scholarly journals Diaphragmatic hernia: a rare complication of hepatic ablation

2020 ◽  
Vol 65 (3) ◽  
pp. 103-106
Author(s):  
Mark T Macmillan ◽  
Shueh Hao Lim ◽  
Hamish M Ireland
Keyword(s):  
Microwave Ablation ◽  
Rare Complication ◽  
Diaphragmatic Injury ◽  
Diaphragmatic Defect ◽  
Emergency Laparotomy ◽  
Effective Technique ◽  
Case Presentation ◽  
Hepatocellular Carcinomas ◽  
Hepatic Ablation ◽  
Life Threatening

Introduction Ablation has become an effective treatment for small hepatocellular carcinomas (HCC). Whilst ablation is a safe and effective technique, diaphragmatic injury is a rarely associated but significant complication. Case presentation: We present a case of a 67 year old patient who developed a diaphragmatic defect following microwave ablation (MWA) for HCC. The diaphragmatic defect progressed to herniation which was complicated by perforation of intrahernial large bowel. The patient was treated by emergency laparotomy and an extended right hemi-colectomy was performed. Conclusion Our report adds to the current available knowledge on diaphragmatic injury following hepatic ablation and demonstrates the potential for life threatening consequences associated with this complication.

A Rare Complication Of Microwave Ablation For Renal Cell Carcinoma; Nephrocolic Fistula

2021 ◽  
Vol 17 ◽  
Author(s):  
Fatih Temel Yilmaz ◽  
Lutfullah Sari ◽  
Mahmut Esat Aykan ◽  
Mehmet Gultekin ◽  
Ilker Oz
Keyword(s):  
Renal Cell Carcinoma ◽  
Case Report ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Microwave Ablation ◽  
Rare Complication ◽  
Case Presentation ◽  
Ablation Therapy ◽  
First Case ◽  
Tumour Ablation

Introduction: Nephrocolic fistula is a pathological connection between the kidney and colon. Percutaneous tumour ablation therapy is a rare cause of iatrogenic nephrocolic fistula in the literature. Case Presentation: Interventional radiologists should be careful, especially in patients with repeated ablation. Granulation of tissue may lead to unexpected results secondary to tissue fragility and impedance changes. Conclusion: In addition, we should keep in mind that there is decreasing hydro dissection benefit in cases with the previous ablation. As far as we know, this is the first case report of an iatrogenic ephrocolic fistula after microwave ablation for recurrence renal cell carcinoma.

scholarly journals Early parastomal evisceration of small bowel following a loop ileostomy for malignant intestinal obstruction

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110158
Author(s):  
Oshan Basnayake ◽  
Y Prasanthan ◽  
Umesh Jayarajah ◽  
NMPG Ganga ◽  
Kanishka De Silva
Keyword(s):  
Small Bowel ◽  
Intestinal Obstruction ◽  
Bronchial Asthma ◽  
Rare Complication ◽  
Loop Ileostomy ◽  
Emergency Laparotomy ◽  
Aortic Lymph Node ◽  
Poor Nutritional Status ◽  
Life Threatening ◽  
Metastatic Colonic Cancer

Evisceration of bowel through the stoma is a rare complication and only few cases have been reported. Although most cases occur in the context of long-standing parastomal hernias, early evisceration may also occur causing significant morbidity to patients. The reported patient is a 53-year-old male with bronchial asthma who was diagnosed to have metastatic colonic cancer underwent a trephine loop ileostomy for intestinal obstruction. On post-operative Day 7, he developed small bowel evisceration through the ileostomy site. The patient underwent an emergency laparotomy and found to have non-viable prolapsed small bowel segment at the stoma site. Furthermore, there were extensive peritoneal deposits and large para aortic lymph node mass and ascites compromising the peritoneal space. Resection of non-viable small bowel and ileostomy refashioning was carried out. The patient was managed in the intensive care unit and he gained function of the ileostomy on post-operative Day 2. On Day 5, he died due to subsequent pneumonia and worsening acute respiratory distress syndrome. Early parastomal evisceration is an extremely infrequent life-threatening complication that requires urgent treatment. Disseminated cancer, bowel obstruction, poor nutritional status, ascites and exacerbation of bronchial asthma were additional risk factors in our patient.

scholarly journals Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Stephanie Cull ◽  
Gebran Khneizer ◽  
Abhishek Krishna ◽  
Razi Muzaffar ◽  
Sameer Gadani ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Microwave Ablation ◽  
Rare Complication ◽  
Rapid Development ◽  
Nuclear Imaging ◽  
Positive Pressure ◽  
Hepatic Hydrothorax ◽  
Pleuroperitoneal Communication ◽  
Life Threatening ◽  
The Right

