scholarly journals CASE OF SUCCESSFUL CURE OF PROXIMAL TRANSECTION PANCREATIC INJURY IN A 6 YEARS CHILDREN

2019 ◽  
Vol 23 (1) ◽  
pp. 38-39
Author(s):  
A. A. Baulin ◽  
L. I. Pogozhev ◽  
N. A. Popov ◽  
V. P. Shishkanov ◽  
V. V. Sretenskii ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pancreatic Duct ◽  
Postoperative Period ◽  
Main Pancreatic Duct ◽  
Clinical Case ◽  
Pancreatic Injury ◽  
Early Postoperative Period ◽  
Complete Rupture

The article presents a clinical case of a traumatic complete rupture of the pancreas at the level of the isthmus in a 6-year-old child. Twelve hours after the injury, laparoscopy, laparotomy, a pancreas rupture at the level of the isthmus was performed. Surgical treatment consisted in stenting the main pancreatic duct with a catheter, carrying the latter through a large duodenal nipple, sealing the parenchyma of the gland, and draining the gland bag. In the early postoperative period, no complications were noted. The stent is removed 5 weeks after the operation. The catamnesis was followed for about a year, complications were not observed.

The inconsistencies between conventional and global lab tests in cardiosurgeric patient (a clinical case)

2020 ◽  
Vol 1 (1) ◽  
pp. 68-70
Author(s):  
Eugene Roitman ◽  
◽  
Keyword(s):  
Postoperative Period ◽  
Clinical Case ◽  
Early Postoperative Period ◽  
The Other ◽  
Laboratory Methods ◽  
Hemostatic System

The clinical case demonstrates inconsistencies between the results of thromboelastography and conventional coagulation lab tests at the early postoperative period of patient undergoing cardiosurgery. The analyzing of the revealed discrepancy proves that the opposition of laboratory methods as 'one against the other' for studying the hemostatic system is unacceptable.

scholarly journals A RARE CASE OF PANCREATIC INJURY WITH TRANSECTION OF MAIN PANCREATIC DUCT MANAGED CONSERVATIVELY

2018 ◽  
Vol 4 (4) ◽  
pp. 286-288
Author(s):  
Ashutosh Ghuge . ◽  
Rajiv Sonarkar . ◽  
Bapuji S Gedam . ◽  
Giriraj Gajendra
Keyword(s):  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Rare Case ◽  
Pancreatic Injury

Novel Promising Technique for Traumatic Pancreatic Injury Management.

2020 ◽  
Author(s):  
Mohammed Hamada Takrouney ◽  
Vipul Prakash Bothara ◽  
Bhushan Jahhav ◽  
Mohamed Abdelkader Osman ◽  
Ibrahim Ali Ibrahim ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Median Time ◽  
Main Pancreatic Duct ◽  
Primary Repair ◽  
Pancreatic Injury ◽  
Pancreatic Trauma ◽  
Average Hospital ◽  
Pancreatic Injuries ◽  
The Status ◽  
Average Operative Time

Abstract Introduction: Pancreatic injuries in children are relatively uncommon. The precise location of the injury, the status of the main pancreatic duct, and the time between diagnosis and intervention are a potentially useful guide for management decisions. We report a successful endoscopic simple primary repair with the pancreatic preservation even with transected main pancreatic duct without duct stenting.Patients and Methods: Between May 2017and December 2019, 3 patients with pancreatic trauma and duct transection underwent endoscopic (laparoscopic and robotic) repair. Demographics, Operative data, Postoperative complications, and clinical outcomes were documented and analyzed.Results: Three patients with pancreatic fractures, 2 patients with grade IV, and one patient grade III injury. The median age was 11 years, the median time of hospital admission after the trauma was 72 hours. The median time of surgical intervention was 24 hours. Average operative time was160 minute and the average hospital stay was 9 days with no recorded postoperative or follow up complications till now.Conclusion: Primary simple pancreatic repair is a promising and plausible technique for the management of pancreatic trauma, especially with duct transaction it maybe instead of all other modalities of pancreatic trauma treatment. We implore all pediatric surgery centers to espouse this technique.

