scholarly journals Scleral Dellen: Early Complication Of Pterygium Surgery And Literature Review

2020 ◽  
Vol 7 (06) ◽  
pp. 4845-4847
Author(s):  
Hatim Boui ◽  
Yassine Mouzari ◽  
Meriem Boui ◽  
Fouad Al Asri ◽  
Karim Reda ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Medical Treatment ◽  
Adjuvant Treatment ◽  
Rare Complication ◽  
Brown Spot ◽  
Beta Radiation ◽  
Simple Excision ◽  
First Case ◽  
Pterygium Surgery ◽  
The Right

Introduction : Severe Scleral Dellen is a rare and early postoperative complication of pterygium surgery. The various cases reported in the literature are mostly related to this surgical technique; simple excision of the conjunctiva, notably either without adjuvant treatment or using mitomycyine C in preoperative or otherwise beta radiation. The particularity of our case is that the scleral Dellen is associated with excision and simple suture of the conjunctiva without adjuvant treatment or cauterization of the vessels. The other particularity of this case is that it is to our knowledge the first case of scleral dellen reported in Morocco, and even at the African level. Case report This case is a 38-year-old military patient with no medical history The patient was scheduled for pterygium surgery. 16 days later, the patient came back after noticing the appearance of a blackish brown spot at the nasal side of the right eye associated with mild eye pain. The slit lamp examination of the involved eye revealed a severe scleral thining, surrounded by an oedematous conjunctiva and the visualization of the ciliary body through the fine sclera. The conjunctival sutures were no longer in place. After three days and with treatement, we observed a scleral cicatrization, followed by a gradual covering of the sclera by conjunctiva. Discussion : In our case as in that described by Garcia-Medina and collaborators, we performed a conjunctival suture with two stitches to cover the sclera. Otherwise, both of the stitches were not found later, which suggests that, like in the Garcia-Medina report; a bad handling by the patient  (eye rubbing), loose stitches or even both. Thus, the sclera would have been exposed in the two cases. Regarding the treatment of this complication, the graft of a conjunctival flap was performed in two cases with favorable evolution. In all other cases, only medical treatment has been successfully initiated. In our case we opted for medical treatment only, including local antibiotic therapy, intensive lubrication with artificial tears (hourly drop) and the occlusion of the eye. The evolution was also favorable under this treatment. Hence, our case is similar to the Garcias-Medina and collaborators one, concerning the surgical technique, and also the scleral Dellen treatment. Although the difference and the particularity of our case was the absence of cauterization use during the surgical act. Conclusion: Scleral Dellen is rare complication of pterygium surgery, which occurs early after the surgical act. Its exact physiopathology remains unknown, but some factors may be incriminated; first of them is the surgical technique as a simple excision with exposed sclera. This complication can occur in patients, without any particular medical or ophthalmological history or any underlying pathology. It could also occur for primary pterygium. Medical treatment alone may be appropriate to manage this complication.

scholarly journals Paediatric case of peripapillary choroidal neovascularisation associated with optic disc drusen treated with aflibercept

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-228134 ◽  
Author(s):  
Weh Loong Gan ◽  
Vernon W Long
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Rare Complication ◽  
Fundus Autofluorescence ◽  
Choroidal Neovascularisation ◽  
First Case ◽  
Optic Disc Drusen ◽  
Intravitreal Aflibercept ◽  
The Right ◽  
Subfoveal Fluid

Peripapillary choroidal neovascularisation (PPCNV) associated with optic disc drusen is a rare complication that can result in severe vision impairment in children. We report the first case of paediatric PPCNV secondary to optic disc drusen successfully treated with intravitreal aflibercept. A 6-year-old girl presented with a one week history of reduced vision in her right eye with best-corrected visual acuity of 20/500. Fundus examination revealed bilateral elevated discs with a peripapillary pigmentary lesion in the right eye. Optical coherence tomography of the right eye showed marked subfoveal fluid. Both B-scan ultrasonography and fundus autofluorescence demonstrated findings consistent with optic disc drusen. Diagnosis of PPCNV was further confirmed on fluorescein fundus angiography. The child received three intravitreal aflibercept injections with complete resolution of the subfoveal fluid. Her visual acuity improved to 20/25 with no recurrence at a 16-month follow-up. No adverse side effects were reported.

scholarly journals Unauthorized medical intervention and informed consent in the common law of Canada prior to the Supreme Court’s decision of Reibl v. Hughes (1899–1980)

