, all p < 0.05). In patients with stones sizes 8-10 mm, Ho:YAG laser lithotripsy had significantly lower upward migration rate, lower double J stent insertion rate, higher stone free rate and less secondary intervention rate. Conclusions: Ho:YAG laser lithotripsy is better and much effective than pneumatic lithotripsy in the management of upper ureteric stones in terms of, stone free rate and secondary intervention rate for stones of sizes about 8 to 10 mm.Although the access of upper ureter is difficult but our small calibre (4.5 fr) ureteoscope and gentle manuevre have made the procedures safe and successful. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.188-192

scholarly journals A Rare Case of Large Impacted Stone in Jejunum Causing Obstruction in a Patient of Gallstone Ileus

2020 ◽  
Vol 27 (1) ◽  
pp. E202014
Author(s):  
Dawood Iqbal Wani ◽  
Satish Parihar ◽  
Ankit Prabhakar ◽  
Nasib Chand Digra ◽  
Ab Hamid Wani
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Rare Case ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Therapeutic Management ◽  
Intestinal Lumen ◽  
Impacted Stone

Gallstone ileus is a rare complication of cholelithiasis that occurs as a result of occlusion of the intestinal lumen by a large sized gallstone accounting for 1-4% cases of small bowel obstruction. The aim of this work is to introduce a case report that emphasize the diagnostic and therapeutic management of gallstone ileus with an enterolith impacted in jejunum (an uncommon site).

Efficacy of cystone versus tamsulosin in treatment of stent-related lower urinary tract symptoms

2021 ◽  
pp. 205141582110002
Author(s):  
Mohammad Ali Ghaed ◽  
Reza Rezaei ◽  
Amineh Shafeinia ◽  
Robab Maghsoudi
Keyword(s):  
Urinary Tract ◽  
Symptom Score ◽  
Lower Urinary Tract Symptoms ◽  
International Prostate Symptom Score ◽  
Lower Urinary Tract ◽  
Visual Analogue Score ◽  
Stent Insertion ◽  
Double J Stent ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Objective: Double-J stent is a common tool used in urological procedures that is inserted for 2–6 weeks, but it may induce abdominal and flank pain, incontinence and irritative urinary symptoms. Alleviation of such symptoms would be useful to improve the patients’ quality of life. Accordingly, in this study, the efficacy of cystone versus tamsulosin in the treatment of double-J stent-related lower urinary tract symptoms was determined. Materials and methods: In this randomised clinical trial, 128 patients who required double-J stent insertion after transureteral lithotripsy during 2018–2019 were enrolled. They were randomly assigned to receive either cystone, tamsulosin, both, or placebo. The international prostate symptom score and visual analogue score data were recorded at baseline, after 2 and 4 weeks across the groups. Results: The international prostate symptom score and visual analogue score factors were statistically different across the case groups receiving cystone, tamsulosin and both drugs versus placebo ( P=0.001). Two weeks after drug administration, the visual analogue score and international prostate symptom score were not statistically different in the tamsulosin, cystone and dual therapy groups; however, after 4 weeks the cystone group had the lowest symptoms. Conclusion: Both tamsulosin and cystone are efficient drugs which would relieve stent-related lower urinary tract symptoms. The administration of cystone with or without tamsulosin for 4 weeks may have the best result in reducing the visual analogue score and international prostate symptom score. Level of evidence: Level I, 1b, therapeutic study, randomised controlled trial

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.

scholarly journals Dicephalus parapagus conjoined twin: a rare case with review of literature

2018 ◽  
Vol 7 (8) ◽  
pp. 3410
Author(s):  
Meenakshi Gothwal ◽  
Charu Sharma ◽  
Garima Yadav ◽  
Pratibha Singh ◽  
Sunil Raikar
Keyword(s):  
Crucial Role ◽  
Rare Case ◽  
Rare Complication ◽  
Primitive Streak ◽  
Termination Of Pregnancy ◽  
Early Termination ◽  
Review Of Literature ◽  
Monochorionic Twins ◽  
Sonographic Diagnosis ◽  
Severe Morbidity

Conjoined twin is a rare complication seen in 1% of monochorionic twins and associated with severe morbidity and mortality. It occurs due to a division event at the primitive streak stage of the human embryonic development at about 13-14 days after fertilisation, in monochorionic monoamniotic gestations.  Early prenatal diagnosis of conjoined twin plays a very crucial role in the management and allows appropriate and timely counselling of couple regarding the different modes of management like early termination of pregnancy or continuation of pregnancy with post-natal surgery. Late diagnoses present with difficult options for parents and obstetrician too. Ultrasound plays a very crucial role in diagnosis of conjoined twin. We are reporting a case of 27 years old primigravida referred to our institute at 13 weeks of gestation with ultra-sonographic diagnosis of dicephalus parapagus conjoined twin and further confirmed after termination of pregnancy.

scholarly journals Bacterial Pericarditis Caused by Penetration of a Migrated Biliary Stent from the Lateral Segment of the Liver: A Case Report

