scholarly journals Conservative Management of the Duodenal Injury during Percutaneous Nephrostomy Placement: A Few and Far between Complications of the Urological Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Aykut Colakerol ◽  
Mustafa Zafer Temiz ◽  
Mubarek Bargicho Adem ◽  
Kamil Ozdogan ◽  
Fatih Celebi ◽  
...  

Herein, we reported a duodenal perforation case as an intestinal injury during a percutaneous nephrostomy procedure. A 73-year-old woman with bilateral nephrostomy catheters was applied to the emergency service with right flank pain. Early in the day, her bilateral nephrostomy catheters had been changed. On physical examination, she had a defense and rebound at her right quadrant, and costovertebral angle tenderness was also positive. In the contrast-enhanced abdominal computed tomography scan, the right nephrostomy catheter was located in the second part of the duodenum, and the contrast agent did not leak into the peritoneum from the injury area. We decided on conservative management of the case with active surveillance using daily blood tests and physical examinations. The nephrostomy catheter in the duodenum was left to prevent fistula between the duodenum and the skin, and a new one was placed in the right kidney. The broad spectrum antibiotherapy regime was applied, and the patient was followed up closely. The catheter in the duodenum was removed on the 20th day, uneventfully, and the patient was discharged successfully on the 24th day with her permanent bilateral nephrostomy tubes. On the first follow-up, one month later, the patient had no active medical complaint.

2020 ◽  
Vol 28 (1) ◽  
pp. 52-55
Author(s):  
Ersin Çintesun ◽  
Denizhan Bayramoğlu ◽  
Emine Uysal ◽  
Çetin Çelik

Objective In this case report, we aimed to discuss a septic pelvic thromboembophlebitis (SPT) case detected 20 days later who had the previous history of cesarean section and had an intrauterine stillbirth vaginally at 30 weeks of gestation. Case(s) A 24-year old patient, who admitted to the emergency service with the complaints of fever and pain in the lower right abdomen and was reported to have a 4 cm formation consistent with thrombus on the right ovarian vein wall in the computed tomography (ST), was hospitalized for follow-up and treatment. The patient whose thrombus showed remission in the check-up tomography scan after the broad-spectrum antibiotherapy and anticoagulant treatment was discharged on the 10th day. The treatment of the patient who did not develop any complication in the follow-ups was completed with recover. Conclusion In conclusion, SPT is a complication which is seen rarely in both obstetric and gynecologic practices. SPT is a disease which may lead to fatal outcomes by late diagnosis but satisfying results with early diagnosis. Abdominal pain and fever symptoms should come to mind in all cases after delivery or operation.


2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094430
Author(s):  
Danqing Liu ◽  
Guangqi Li ◽  
Jun Qiu ◽  
Jianyan Wang ◽  
Genwang Pei

Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient’s physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient’s 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians’ awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.


2020 ◽  
pp. 039156031989615
Author(s):  
Simone Sforza ◽  
Giorgio Persano ◽  
Chiara Cini ◽  
Idanna Sforzi ◽  
Antonio Andrea Grosso ◽  
...  

Introduction: Renal trauma is a relevant cause of morbidity in children older than 1 year. Most patients are currently managed conservatively, even in case of high-grade traumas; nevertheless, harmful complications may occur even in hemodynamically stable patients. We present a case of grade IV blunt renal trauma complicated by post-traumatic pseudoaneurysm. Case description: A 10-year-old girl was referred to our institution for grade IV trauma of the right kidney. During observation she had persistent hematuria that caused anemia. A second contrast-enhanced computed tomography scan revealed a posttraumatic pseudoaneurysm that was successfully treated by angiographic embolization. Conclusions: Although extremely rare after blunt renal trauma, post-traumatic renal pseudoaneurysm may cause severe blood loss and anemia, and angioembolization is therefore indicated. This condition should be suspected and move physicians to investigate further.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eltaib Saad ◽  
Lauren O’Connell ◽  
Anne M. Browne ◽  
W. Khan ◽  
R. Waldron ◽  
...  

We report on a 59-year-old female with symptomatic cholelithiasis on a background of morbid obesity who underwent an elective LC with an uncomplicated intraoperative course; however, she experienced a refractory hypotension within one hour postoperatively with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. A triphasic computed tomography scan revealed a large intrahepatic subcapsular haematoma (ISH) measuring 21   cm × 3.1   cm × 17   cm surrounding the lateral surface of the right hepatic lobe without active bleeding. She was managed conservatively with serial monitoring of haemoglobin and haematoma size. A follow-up ultrasound scan after eight weeks confirmed complete resolution of the haematoma. Giant ISH is a fairly rare, but life-threatening complication following LC which merits special attention. This case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH, although being rare event, in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH.


2003 ◽  
Vol 33 (1) ◽  
pp. 53-54 ◽  
Author(s):  
Bello B Shehu ◽  
Nasiru J Ismail

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.