2020 ◽  
pp. 260-282
Author(s):  
Anatoliy Lytvynenko
Keyword(s):  
Informed Consent ◽  
Medical Treatment ◽  
Common Law ◽  
Case Law ◽  
Medical Intervention ◽  
Invasive Treatment ◽  
First Case ◽  
The Common ◽  
The Right ◽  
The Given

The given article deals with the Canadian legacy of civil actions on negligence and technical assault or battery involving an unauthorizedmedical interference to plaintiff. In modern doctrine and case-law, the given concept is named “informed consent”, upon whichthe patient is not a mere subject of medical treatment, but has a substantial set of patient rights, involving the informational ones, whichincludes his right to be informed on further invasive treatment and thus to be able to assent or decline it. The doctrine of informed consent,arising from actions on unauthorized medical treatment in both common law and civil law jurisdictions, has a centuryfold historyin the jurisprudence. In the common-law world, it was bred in the end of the 19th century primarily in the jurisprudence of Americancourts, but still has its distinct peculiarities in the common law of Canada throughout the twentieth century. The span on the researchedjurisprudence embraces the time period of 1899 (judgment of Parnell, which was the first case to deal with the subject) to 1980 (caseof Reibl v. Hughes), where the Canadian Supreme Court has firmly recognized the principle of informed consent in the acting commonlaw. In the 1990s, the principles of informed consent had been codified. The author has investigated on the evolvement of the conceptof patient’s right to autonomy in the state from the very beginning to the judgment of Reibl v. Hughes in 1980, and has researched theroots of the “right to autonomy” as an extension of the right to privacy, which has penumbrally existed in Canadian jurisprudence forover a century, despite having been recognized as such relatively recently, despite an existence of various early case-law legacy. Apartfrom the abovesaid, the author aimed to define the authorities used by Canadian courts in the earlier cases dealing with unconsentedsurgery, which involves judgments from other jurisdictions as well as professional legal and medical textbooks.

scholarly journals Diagnostic and therapeutic management of hydrothorax in peritoneal dialysis

2021 ◽  
Vol 4 (2) ◽  
pp. 95-103
Author(s):  
Larbi Bencheikh ◽  
Antonio D'Urso ◽  
Françoise Heibel
Keyword(s):  
Peritoneal Dialysis ◽  
Surgical Technique ◽  
Pleural Space ◽  
Therapeutic Management ◽  
Mechanical Complication ◽  
Central Catheter ◽  
First Case ◽  
Thoracic Approach ◽  
The Subject ◽  
The Right

Hydrothorax is a rare mechanical complication of peritoneal dialysis (PD) which often results in discontinuation of the technique. According to studies, its incidence is estimated  at 1.6 to 2%. In the majority of cases, its location is on the right. It is secondary to the passage of dialysate from the peritoneal cavity to the pleural space through a diaphragmatic breach, which may be acquired or congenital. The additional tests necessary to confirm the diagnosis are often invasive and expensive, and are not the subject of any consensus. It is the same for the therapeutic management, which goes from the simple transient interruption of the dialysis to heavy treatments such as thoracotomy. In our center, we have opted to simplify the management of patients with hydrothorax. From a diagnostic standpoint, we use simple, minimally invasive and less expensive examinations. For the therapeutic management, we have opted, since our first case in 2000, for a simple and less aggressive surgical technique, with an abdominal and non-thoracic approach allowing the installation of a sub-diaphragmatic prosthesis by laparoscopic route to seal the lesions breaches. Out of 10 operated patients, 2 (20%) presented with a relapse of hydrothorax and were permanently transferred to hemodialysis. The remaining 8 (80%) were able to resume PD without subsequent recurrence or complications, after a 3- to 4-week PD interruption period during which all patients were hemodialyzed through a simple central catheter.  

scholarly journals Inflammatory myofibroblastic tumour in the right ventricle of a 66-year-old man

2019 ◽  
Vol 29 (6) ◽  
pp. 967-968
Author(s):  
Diego Monzón Díaz ◽  
Gregorio Cuerpo Caballero ◽  
Angela Irabien Ortiz ◽  
Ángel Gonzalez Pinto
Keyword(s):  
Surgical Technique ◽  
Right Ventricle ◽  
Surgical Resection ◽  
Rare Entity ◽  
Inflammatory Myofibroblastic Tumour ◽  
Review Of The Literature ◽  
First Case ◽  
The Right

Abstract Herein, we present the case of a 66-year-old man with an inflammatory myofibroblastic tumour. An inflammatory myofibroblastic tumour is an extremely rare entity, with only 60 cases having been reported to date in the literature. The origin of this type of tumour is unknown and the treatment of choice is surgical resection. We present the surgical technique of our case and a review of the literature regarding this tumour. This is the first case described in a man above 60 years of age with a tumour located in the right ventricle.

