scholarly journals Option of staged treatment of a patient with a gunshot wound to the duodenum.

2021 ◽  
Vol 14 (2) ◽  
pp. 119-123
Author(s):  
Daria Vladimirovna Zuykevich ◽  
Dmitry Yuryevich Semenov ◽  
Dmitry Viktorovich Kulikov ◽  
Yuri Sergeevich Chekmasov ◽  
Elena Sergeevna Did-Zurabova ◽  
...  
Keyword(s):  
Small Intestine ◽  
Biliary Tract ◽  
Gunshot Wound ◽  
Clinical Case ◽  
Duodenal Injuries ◽  
Staged Treatment

The article presents a method of treatment of patients with multiple duodenal injuries, which consists in implanting a section of the duodenum with a Vater papilla into the small intestine, which avoids complex and traumatic operations on the biliary tract and related complications. We present a clinical case with a follow-up period of 7 years. No data were obtained for the presence of complications in the long-term period.

scholarly journals A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuhisa Okada ◽  
Yasumitsu Hirano ◽  
Shintaro Ishikawa ◽  
Hiroka Kondo ◽  
Toshimasa Ishii ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Gastrointestinal Tract ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Clear Cell ◽  
Clear Cell Sarcoma ◽  
Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

scholarly journals Clinical case and short review of extreme short bowel syndrome: an update 21 years after

2016 ◽  
Vol 10 (1) ◽  
pp. 45
Author(s):  
Pasquale Mansueto ◽  
Aurelio Seidita ◽  
Salvatore Iacono ◽  
Antonio Carroccio
Keyword(s):  
Small Intestine ◽  
Short Bowel Syndrome ◽  
Clinical Case ◽  
Ileocecal Valve ◽  
Short Review ◽  
Short Bowel ◽  
Massive Resection ◽  
Low Weight ◽  
Clinical Conditions

Short bowel syndrome refers to the malabsorptive state caused by loss of significant portions of the small intestine, whose clinical framework is characterized by malnutrition, diarrhea, dehydration, weight loss, and low-weight-related symptoms/signs. These clinical conditions seem to be related to the length of resection. Twenty-one years ago we reported the clinical case of an infant, who underwent a massive resection of the loops of the small intestine, of the cecum and of part of the ascending colon, due to intestinal malrotation with volvulus. The residual small intestine measured just 11 cm and consisted of the duodenum and a small part of jejunum, in the absence of the ileocecal valve, configuring the case of a <em>ultra-short bowel syndrome</em>. In this report, we update the case, reporting the patient succeeded to obtain a good weight gain and to conduct a quite normal lifestyle, despite the long-term consequences of such resection.

Giant condiloma of Bushke-Levenstein of anal canal and perianal skin. Clinical case

2021 ◽  
pp. 25-35
Author(s):  
Anton Ivanovich Grechin ◽  
Grigory Vladimirovich Rodoman ◽  
Evgeny Konstantinovich Naumov ◽  
Leonid Vladimirovich Kornev ◽  
Evgeny Mikhailovich Fominykh
Keyword(s):  
High Temperature ◽  
Literature Review ◽  
Clinical Case ◽  
Practical Interest ◽  
Perianal Skin ◽  
Evidence Based ◽  
Perianal Region ◽  
Healing Wound ◽  
Staged Treatment

The article is devoted to a rare disease of the perianal region — Buschke-Levenshtein tumor. A clinical case and a literature review on the etiology, pathogenesis and experience of treating such tumors are presented. Evidence based sources show that currently there is no generally accepted tactics of managing patients with this pathology. In this regard, each case of treatment of such patients is of not only scientific but also practical interest. In this case, the tactics of staged treatment with the use of high-temperature dissectors and immunocorrection was chosen, which made it possible to achieve a good clinical result without the formation of extensive and long-term non-healing wound defects in the perianal region.