Acquired diaphragmatic perforation leading to massive hepatic hydrothorax and respiratory failure is a rare complication of microwave ablation (MWA) of hepatocellular carcinoma (HCC). Imaging modalities to detect pleuroperitoneal communication remain poorly described. We report a nuclear imaging technique used to efficiently diagnose and locate diaphragmatic defects. A 57-year-old male with cirrhosis and HCC presented with respiratory distress after undergoing MWA of a HCC lesion. He was admitted to the intensive care unit for noninvasive positive pressure ventilator support. Chest radiography revealed a new large right pleural effusion. Large-volume thoracentesis was consistent with hepatic hydrothorax. The fluid reaccumulated within 24 hours; therefore an acquired diaphragmatic perforation induced by the ablation procedure was suspected. To investigate,  99mTechnetium-labeled albumin was injected into the peritoneal cavity. The tracer accumulated in the right hemi thorax almost immediately. The patient then underwent transjugular intrahepatic portosystemic shunting in efforts to relieve portal hypertension and decrease ascites volume. Unfortunately, the patient deteriorated and expired after few days. Although diaphragmatic defects develop in cirrhotic patients, such small fenestrations do not normally lead to rapid development of life-threatening pleural effusion. MWA procedures can cause large diaphragmatic defects. Immediate detection of this complication is essential for initiating early intervention.

scholarly journals Liver haematoma in pregnancy: A rare complication of HELLP syndrome

2021 ◽  
Vol 10 (2) ◽  
pp. 101-103
Author(s):  
Chandani Pandey ◽  
Junu Shrestha ◽  
Bishwodeep Timilsina ◽  
Prerana Bhattarai ◽  
Apariharya Rana
Keyword(s):  
Hellp Syndrome ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Emergency Laparotomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Condition Diagnosis ◽  
Liver Haematoma ◽  
In Pregnancy

Liver haematoma complicating pregnancy with HELLP syndrome is a rare but life-threatening condition. Diagnosis requires a high index of suspicion. Here a case of liver haematoma is presented in a 29 years multigravida at 34 weeks of pregnancy. Initially hypertension was not revealed since she had presented in shock. She had presented with on and off epigastric pain for many days. In context of haemoperitoneum in ultrasound, emergency laparotomy was done and liver haematoma diagnosed intraoperatively. Haematoma was managed with packing and second look laparotomy was done to remove the packs. Haematoma gradually resolved over period of months.

scholarly journals Faecopneumothorax revealing a neglected traumatic diaphragmatic hernia

2019 ◽  
Vol 6 (2) ◽  
pp. 26-27
Author(s):  
B Chaoui ◽  
I Nassar ◽  
N MoatassimBillah
Keyword(s):  
Diaphragmatic Hernia ◽  
Rare Complication ◽  
Case Presentation ◽  
Traumatic Diaphragmatic Hernia ◽  
Latent Stage ◽  
Left Hypochondrium ◽  
Life Threatening ◽  
Therapeutic Attitude ◽  
Post Traumatic ◽  
Diaphragmatic Hernias

Introduction: Tension fecopneumothoraxis a rare but serious complication of traumatic diaphragmatic hernias. The diagnosis of the hernia can be delayed from a few days to some years and will be made on occasion of complications representing the dramatic evolution of the “latent stage” of disease. Only few cases of post-traumatic faecopneumothorax are described in the literature. This clinical evolution is associated to a significant increase in morbidity (30–80% of cases). This is particularly the case with our patient. Case presentation: We report the case of a 26-year-old who had a trauma of the left hypochondrium about a year ago and who presented an acute intestinal occlusion, an X ray abdomen and chest was performed, showing abundant hydropneumothorax, thethoracoabdominal scan reveals an abundant effusion with heterogeneous density in the left pleural cavity, associated with an intrapleural hernia of the large intestine Discussion: Tension fecopneumothorax is a very rare complication of traumatic diaphragmatic hernia, only few cases are described in the literature, the mechanisms of the injury can blunt or penetrating, it occurs after intrapleural perforation of a strangulated colon, and very often its life threatening. Conclusion: According to our knowledge and review of the literature, Tension fecopneumothorax complicating a traumatic diaphragmatic hernia is very rare; the diagnosis is made by thoracic radiography and thoracoabdominalCT, which also allow orientation of the therapeutic attitude with non-negligible post-operative complications.

scholarly journals Adrenocortical Carcinoma Presenting with Signs of Acute Abdomen

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios Symeonidis ◽  
Ioannis Chatzinikolaou ◽  
Georgios Koukoulis ◽  
Ioannis Mamaloudis ◽  
Konstantinos Tepetes
Keyword(s):  
Acute Abdomen ◽  
Adrenocortical Carcinoma ◽  
Clinical Presentation ◽  
Mass Effect ◽  
Emergency Laparotomy ◽  
Rare Presentation ◽  
Case Presentation ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Adrenocortical Carcinomas

