scholarly journals Case Report: Spontaneous perforation of choledochal cyst in an infant: Successful management in a centre with limited means

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1467
Author(s):  
Rafey Abdul Rahman ◽  
Umesh Kumar Gupta
Keyword(s):  
Case Report ◽  
Choledochal Cyst ◽  
Tube Placement ◽  
Definitive Treatment ◽  
Spontaneous Perforation ◽  
Successful Management ◽  
Biliary Peritonitis ◽  
T Tube ◽  
Initial Surgery ◽  
Definitive Surgery

Background: Biliary peritonitis due to a ruptured choledochal cyst (CC) is a rare occurrence. The difference between bile duct perforation (BDP) and ruptured choledochal cysts continues to be a matter of debate. Simple drainage, T tube placement and cholecystostomy have been proposed as the initial treatment of choice. Definitive surgery in the form excision of the CC and hepatico-enterostomy has been described as the ideal treatment option. We report a successful management of a unique case of perforated choledochal cyst in an infant who presented with biliary peritonitis. Case report: An 8 months old female child presented with biliary peritonitis as result of spontaneous perforation of a choledochal cyst. The patient was successfully managed initially by placement of T tube in the perforated cyst followed by a T tube cholangiogram. Definitive surgery was performed 5 weeks after the initial surgery in which cyst was excised and hepatico-duodenostomy was performed. The child is currently in follow up and doing well. Conclusion: Perforated CC can present as acute abdomen sometimes having only subtle signs. In absence of any previous established diagnosis of CC and trained radiological support the condition becomes challenging to diagnose preoperatively. External T-tube drainage followed by T-tube cholangiogram can help in delineating the anatomy. Cyst excision along with hepaticoportoentersomy remains the gold standard definitive treatment.

scholarly journals Modified method of T-tube placement in cases of ruptured choledochal cyst having complete loss of anterior wall

2011 ◽  
Vol 17 (1) ◽  
pp. 77 ◽  
Author(s):  
Ahmed Intezar ◽  
RawatD Jile ◽  
Anshuman Sharma ◽  
Anand Pandey ◽  
Ashish Wakhlu ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Anterior Wall ◽  
Complete Loss ◽  
Tube Placement ◽  
T Tube ◽  
Modified Method

scholarly journals Endoscopic T-tube placement in the management of lye-induced esophageal perforation: Case report of a safe treatment strategy

2009 ◽  
Vol 3 (1) ◽  
pp. 19 ◽  
Author(s):  
Mary McMahon ◽  
Fardod O'Kelly ◽  
Kheng Lim ◽  
Narayanasamy Ravi ◽  
John Reynolds
Keyword(s):  
Case Report ◽  
Esophageal Perforation ◽  
Treatment Strategy ◽  
Tube Placement ◽  
Safe Treatment ◽  
T Tube

scholarly journals Biliary Peritonitis due to Spontaneous Perforation of Choledochus: A Case Report

2011 ◽  
Vol 75 (S1) ◽  
pp. 96-98 ◽  
Author(s):  
Mushtaq A. Laway ◽  
Iftikhar H. Bakshi ◽  
Mubbashir Shah ◽  
Showkat A. Paray ◽  
Mohd Sadiq Malla
Keyword(s):  
Case Report ◽  
Spontaneous Perforation ◽  
Biliary Peritonitis

Erratum: Recurrent Laryngeal Nerve Dissection

1980 ◽  
Vol 45 (3) ◽  
Author(s):  
Frank B. Wilson ◽  
D. J. Oldring ◽  
Kathleen Mueller
Keyword(s):  
Case Report ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Long Period ◽  
Initial Surgery

On page 112 of the report by Wilson, Oldring, and Mueller ("Recurrent Laryngeal Nerve Dissection: A Case Report Involving Return of Spastic Dysphonia after Initial Surgery," pp. 112-118), the paraphrase from Cooper (1971), "if the patients are carefully selected and are willing to remain in therapy for a long period of time," was inadvertantly put in quotation marks.

Two Siblings with Total Colonic Aganglionosis Extended to the Ileum

Swiss Surgery ◽  
2003 ◽  
Vol 9 (4) ◽  
pp. 187-189
Author(s):  
Aslan ◽  
Caglar ◽  
Karagüzel ◽  
Melikoglu
Keyword(s):  
Intestinal Obstruction ◽  
Loop Ileostomy ◽  
Good Condition ◽  
Disease Type ◽  
Definitive Treatment ◽  
Entire Colon ◽  
Total Colonic Aganglionosis ◽  
Protective Ileostomy ◽  
Definitive Surgery ◽  
Partial Intestinal Obstruction

Total colonic aganglionosis (TCA) extended to the ileum is seen quite rare among infants with Hirschsprung's disease. Type and timing of definitive surgery in these patients are controversial. This report was presented to discuss the management of two siblings with TCA. Case 1: A two-day-old girl was operated for partial intestinal obstruction. During laparotomy, serial frozen biopsies proved TCA extended to the terminal ileum and a loop ileostomy was performed. At five months of age, a modified Duhamel-Martin procedure without protective ileostomy was performed. An endo-GIA stapler was transanally used for colo-ileal anastomosis. She is doing well for the last five years. Case 2: A one-day-old boy admitted to the hospital with similar findings to his sister. Frozen biopsies during first laparotomy proved that majority of ileum and entire colon was aganglionic and a proximal ileostomy was performed. At 10 months of age, he underwent a similar Duhamel-Martin operation. He is in a good condition for the last four years. Conclusion: In infants, our modification on Duhamel-Martin procedure, which is based on the use of an endo-GIA stapler transanally for colo-ileal anastomosis without protective ileostomy, may be utilized as an alternative method in the definitive treatment of patients with TCA.

scholarly journals Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199611
Author(s):  
Evelyne Sandjojo ◽  
Vanessa AMC Jaury ◽  
Yufi K Astari ◽  
Mahendria Sukmana ◽  
Rizky A Haeruman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Atrioventricular Block ◽  
Pacemaker Implantation ◽  
Uncontrolled Hypertension ◽  
Definitive Treatment ◽  
Inferior Wall ◽  
Complete Atrioventricular Block ◽  
History Of ◽  
Complete Atrioventricular

Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.

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