Seizures after evacuation of subdural hematomas: incidence, risk factors, and functional impact

2010 ◽  
Vol 112 (2) ◽  
pp. 455-460 ◽  
Author(s):  
Alejandro A. Rabinstein ◽  
Seung Young Chung ◽  
Leslie A. Rudzinski ◽  
Giuseppe Lanzino
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Functional Impairment ◽  
Postoperative Period ◽  
Strong Association ◽  
Early Postoperative Period ◽  
Acute Subdural Hematoma ◽  
Early Functional Outcome ◽  
Gcs Score

Object The purpose of this study was to evaluate the incidence of seizures or epileptiform abnormalities on electroencephalography (EEG) studies in patients undergoing surgical treatment for acute subdural hematoma (SDH). Methods This was a retrospective study of 134 consecutive patients with acute or acute-on-chronic SDH who underwent surgical treatment at the authors' institution between January 2004 and July 2008. Detailed information was collected regarding baseline clinical data (including preexistent functional impairment); Glasgow Coma Scale (GCS) sum scores before and 24 hours after surgery; presence of clinical seizures; EEG findings; and functional outcome on discharge and up to the 6-month follow-up. All brain CT scans were reviewed to calculate SDH volume and midline shift. The Glasgow Outcome Scale (GOS) score was used for functional assessment, and GOS scores of 1–3 were considered indicative of poor outcome. Univariate and multivariate logistic regression analyses were performed to identify statistical associations. Results Clinical seizures or epileptiform changes on EEG were observed during the acute postoperative period in 33 patients (25%). Preexistent functional impairment and seizures/epileptiform EEG findings after surgery were independently associated with poor functional outcome upon hospital discharge (p < 0.001 for both). Preexistent functional impairment (p < 0.001), lower GCS score before surgery (p = 0.04), and lower GCS score 24 hours after surgery (p = 0.007), but not seizures/epileptiform EEG findings, were independently associated with poor functional recovery at 1- to 6-month follow-up evaluations. Seizures/epileptiform EEG findings had a strong association with lower GCS scores after surgery (p = 0.01), and they were more common in patients who underwent evacuation by craniotomy (p = 0.02). Conclusions Epileptic complications are common after acute SDH evacuation, and should be suspected in patients with an unanticipated depressed level of consciousness after surgery. Seizures worsen early functional outcome, but delayed favorable recovery is possible. Therefore, one should be cautious when discussing prognosis in the early postoperative period of patients with epileptic complications.

scholarly journals SURGICAL TREATMENT OF CAROTID STENOSIS IN PATIENTS WITH CORONARY HEAR+T DISEASE IN ORDER TO PREVENT ISCHEMIC STROKE

2020 ◽  
pp. 124-126
Author(s):  
I. S. Pulyaeva ◽  
V. A. Prasol
Keyword(s):  
Ischemic Stroke ◽  
Surgical Treatment ◽  
Carotid Stenosis ◽  
Postoperative Period ◽  
Stable State ◽  
Length Of Hospital Stay ◽  
Early Postoperative Period ◽  
Main Stage ◽  
Simultaneous Operations ◽  
Ischemic Attack

Summary. Goal. To analyze the results of surgical treatment of carotid stenosis in patients with coronary heart disease in order to prevent ischemic stroke. Materials and methods. The analysis included 18 patients treated in the SI «V. T. Zaitseva IGUS of NAMNU» from 2017 to 2019 in combined atherosclerotic lesions of the coronary and carotid arteries which evaluated the reserve brain. Results and discussion. All patients with two-stage treatment of the first and second groups were discharged in a stable state, one had a clinic of transient ischemic attack in the postoperative period. Conclusions. Simultaneous operations are advisable in patients with a reduced reserve of both coronary and cerebral circulation. The risk of developing cerebral and cardiac postoperative complications is comparable with the results of phased operations, reducing the length of hospital stay of the patient. The results of the hypoxic test serve as an additional criterion for the decision to impose an internal intra-arterial shunt. This allows you to reduce the time of the main stage of carotid endarterectomy and to avoid additional possible complications in the early postoperative period.

scholarly journals Uncommon inappropriate shock of subcutaneous defibrillator in early postoperative period due to air in close proximity of shock electrode is presented