LONG-TERM FOLLOW-UP ASSESSMENT OF POTENTIAL ADVERSE EFFECTS AFTER RADIOFREQUENCY ABLATION IN AN INFANT (A CLINICAL CASE)

2019 ◽  
Vol 8 (3) ◽  
pp. 136-141
Author(s):  
O. Yu. Dzhaffarova ◽  
L. I. Svintsova ◽  
I. V. Plotnikova ◽  
S. N. Krivolapov
Keyword(s):  
Radiofrequency Ablation ◽  
Electrical Activity ◽  
Clinical Case ◽  
Case Reports ◽  
Electrophysiological Study ◽  
Mapping System ◽  
Long Term Follow Up ◽  
Myocardial Electrical Activity

The article presents a long-term follow-up of the patient who underwent an intracardiac electrophysiological study (EPS) and radiofrequency ablation (RFA) of focal tachycardia at the age of 2 months. 12 years after the indexed procedure, Wolff-Parkinson-White (WPW) syndrome was diagnosed and required repeat RFA procedure. The atrial map of the first ablated zone was reconstructed using non-fluroscopic mapping system. EPS reported the absence of myocardial electrical activity reduction zones. There were no damages after the indexed ablation. Our findings suggested the normal electrical activity of the atrial tissue in the long-term period following the indexed RFA. This clinical case reports the absence of post-ablation necrosis and successful restoration of the electrical activity of the myocardium with the child’s growth.

scholarly journals First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up

2017 ◽  
Vol 42 (3) ◽  
pp. E2 ◽  
Author(s):  
Zachary C. Gersey ◽  
S. Shelby Burks ◽  
Kim D. Anderson ◽  
Marine Dididze ◽  
Aisha Khan ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Gunshot Wound ◽  
Nerve Repair ◽  
Nerve Graft ◽  
Sensory Function ◽  
Long Term Follow Up

OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were used to supplement human peripheral nerve repair in long-segment injury. Both patients had significant improvement in both motor and sensory function with correlative imaging. This study demonstrates preliminary safety and efficacy of SC transplantation for peripheral nerve repair.

Leukoencephalopathy, cerebral calcifications, and cysts: A clinical case involving a long-term follow-up and literature review

2017 ◽  
Vol 373 ◽  
pp. 60-65 ◽  
Author(s):  
Ryota Tamura ◽  
Takayuki Ohira ◽  
Katsura Emoto ◽  
Hirokazu Fujiwara ◽  
Tomo Horikoshi ◽  
...  
Keyword(s):  
Literature Review ◽  
Clinical Case ◽  
Cerebral Calcifications ◽  
Long Term Follow Up

scholarly journals TOTAL MANDIBULAR DEFECT RECONSTRUCTION BY TOTAL TITANIUM PATIENT-SPECIFIC IMPLANT: CLINICAL EFFICACY AND LONG TERM FOLLOW UP. CLINICAL CASE

2021 ◽  
Vol 74 (4) ◽  
pp. 1037-1041
Author(s):  
Denis M. Chernohorskyi ◽  
Yuriy V. Chepurnyi ◽  
Oleksandr A. Kanyura ◽  
Andriy V. Kopchak
Keyword(s):  
Clinical Case ◽  
Treatment Method ◽  
Patient Specific ◽  
Surgical Approaches ◽  
Final Decision ◽  
Good Tool ◽  
Long Term Follow Up ◽  
Mandibular Defect