Phaco-antigenic glaucoma following uncomplicated cataract surgery

2019 ◽  
Vol 29 (1_suppl) ◽  
pp. 22-26
Author(s):  
Alexander Kin Chiang Chiu ◽  
Divya Mathews
Keyword(s):  
Intraocular Pressure ◽  
Medical Treatment ◽  
Cataract Surgery ◽  
Surgical Procedure ◽  
Rare Complication ◽  
Case Description ◽  
Rare Presentation ◽  
History Of ◽  
The Right ◽  
Vitreous Biopsy

Introduction: Phaco-antigenic glaucoma occurs in less than 1% of cataract surgeries. Managing this rare complication is challenging, especially when there are few documented cases reported. We describe the challenges of managing a case of bilateral phaco-antigenic glaucoma following uncomplicated cataract surgery requiring viscocanalostomy. Case description: An 82-year-old atopic lady presented with a 2-day history of painful injected right eye. She was 4 days post left and 8 days post right uncomplicated cataract surgery. On examination, the anterior chambers were deep with no hypopyon. Intraocular pressure was raised at 38 mmHg in the right eye and 24 mmHg in the left eye initially. However, intraocular pressure remained uncontrolled despite maximum medical treatment; she attended A + E six times within 11 days with intraocular pressures of up to 48 mmHg in the right eye and 46 mmHg in the left eye. A vitreous biopsy was reported negative for infective organisms. Eventually, bilateral viscocanalostomies were performed and vision improved to 0.24 logMAR in both eyes with intraocular pressures of 8 mmHg in the right eye and 10 mmHg in the left eye. Conclusion: We present a rare presentation of phaco-antigenic glaucoma following an uncomplicated cataract surgical procedure with good results following timely intervention.

scholarly journals Blunt Hohman-Lever Technique for Reduction of Intertrochanteric Fracture – A Surgical Technique

2020 ◽  
pp. 1-7
Author(s):  
Raviraj A. ◽  
K. Abhishek Sugumar ◽  
Vidyasagar Maalepati ◽  
Vivek Kumar N. Savsani ◽  
Ashish Anand
Keyword(s):  
Surgical Technique ◽  
Closed Reduction ◽  
Intertrochanteric Fracture ◽  
English Literature ◽  
Trochanteric Fracture ◽  
First Case ◽  
History Of ◽  
Nail Insertion ◽  
The Right

We present a 60 years old patient who presented to us with history of domestic fall and sustained injury to the right hip and was diagnosed with trochanteric fracture right side. As closed reduction was not acceptable and bone spike was not available in the set, we designed our own technique of using a bone lever introduced from the same incision from where reaming/nail insertion was done. To the best of our knowledge this technique has never been described before in english literature. Since our first case we have tried it in 6 other patients and without any issues.

Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 227-236 ◽  
Author(s):  
Majno ◽  
Mentha ◽  
Berney ◽  
Bühler ◽  
Giostra ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Therapeutic Option ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Multidisciplinary Program ◽  
First Case ◽  
Living Donor Transplantation ◽  
The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

Hepatic brucelloma: a rare complication of a common zoonotic disease

2020 ◽  
Vol 13 (12) ◽  
pp. e237076
Author(s):  
George Vatidis ◽  
Eirini I Rigopoulou ◽  
Konstantinos Tepetes ◽  
George N Dalekos
Keyword(s):  
Rare Complication ◽  
Surgical Excision ◽  
Coombs Test ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Ct Guided ◽  
Rare Manifestation ◽  
Bone Marrow Cultures ◽  
History Of ◽  
The Right

Hepatic brucelloma (HB), a rare manifestation of brucellosis, refers to liver involvement in the form of abscess. A 35-year-old woman stockbreeder was admitted due to 1-month history of evening fever, sweating and weight loss, while she was on 3-week course of rifampicin/doxycycline for suspected brucellosis. On admission, she had hepatosplenomegaly and a systolic murmur, while cholestasis, increased inflammation markers and a strong-positive Wright-Coombs test were the main laboratory findings. As blood and bone marrow cultures were unrevealing, further investigation with CT imaging showed a central liver calcification surrounded by heterogeneous hypodense area being compatible with HB. Material from CT-guided drainage tested negative for Brucella spp. After failure to improve on a 10-week triple regiment, surgical excision was decided and Brucella spp were identified by PCR. Our case highlights challenges in establishing HB diagnosis, which should be considered on the right epidemiological context and when serological and radiological evidence favour its diagnosis.

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