scholarly journals Cesarean scar pregnancy: scope for hysteroscopy

2019 ◽  
Vol 8 (5) ◽  
pp. 2138
Author(s):  
Nitin H. Shah ◽  
Aditi V. Joshi ◽  
Renu Agrawal
Keyword(s):  
Surgical Intervention ◽  
Treatment Modalities ◽  
Uterine Perforation ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Products Of Conception ◽  
Long Term Follow Up ◽  
Previous Cesarean

Scar ectopic pregnancy also known as cesarean scar pregnancy is a rare form of an extrauterine pregnancy. The blastocyst is implanted at the site of the previous cesarean scar. Most patients remain asymptomatic and are detected on routine ultrasonography imaging. The diagnosis and management of this condition is hence challenging and difficult. A timely ultrasonography in the early weeks of gestation is the key to preventing catastrophic events like uterine perforation and excessive hemorrhage. There is a wide armamentarium of treatment modalities to choose from, however each case must be individualised. Medical management has its own limitations and often patients are required to have a long-term follow-up. We present a case of a cesarean scar pregnancy managed conservatively with systemic methotrexate but subsequently requiring surgical intervention done successfully via hysteroscopy. A repeat ultrasonography done a fortnight later revealed no retained products of conception.

Chronic Plantar Heel Pain: Treatment with a Short Leg Walking Cast

1996 ◽  
Vol 17 (1) ◽  
pp. 41-42 ◽  
Author(s):  
Christopher L. Tisdel ◽  
Marion C. Harper
Keyword(s):  
Complete Resolution ◽  
Surgical Intervention ◽  
Pain Treatment ◽  
Heel Pain ◽  
Treatment Modalities ◽  
Plantar Heel Pain ◽  
Long Term Follow Up

The efficacy of a short leg walking cast in the treatment of chronic plantar heel pain was assessed for 32 patients with 37 involved extremities treated over a 2-year period. All patients had failed numerous other treatment modalities and had been symptomatic for an average of 1 year. Long-term follow-up for 24 patients with 28 involved extremities revealed complete resolution of pain for 7 extremities (25%), improvement for 17 (61%), and no improvement for 4 (14%). Ten (42%) patients were completely satisfied with cast treatment, 3 (12%) were satisfied with reservations, and 11 (46%) were dissatisfied. Casting appears to be a reasonable option for patients with recalcitrant heel pain and should be offered before surgical intervention.

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

scholarly journals LGG-40. NATURAL COURSE AND MANAGEMENT OF SMALL ASYMPTOMATIC LESION SUSPECTED OF LOW-GRADE GLIOMA IN CHILDREN

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii374-iii374
Author(s):  
Ai Muroi ◽  
Takao Tsurubuchi ◽  
Hidehiro Kohzuki ◽  
Ryoko Suzuki ◽  
Hiroko Fukushima ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Natural Course ◽  
Low Grade ◽  
Diffuse Astrocytoma ◽  
Mr Images ◽  
Initial Examination ◽  
Long Term Follow Up ◽  
Intracranial Lesions

Abstract OBJECTIVE The natural course of incidentally discovered small intracranial lesions has not been well discussed. Surgical intervention, including resection and biopsy, could be achieved if the lesion is growing. We present 13 cases with incidentally found, small non-enhancing lesions without related symptoms. METHODS We retrospectively reviewed a series of 13 children with T1 hypointense and T2 hyperintense intracranial lesions less than 20 mm in diameter without enhancement. We excluded the patients with NF-1 or Tuberous sclerosis. RESULTS Most patients underwent MRI for headache unrelated to the lesions. All cases were located supratentorially. The median age of the patients at the initial examination was 8.9 years (range, 2.2–14.6). Of these children, 2 patients (15.3%) underwent surgery because of progression on follow-up MR images. The pathological diagnosis was compatible with diffuse astrocytoma. Patients were followed for a median of 55 months (range, 11–87) and the overall survival rate was 100%. No patient experienced increase in size after 3 years of follow-up. CONCLUSIONS In most patients with small intracranial lesions, the lesions remained stable and conservative management was appropriate. However, in a few cases, the lesions changed in size or quality and surgical intervention was necessary. Long-term follow-up at least 3 years is mandatory.

