Surgical Procedure of Segmentectomy as a Possible Cause of Postoperative Cerebral Embolism: A Case Report

Abstract Background Cerebral embolism after lobectomy is a life-threatening complication during the early postoperative period. However, it is unclear if cerebral embolism can develop after segmentectomy. Case presentation We experienced a case of a 37-year-old man who demonstrated early symptom of acute ischemic stroke in early postoperative period after right upper posterior segmentectomy and performed intra-arterial mechanical thrombectomy (IAMT) successfully. Conclusions Long and irregular pulmonary vein stump (PVS) and endothelial injury caused by surgical procedure may lead to cerebral embolism after segmentectomy. We believe that doing preoperative pulmonary vascular assessment and using appropriate surgical procedure may reduce the rate of cerebral embolism.

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Surgical Procedure of Segmentectomy as a Possible Cause of Postoperative Cerebral embolism: A Case Report

10.21203/rs.3.rs-73048/v2 ◽

2020 ◽

Author(s):

Peirui Chen ◽

Qiushan Qing ◽

Mingqiang Diao ◽

Xiaokang Sun ◽

Junrong Yang ◽

...

Keyword(s):

Postoperative Period ◽

Surgical Procedure ◽

Mechanical Thrombectomy ◽

Early Postoperative Period ◽

Cerebral Embolism ◽

Case Presentation ◽

Early Symptom ◽

Life Threatening ◽

Pulmonary Vein Stump ◽

Possible Cause

Abstract Background: Cerebral embolism after lobectomy is a life-threatening complication during the early postoperative period. However, it is unclear if cerebral embolism can develop after segmentectomy. Case Presentation: We experienced a case of a 37-year-old man who demonstrated early symptom of acute ischemic stroke in early postoperative period after right upper posterior segmentectomy and performed intra-arterial mechanical thrombectomy (IAMT) successfully.Conclusions: long and irregular pulmonary vein stump (PVS) and endothelial injury caused by surgical procedure may lead to cerebral embolism after segmentectomy. We believe that doing preoperative pulmonary vascular assessment and using appropriate surgical procedure may reduce the rate of cerebral embolism.

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Urgent surgery for thyroid diseases and complications of early postoperative period

Pediatrician (St Petersburg) ◽

10.17816/ped44103-115 ◽

2013 ◽

Vol 4 (4) ◽

pp. 103-115 ◽

Cited By ~ 2

Author(s):

Anatoly Philippovich Romanchishen ◽

Philipp Anatolievich Romanchishen ◽

Igor Vladimirovich Karpatsky ◽

Kristina Victorovna Vabalayte

Keyword(s):

Postoperative Period ◽

Postoperative Bleeding ◽

Early Postoperative Period ◽

Anaplastic Carcinoma ◽

Thyroid Diseases ◽

Endocrine Surgery ◽

Urgent Surgery ◽

Appropriate Treatment ◽

Retrosternal Goiter ◽

Life Threatening

The analysis of surgical treatment results of 27.253 patients with various diseases of thyroid cancer is performed in St. Petersburg, Endocrine Surgery and Oncology Center. A classification of urgent surgery for complications of disease (277/1.0 %) or postoperative states that required reinterventions (246/0.9 %) in period from 1973 to 2012 is developed. Altogether immediate and urgent operations are performed in 523 (1.9 %) patients. Various thyroid diseases (cervical-retrosternal goiter, anaplastic carcinoma, strumitis, thyroiditis) or the progression of inflammation of the neck and / or mediastinum became a cause of neck compression and subsequently required urgent interventions in 277 (1.0 %) cases. Complications of early postoperative period (mobility disorders of the vocal cords, postoperative bleeding, and rupture of the trachea) served as an occasion to emergency operations in 246 (0.9 %) cases. The measures of prevention, prompt diagnosis and appropriate treatment of patients with life-threatening complications in thyroid surgery are examined.

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Outcomes of patients diagnosed with COVID-19 in the early postoperative period following cardiac surgery

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa143 ◽

2020 ◽

Vol 31 (4) ◽

pp. 483-485

Author(s):

Martin T Yates ◽

Damian Balmforth ◽

Ana Lopez-Marco ◽

Rakesh Uppal ◽

Aung Y Oo

Keyword(s):

Cardiac Surgery ◽

Postoperative Period ◽

Elective Surgery ◽

Length Of Hospital Stay ◽

Early Postoperative Period ◽

Surgical Patients ◽

Significant Length ◽

Life Threatening ◽

Protective Environment ◽

Poor Outcomes

Abstract The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period. We identified 9 patients who developed COVID-19 infection following cardiac surgery. These patients had a significant length of hospital stay and extremely poor outcomes with mortality of 44%. In conclusion, the outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. In order to offer cardiac surgery, units must implement rigorous protocols aimed at maintaining a COVID-19 protective environment to minimize additional life-threatening complications related to this virus infection.