2020 ◽  
Vol 26 (4) ◽  
pp. 53-58
Author(s):  
E. B. Kropotkin ◽  
E. A. Ivanitsky ◽  
A. Yu. Cheremisina ◽  
O. V. Kostyleva ◽  
V. A. Sakovich
Keyword(s):  
Case Report ◽  
Postoperative Period ◽  
Clinical Case ◽  
Early Postoperative Period ◽  
Inappropriate Shock ◽  
Subcutaneous Defibrillator ◽  
Close Proximity

Clinical case report of uncommon inappropriate shock of subcutaneous defibrillator in early postoperative period due to air in close proximity of shock electrode is presented.

scholarly journals Clinical case of surgical treatment of giant central anastomosis aneurysm after autovenous femoropopliteal bypass

2021 ◽  
Vol 38 (1) ◽  
pp. 144-150
Author(s):  
Vladimir A. Samartsev ◽  
Dmitry S. Vaganov ◽  
Andrey Yu. Oparin ◽  
Ilya A. Karasov ◽  
Eugeny V. Kruglov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Efficient Method ◽  
Postoperative Period ◽  
Clinical Case ◽  
Lower Extremities ◽  
Femoropopliteal Bypass ◽  
Proximal Anastomosis ◽  
Surgical Revascularization ◽  
Aneurysm Development

Ahterosclerosis of vessels of the lower extremities is widely distributed in the population. Open surgical revascularization is an efficient method for treatment of this pathology. One of the rare postoperative complications is an anastomosis aneurysm development. We report about a clinical case of a 74-year-old male with a giant (25 cm in diameter) aneurysm of the proximal anastomosis after femoropopliteal bypass. Open aneurysmectomy was performed, and the postoperative period was uneventful.

scholarly journals Secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after simultaneous and hybrid surgical treatment

2021 ◽  
Vol 10 (4) ◽  
pp. 58-67
Author(s):  
O. V. Maleva ◽  
O. A. Trubnikova ◽  
I. V. Таrasova ◽  
S. V. Ivanov ◽  
O. L. Barbarash
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Postoperative Cognitive Dysfunction ◽  
Early Postoperative Period ◽  
Brachiocephalic Artery ◽  
Neurological Outcomes ◽  
Simultaneous Surgery ◽  
Artery Disease ◽  
Hybrid Group

Aim. To compare secondary neurological outcomes in patients with brachiocephalic and coronary artery disease in the early postoperative period after different surgical treatment strategies (simultaneous and hybrid).Methods. Secondary neurological outcomes were evaluated in 43 patients with coronary and brachiocephalic artery disease in the early postoperative period after (1) carotid endarterectomy and on-pump coronary artery bypass surgery; (2) percutaneous coronary intervention and carotid endarterectomy. Demographic, clinical, instrumental data were collected. Neuropsychological assessment was performed using the Mini-Mental State Examination and Frontal Assessment Battery. Memory, attention and neurodynamics were measured using the “Status-PF” software at days 2–3 before the surgery and at days 5–7 after it. The presence of postoperative cognitive dysfunction was estimated on the basis of criteria defined as a 20% decline on 20% of the tests. Statistical analysis was performed using the software package “Statistica 10.0”.Results. Patients who underwent hybrid intervention demonstrated improved attention and memory in the early postoperative period. Complex visual-motor reaction significantly increased in patients after simultaneous surgery. Attention differed significantly in both groups. Thus, patients from the hybrid group processed more characters per 1 and 4 minutes while completing the Bourdon proof reading test. The total number of processed characters prevailed in the hybrid group. Cognitive processing speed was higher in the hybrid group according to the brain performance test. The incidence of early postoperative cognitive dysfunction was 60% in patients after simultaneous surgery and 11% in patients after hybrid surgery (p = 0.006, OR±SE 12.5±3.2).Conclusion. Hybrid intervention has shown its superiority over simultaneous intervention in terms of low rate of early cognitive impairment, thereby confirming the necessity to take into account the obtained results while selecting the optimal surgical treatment in patients with coronary and brachiocephalic artery disease present with cognitive deficits at baseline.

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