Early and late outcomes of surgical repair of double-chambered right ventricle: a single-centre experience

2020 ◽  
Vol 30 (3) ◽  
pp. 409-412
Author(s):  
Murat Surucu ◽  
İlkay Erdoğan ◽  
Birgül Varan ◽  
Murat Özkan ◽  
N. Kürşad Tokel ◽  
...  
Keyword(s):  
Ventricular Septal Defect ◽  
Right Ventricle ◽  
Septal Defect ◽  
Surgical Intervention ◽  
Systolic Pressure ◽  
Presenting Symptoms ◽  
Long Term Follow Up ◽  
The Right

AbstractObjective:Double-chambered right ventricle is characterised by division of the outlet portion of the right ventricle by hypertrophy of the septoparietal trabeculations into two parts. We aim to report our experiences regarding the presenting symptoms of double-chambered right ventricle, long-term prognosis, including the recurrence rate and incidence of arrhythmias after surgery.Methods:We retrospectively investigated 89 consecutive patients who were diagnosed to have double-chambered right ventricle and underwent a surgical intervention from 1995 to 2016. The data obtained by echocardiography, cardiac catheterisation, and surgical findings as well as post-operative follow-up, surgical approaches, post-operative morbidity, mortality, and cardiac events were evaluated.Results:Median age at the time of diagnosis was 2 months and mean age at the time of operation was 5.3 years. Concomitant cardiac anomalies were as follows: perimembranous ventricular septal defect (78 patients), atrial septal defect (9 patients), discrete subaortic membrane (32 patients), right aortic arch (3 patients), aortic valve prolapse and/or mild aortic regurgitation (14 patients), and left superior caval vein (2 patients). The mean follow-up period was 4.86 ± 4.6 years. In these patients, mean systolic pressure gradient in the right ventricle by echocardiography before, immediately, and long-term after surgical intervention was 66.3, 11.8, and 10.4 mmHg, respectively. There were no deaths during the long-term follow-up period. Surgical reinterventions were performed for residual ventricular septal defect (2), residual pulmonary stenosis (1), and severe tricuspid insufficiency (1).Conclusion:The surgical outcomes and prognosis of double-chambered right ventricle are favourable, recurrence and fatal arrhythmias are unlikely in long-term follow-up.

Long-Term Follow-Up for Children Treated With Surgical Intervention for Chronic Rhinosinusitis

2006 ◽  
Vol 116 (12) ◽  
pp. 2099-2107 ◽  
Author(s):  
Rodney P. Lusk ◽  
Marcella R. Bothwell ◽  
Jay Piccirillo
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Intervention ◽  
Long Term Follow Up

scholarly journals Live Cesarean Scar Pregnancy: A Case Report

2020 ◽  
pp. 1-4
Author(s):  
Zohra Amin ◽  
Anu Dua ◽  
Arzoo Amin ◽  
Zohra Amin
Keyword(s):  
Surgical Management ◽  
Medical Management ◽  
Cesarean Scar Pregnancy ◽  
Initial Management ◽  
Cesarean Scar ◽  
Threatening Condition ◽  
Life Threatening ◽  
Specific Symptoms ◽  
Previous Cesarean

Introduction: The overall incidence of Cesarean scar pregnancy is increasing due to Cesarean rates. This life-threatening condition has been historically managed in various ways as no single modality is reliable enough. We report this case of live CSP managed initially with Fetocide followed by Methotrexate but requiring Surgical management later on. Presentation: A 32 years old para 5 with four previous Cesarean sections was diagnosed with live CSP. HCG level was 76,619. The initial management was fetocide with KCL followed by Methotrexate. The treatment was considered successful in view of appropriate reduction in serum HCG levels. The woman required surgical management 10 weeks after the initial management, but the blood loss was minimal. Discussion: A CSP may be asymptomatic or present with non-specific symptoms. The rate of initial misdiagnosis is as high as 76%. TVUSS enables correct CSP diagnosis and implementation of minimally invasive effective treatment. HCG levels can affect the overall outcome, but medical management can be considered even with high HCG levels. Conclusion: CSP is a life-threatening condition, therefore timely diagnosis and appropriate management is crucial. Medical management can be considered in most cases even with high HCG, but management has to be tailored according to the patient. Close follow up of patient after Medical treatment is important as they may require further intervention.

Surgical management of uterine torsion through ventral celiotomy in eleven mares

2019 ◽  
Author(s):  
Jasmeet Singh Khosa ◽  
Arun Anand ◽  
Vandana Sangwan ◽  
Shashi Kant Mahajan ◽  
Jitendra Mohindroo ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Surgical Management ◽  
Surgical Intervention ◽  
Normal Position ◽  
Inhalation Anesthesia ◽  
Uterine Torsion ◽  
Long Term Follow Up ◽  
Veterinary Hospital

This article describes the surgical management of uterine torsion by midline celiotomy for cesarean section in 11 mares presented with signs of colic at a teaching veterinary hospital. The mares were either in full term of gestation (n = 6) or in advanced stage of pregnancy (n = 5). Majority of the mares (44.5%) were in fourth parity. 78% cases of uterine torsion were post cervical and clockwise and (22%) cases were post cervical and anticlockwise. For surgical intervention, mares were anesthetized using a combination of xylazine (1.1 mg/kg) and ketamine (2.2 mg/kg), intravenously and maintained on isoflurane inhalation anesthesia. Midline celiotomy was performed, and foals were delivered by cesarean section. Before closing the abdominal wound, the uterus was detorted manually and confirmed per-vaginally for its normal position. After long-term follow-up, the study reported 90.0% (10/11) survival rate out of which, seven were bred successfully.

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