Background. Adrenocortical carcinomas represent rare malignancies. In cases of hormone-secreting tumors, the hormone in excess determines the nearly diagnostic clinical presentation. Biologically inert tumors are diagnosed either due to the mass effect or incidentally. The purpose of the present study was to present an extremely rare presentation pattern of adrenocortical carcinoma.Case Presentation. We present the case of a 35-year-old female patient that underwent emergency laparotomy due to signs of acute abdomen and concomitant cardiovascular collapse caused by a spontaneously ruptured large adrenocortical carcinoma.Conclusion. Spontaneous rupture of an adrenocortical carcinoma presenting with signs of acute abdomen is an extremely rare clinical scenario. Increased level of suspicion is essential in order to diagnose and treat timely this life-threatening complication.

scholarly journals Pott's puffy tumor: as a very rare and unpredicted complication of ipsilateral pan sinusitis - case presentation and review of articles

2021 ◽  
Vol 4 (4) ◽  
pp. 181-184
Author(s):  
K.M. Bofares ◽  
Z.A. Haqqar ◽  
I.M. Ali
Keyword(s):  
Brain Abscess ◽  
Rare Complication ◽  
Rare Condition ◽  
Frontal Area ◽  
Rare Clinical Entity ◽  
Frontal Sinusitis ◽  
Case Presentation ◽  
Pott’S Puffy Tumor ◽  
Life Threatening ◽  
Subdural Abscess

Pott's puffy tumor is considered as a rare clinical entity. It is developed as a rare complication of frontal sinusitis. In addition, the trauma to the frontal area is another suggested cause. The Pott's puffy tumor is presented as a forehead swelling due to sub-periosteal collection. Although, the Pott's puffy tumor is a rare condition but at the same time, it can be serious because it may lead to life threatening complications namely, extradural abscess, subdural abscess, meningitis, encephalitis, and brain abscess. Thus, the Pott's puffy tumor is classified as a very significant surgical emergency.

scholarly journals Life-threatening bleeding with intussusception due to gastrointestinal stromal tumor: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Min Sung Kim ◽  
In Teak Woo ◽  
Young Min Jo ◽  
Jin Hyung Lee ◽  
Byung Sam Park
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Rare Case ◽  
Massive Bleeding ◽  
Stromal Tumor ◽  
Emergency Laparotomy ◽  
Immunochemical Analysis ◽  
Case Presentation ◽  
Rare Finding ◽  
Low Blood Pressure ◽  
Life Threatening

Abstract Background Massive intraluminal bleeding requires urgent intervention and management. However, the source of bleeding on the small intestine is difficult to determine. Intestinal tumor with intussusception is a rare and normally not an urgent condition. Herein, we present a rare case of intestinal intussusception with massive bleeding due to jejunal gastrointestinal stromal tumor (GIST) that required emergency surgical treatment. Case presentation A 51-year-old male was admitted to the emergency department complaining of abdominal pain and acute hematochezia. Esophagogastroduodenoscopy (EGD) and colonoscopy could not determine the source of the bleeding site. Abdominal pelvic computed tomography (AP-CT) revealed GIST with intussusception, strongly suggestive of distal jejunal bleeding. Unresponsive transfusion with low blood pressure and continuous hematochezia led to emergency laparotomy. GIST, which was the leading point for intussusception, was located in the jejunum and showed mucosal ulceration of approximately 3.5 cm in diameter. Following resection and functional anastomosis, histology revealed a GIST with low mitotic count (< 5 per 50HPF). Moreover, immunochemical analysis revealed positivity for c-kit (CD117) and DOG-1. There were no complications 2 months after surgery. Conclusions Intussusception associated with GIST is a rare finding that can be life-threatening if it occurs with an ulcer. This case showed that the early detection of bleeding and emergency surgery could prevent severe complications.

scholarly journals Prolapsed submucosal pyomyoma postpartum, a rare complication of fibroids

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingxue Wang ◽  
Zheng Li ◽  
Yu Sun
Keyword(s):  
Rare Complication ◽  
Large Diameter ◽  
Clinical Suspicion ◽  
Postpartum Women ◽  
Toxic Shock ◽  
Healthy Baby ◽  
Case Presentation ◽  
Future Fertility ◽  
Life Threatening ◽  
Obvious Source

Abstract Background Pyomyoma is an unusual fibroid that usually develops during the puerperal or postmenopausal period. If not promptly diagnosed and treated, it can become life threatening. Although various conservative and surgical therapies have been discussed in the literature for this condition, there are very few reports related to the management of prolapsed pedunculated submucosal myoma. Case presentation In this case report, an intramural fibroid transformed into a pedunculated submucosal pyomyoma, which prolapsed into the vagina after a miscarriage and caused life-threatening toxic shock. Apart from prompt antibiotic treatment, a transabdominal myomectomy rather than hysterectomy was performed due to the very large diameter of the pyomyoma. As a result, fertility was preserved, and the patient conceived naturally and delivered a healthy baby two years later. Discussion and conclusions It is important to maintain strong clinical suspicion for pregnant or postpartum women with a triad of pain, sepsis without an obvious source and a known diagnosis of leiomyoma. Timely recognition and prompt surgical treatment with antibiotics are necessary and could conserve the uterus for future fertility.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

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