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 132
Author(s):  
Hsiao-Yun Chao ◽  
Chih-Huang Li ◽  
Shou-Yen Chen
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Early Detection ◽  
Adverse Events ◽  
Patient Outcomes ◽  
Rare Case ◽  
Biliary Stent ◽  
Stent Insertion ◽  
Distal Migration ◽  
Bacterial Pericarditis

Endoscopic biliary stent insertion is a well-established procedure that is indispensable in the management of various benign and malignant biliary disorders, and one that helps prevent mortality related to invasive surgical procedures. We report a rare case of the distal migration of a biliary stent outside the abdomen to the pericardium, inducing constrictive pericarditis and septic shock. This case alerts clinicians to be aware of potential adverse events that can lead to unfavorable patient outcomes. Such adverse events can be effectively avoided through early detection and intervention.

To Be or Knot to Be: A Rare Case of Nasogastric Tube Knotting

2020 ◽  
pp. 97-99
Author(s):  
Muzna Iftikhar ◽  
Shahbaz Bakhat Kayani ◽  
Atiq Ur Rehman
Keyword(s):  
Respiratory Distress ◽  
Young Patient ◽  
Nasogastric Tube ◽  
Tracheoesophageal Fistula ◽  
Rare Case ◽  
Rare Complication ◽  
Clinical Care ◽  
Nasogastric Intubation ◽  
Laryngeal Injury ◽  
Gastric Decompression

Nasogastric intubation is a frequent practice in clinical care used for administering enteral feed, gastric decompression, and lavage. The knotting of a nasogastric tube is a rare complication with only a few incidences of narrow bore nasogastric tube knotting and even fewer wide-bore tubes reported [1-4]. Unrecognized knotting of the nasogastric tube with inadvertent removal may cause catastrophic consequences like epistaxis, respiratory distress’ severe laryngeal injury, and tracheoesophageal fistula [5-7]. Tubes have been found to be kinked and less commonly knotted. Cases of knotting have previously been identified during insertion or blockage of the tubes post-insertion. Ours is a case of nasogastric tube knotting identified in a young patient with a working tube that knotted over itself during removal.

scholarly journals Incidence of bacterial colonisation after indwelling of double-J ureteral stent

2016 ◽  
Vol 87 (4) ◽  
pp. 291 ◽  
Author(s):  
Hasan Riza Aydin ◽  
Lokman Irkilata ◽  
Mustafa Aydin ◽  
Selim Gorgun ◽  
Hüseyin Cihan Demirel ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Early Period ◽  
Stent Insertion ◽  
Bacterial Colonisation ◽  
E Coli ◽  
Double J Stent ◽  
Aseptic Conditions ◽  
Tract Infections

Objective: To determine the bacterial colonisation after double-J stent use and the risk factors for bacteriuria linked to the stent. Materials and Methods: A total of 102 patients (61 men and 41 women, mean age 47.5 ± 14.16) were examined. The stents were removed under aseptic conditions, and a urine culture was obtained before the removal of the stents. After the stents were removed, the upper, central and lower sections were separated, and washing water was sent through the stent. Results: Bacterial colonisation was found in 29.4% (30 of 102) of the stents. The most frequently observed microorganisms were determined as staphylococcus, coagulase negative (8 of 30) and E. coli (5 of 30). The washing fluid used to clean the interior of the catheter produced pathogens in 8 patients (7.8%), and these pathogens were observed to be the same microorganisms that colonised the outside of the stent. There was no statistical difference between the patients with colonisation and those without in terms of age, gender, duration of stenting and reason for stent insertion. Conclusions: Though stent colonisation does not always entail symptomatic urinary tract infections, as shown in our study, the pathogens in the urine culture are the same as those colonising the stent, confirming the reality that colonisation is the main factor in these events. Additionally, according to our study, significant colonisation may be found in the first 3 weeks, contrary to the literature, causing us to consider that urinary tract infections may develop even in the early period.

scholarly journals Lactulose to the Rescue: A Case of Toxic Hepatic Encephalopathy Caused by Portosystemic Shunting and Epistaxis in a Patient with Hereditary Hemorrhagic Telangiectasia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Ruchit N. Shah ◽  
Michael Makar ◽  
Nasir Akhtar ◽  
Erin Forster
Keyword(s):  
Hepatic Encephalopathy ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Rare Case ◽  
Autosomal Dominant ◽  
Rare Complication ◽  
Multiple Organ ◽  
Autosomal Dominant Disorder ◽  
Life Saving ◽  
Organ Systems ◽  
Portosystemic Shunting

Hereditary hemorrhagic telangiectasia (HHT) is an uncommon autosomal dominant disorder characterized by telangiectasias and arteriovenous malformations. Multiple organ systems are involved including the skin, lungs, gastrointestinal tract, and brain. Hepatic encephalopathy is an extremely rare complication of HHT and early diagnosis and treatment can be life-saving. We present a rare case of hepatic encephalopathy caused by HHT-induced portosystemic shunting treated with lactulose.

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