2018 ◽  
Vol 12 (3) ◽  
pp. 709-714 ◽  
Author(s):  
Usman Pirzada ◽  
Hassan Tariq ◽  
Sara Azam ◽  
Kishore Kumar ◽  
Anil Dev

A 42-year-old man presented to the emergency room with complaints of periumbilical abdominal pain. A contrast-enhanced computed tomography revealed mucosal thickening in the small bowel of the right abdomen. There was a fairly large small bowel diverticulum associated with this segment. Findings were suggestive of small bowel diverticulitis or possibly focal enteritis. A Meckel’s diverticulum scan was diagnostic of Meckel’s diverticulum. The patient was then immediately taken to the operating room for emergency laparotomy and was intra-operatively found to have a thickened Meckel’s diverticulitis with adjacent small bowel obstruction. Meckel’s diverticulectomy was performed in continuity with the adjacent inflamed small bowel. The patient had a stable postoperative course without any complications and was discharged within 10 days. At the 3-month follow-up, the patient was well and remained asymptomatic.


Author(s):  
Gang Ji ◽  
Jianwei Zhou ◽  
Jinbao Gao ◽  
Weixia Bai ◽  
Fei Wang

AbstractThe purpose of this study was to present a medial plication using an arthroscopic all-inside technique for the treatment of patellar instability in adolescents. From July 2009 to June 2012, 19 patients with acute patellar dislocation were operated by this technique. Of these patients, follow-up was available in 17 patients at an average of 3 years (range: 1.5–4 years). At the follow-up, we evaluated the patients with physical examinations, radiographs, computed tomography scan, as well as the Lysholm and Kujala scoring scales. No recurrence of patellar instability has been found. The recovery of knee mobilization resulted to be good. We think this could be a valid technique to treat patellar instability in adolescents with less associated morbidity and good cosmetic results.


1994 ◽  
Vol 80 (3) ◽  
pp. 548-551 ◽  
Author(s):  
Constance R. Chu ◽  
Randall M. Chesnut

✓ A case of a nerve root anomaly in a patient presenting with cervical radiculopathy is presented. The patient was treated with posterolateral exploration and decompression, resulting in relief of pain and improvement in strength. Both the preoperative contrast-enhanced computerized tomography scan and the magnetic resonance image demonstrated an abnormality behind the C-4 body extending from the right C3–4 neural foramen to the neural foramen at C4–5. At surgery, a dural-encased structure was discovered connecting the C-4 and C-5 nerve roots within the spinal canal. This paper describes the first reported case of a cervical nerve root anomaly of this type, representing a variant of a conjoined nerve root. The occurrence of such nerve root anomalies in the cervical spine should be entered into the differential diagnosis and treatment of cervical radiculopathy.


2022 ◽  
Vol 8 ◽  
Author(s):  
Qilong Wang ◽  
Zhihua Cheng ◽  
Liang Tang ◽  
Qi Wang ◽  
Ping Zhang ◽  
...  

Herein, we report the case of a 59-year-old man with intermittent claudication of ~100 m, who complained of resting pain in his lower right extremity. A pelvic, contrast-enhanced, computed tomography scan showed the presence of cystic density in the lower segment of the right common femoral artery. Faced with the risk of acute limb ischemia, we navigated a challenging diagnostic procedure to choose an appropriate treatment for him. Additionally, we performed a pathological investigation of the excised common femoral artery following the excision bypass. On postoperative day 5, the patient was discharged from the hospital. During the 2-year follow-up, no new cysts were discovered, and the patient had favorable prognosis.


2020 ◽  
Vol 7 (2) ◽  
pp. 47-53
Author(s):  
Angga Hendro Priyono ◽  
Exsa Hadibrata

ABSTRACT  Background: The incidence of nephrolithiasis in children increases over time. It has been reported an increase of 6 to 10% per year for the last twenty-five years. Research in developing country showed that urinary tract infection and metabolic disorders were the caused of nephrolithiasis. Illustration Case: Three years 10 months old boy had a complaint of pain in plank region followed by tea-like urine since two months ago. Physical examination showed that he appeared to be moderately ill and compos mentis. His physical examinations were normal except positive ballotement and positive costoverebral angle (CVA) pain in the right flank region. Laboratory finding showed positive eritrocyte in urinalysis. Ultrasonography and abdominal CT-scan consistent with nephrolithiasis. Management: Pyelolitotomy was performed under general anesthesia. Postoperatively, patient treated in a pediatric surgery room and observation was carried out. He was given  D5NS 500 ml administered 20 drops per minute microdrip IV, paracetamol 3 x 225 mg IV, and cefotaxime injection 2 x 500 mg IV after a skin test first.  Result and Follow Up: An irregular stone 1,5 cm x 1 cm in size consist of 45% ammonium urate, 31% sodium urate monohydrate, and 24% amorphous calcium phosphate carbonate was found. Discussion: Nephrolithiasis in children occurs due to several related conditions such as genetics, ethnicity, climate, and nutrition. Complications can be prevented by managing and controlling appropriate risk factors.


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