The aim of this clinical case in demonstrating the possibility of replacing total defect of the mandible with a patient specific implant and the result of long-term follow up. Literature data on the replacement of total mandibular defects are extremely limited and they are presented by only several clinical cases where various surgical approaches were used. In the available literature, there are two approaches to solving this problem, including the replacement of the jaw with vascularised bone grafts, of which the fibula flap is the most promising, and the implantation of endoprostheses of the jaws, of which patient-specific anatomical endoprostheses made using additive technologies are the most advanced. The concept of using patient-specific endoprostheses of the whole mandible is considered revolutionary because it has a number of significant benefits, including the greatest accuracy in restoring the anatomical shape of the mandible. One of the unresolved problems associated with the installation of total mandibular endoprostheses is the prosthetic rehabilitation of patients using fixed structures. The analysis of the presented case can be a good tool for the clinician and bioengineer while making the final decision on the treatment method and modality in patients who need an identical option for the repair of a mandibular defect. Based on CT data, we can conclude that the employed approach, methodology of design and manufacture of patient-specific titanium mandibular endoprosthesis for the total defect demonstrated the sufficient efficacy, which suggest the need for further systematic studies to address this issue.

Long-Term Impact of Bariatric Surgery

2017 ◽  
Author(s):  
Michael E. Hochman
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Abdominal Surgery ◽  
Vertical Banded Gastroplasty ◽  
Clinical Case ◽  
Long Term Impact ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in abdominal surgery. Does bariatric surgery in obese individuals reduce mortality? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible bariatric surgery, including gastric banding, vertical banded gastroplasty, or gastric bypass, for an obese man who has not had success with dieting.

Successful Surgical Management of Encapsulating Peritoneal Sclerosis

2005 ◽  
Vol 25 (4_suppl) ◽  
pp. 39-47 ◽  
Author(s):  
Hideki Kawanishi ◽  
Hiroshi Watanabe ◽  
Misaki Moriishi ◽  
Shinichiro Tsuchiya
Keyword(s):  
Small Intestine ◽  
Bowel Obstruction ◽  
Operating Time ◽  
Chronic Glomerulonephritis ◽  
Complete Relief ◽  
Bacterial Peritonitis ◽  
Initial Surgery ◽  
Therapeutic Guidelines

♦ Background Encapsulating peritoneal sclerosis (EPS) is a serious complication of long-term peritoneal dialysis (PD). The mortality rate for EPS has been high, primarily because of complications related to bowel obstruction. Also, therapeutic guidelines for EPS have not yet been established. In our hospital, favorable postoperative results were obtained in 50 patients whose EPS was treated surgically. ♦ Patients All patients had chronic glomerulonephritis as the underlying kidney disease. All had undergone PD for between 29 months and 220 months (average: 113.9 months). During the course of PD, 3 patients developed EPS and were subsequently transferred to hemodialysis (HD). The other 47 patients (94.0%) developed EPS after discontinuation of PD. The reasons for transfer to HD were inadequate ultrafiltration (26 patients), bacterial peritonitis (16 patients), hypoalbuminemia (2 patients), renal transplantation (3 patients), and occurrence of EPS (3 patients). ♦ Intervention At laparotomy, a definitive diagnosis of EPS was established in all patients by the presence of clumped intestine cocooned with a dense sclerotic membrane. In all cases, the small intestine was completely released by ablation of the capsules, resulting in resolution of the bowel obstruction symptoms. In 5 patients, the large intestine was ablated solely at the region of the sigmoid colon. The operating time varied from 3 hours to 18 hours (average: 6.9 hours). Oral food intake was initiated 5 – 60 days (average: 10.2 days) after surgery. ♦ Results Perforation of the small intestine was detected postoperatively in 2 patients, who died 26 days and 37 days after surgery. The remaining 48 patients were followed for between 9 months and 107 months (average: 34.6 months). During follow-up, 6 – 12 months after the initial surgery, 4 patients experienced a recurrence of bowel obstruction symptoms that required a second laparotomy with enterolysis. Excluding the 2 patients with fatal outcomes, 46 patients (96%) experienced complete relief from bowel obstruction symptoms. The remaining 2 patients continued to experience mild, sub-acute bowel obstruction symptoms that could be successfully controlled solely by diet. ♦ Conclusions Surgical treatment of 50 patients with EPS produced successful outcomes in all but 2 patients (96% success). Encapsulating peritoneal sclerosis should be actively treated by surgeons who genuinely understand this pathologic condition.

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