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Massive Hematochezia from a Large Bleeding Duodenal Diverticulum

Case Reports in Gastrointestinal Medicine ◽

10.1155/2021/5585264 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

Marcus Juan Esteban ◽

Amit Sureen ◽

Daniel Herlihy ◽

Sherif Elhanafi ◽

Marc J. Zuckerman

Keyword(s):

Duodenal Diverticulum ◽

Common Finding ◽

Upper Endoscopy ◽

Gi Tract ◽

Case Presentation ◽

Epinephrine Injection ◽

Duodenal Diverticula ◽

Life Threatening ◽

Possible Cause ◽

Prompt Diagnosis

Background. Duodenal diverticula are a rare cause of gastrointestinal (GI) bleeding despite being a common finding in the GI tract. We present a case of a patient who had massive hematochezia due to a complex duodenal diverticulum. Case Presentation. A 74-year-old Hispanic female presented initially with generalized weakness. During admission, the patient had an episode of a large amount of hematochezia and had to be transferred to the intensive care unit (ICU). Upper endoscopy was done using a forward-viewing endoscope which revealed a bleeding complex duodenal diverticulum. Successful hemostasis was achieved through epinephrine injection followed by placement of hemostatic clips. Conclusion. Although rare, gastroenterologists need to be aware of duodenal diverticulum as a possible cause of gastrointestinal bleed. It could be life-threatening, and thus, prompt diagnosis and management is necessary.

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Outcome of surgical emergencies in COVID positive individuals- a Case series

International Journal of Case Reports ◽

10.28933/ijcr-2021-07-2107 ◽

2021 ◽

pp. 243

Author(s):

◽

Keyword(s):

Postoperative Period ◽

Surgical Procedure ◽

Tertiary Care ◽

Case Series ◽

Early Postoperative Period ◽

Pulmonary Complications ◽

Rt Pcr ◽

Tertiary Care Centre ◽

Surgical Emergencies ◽

Morbid Conditions

Introduction: This manuscript will dealt with the outcome of emergency surgeries in COVID19 positive individuals. We are under the second wave of COVID pandemic. The research is ongoing regarding the outcome of patients who are undergoing, surgical treatment with COVID Rt-PCR positivity or become COVID positive during early postoperative period. Materials and Methods: All the patients who attended the emergency department of a tertiary care centre were screened for COVID -19 by RT-pcR and the patients who are COVID positive but needed emergency surgical procedure were included in the study. A cohort of 49 patients who were COVID positive and needed emergency surgical procedure due to various causes were included in the study. Results:The causes of acute surgical emergencies were acute appendicitis, appendicular perforation, perforative peritonitis, obstructed/ strangulated inguinal hernia, intestinal obstruction, diabetic foot and perianal abscess. Most of the patients belong to the age group between 40 – 70 years. 63.8% were males. The mortality rate was 12.8%. More than one co-morbid condition was present in 8.5% of individuals. Most of the patients got discharged in 10 – 12 days. 40.4% have co morbid conditions like diabetes or hypertension. 8.5% had more than one co morbid conditions. Diabetes was present in 27.7% of cases Conclusion: The mortality was high during the postoperative period of COVID positive cases, extreme care and precaution should be taken to avoid pulmonary complications

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Cerebral Thromboembolism after Lobectomy for Lung Cancer: Pathological Diagnosis and Mechanism of Thrombus Formation

Cancers ◽

10.3390/cancers11040488 ◽

2019 ◽

Vol 11 (4) ◽

pp. 488 ◽

Cited By ~ 2

Author(s):

Hirotsugu Hashimoto ◽

Genki Usui ◽

Yuta Tsugeno ◽

Keisuke Sugita ◽

Gulanbar Amori ◽

...

Keyword(s):

Lung Cancer ◽

Thrombus Formation ◽

Therapeutic Option ◽

Primary Lung Cancer ◽

Early Postoperative Period ◽

Left Upper Lobectomy ◽

Specific Complication ◽

Life Threatening ◽

Molecular Therapies ◽

Pulmonary Vein Stump

Lung cancer is the leading cause of cancer-related deaths worldwide. Although molecular therapies have emerged as efficacious strategies for the treatment of lung cancer, surgical resection is still recommended as a radical therapeutic option. Currently, lobectomy is regarded as the most reliable radical treatment of primary lung cancer. Among the various complications after lobectomy, cerebral thromboembolism requires attention as a life-threatening complication during the early postoperative period. It occurs in 0.2–1.2% of surgical cases of lung cancer and typically develops following left upper lobectomy with a long pulmonary vein stump (PVS). PVS-associated thrombosis is known to cause cerebral thromboembolism after such procedures; however, distinguishing this specific complication from that caused by postoperative atrial fibrillation is challenging. We summarize herein the diagnostic pathology of thrombus formation in accordance with its thrombogenic mechanism. We focus on the potential utility of the pathological assessment of thrombectomy specimens. The morphological information obtained from these specimens enables the presumption of thrombogenic etiology and provides useful clues to both select an appropriate pharmacotherapy and determine a follow-up treatment for cerebral thromboembolism.

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Retroperitoneal abscess with pylephlebitis caused by lumbar acupuncture: a case report

BMC Surgery ◽

10.1186/s12893-019-0613-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Hayemin Lee ◽

Kiyoung Sung ◽

Jinbeom Cho

Keyword(s):

Chronic Back Pain ◽

Diagnosis And Treatment ◽

Retroperitoneal Abscess ◽

Case Presentation ◽

Complex Anatomy ◽

Life Threatening ◽

Operative Findings ◽

Treatment Procedures ◽

Possible Cause ◽

Symptoms And Signs

Abstract Background Retroperitoneal abscess (RA) is an unusual life-threatening disease that has insidious and occult presentations. Although the incidence of this disease is low, diagnosis and treatment are challenging due to its nonspecific presentation and the complex anatomy of the retroperitoneal space. Recently, we experienced one case of a RA with extensive thrombophlebitis of the portal venous system. Case presentation An 80-year-old male presented to the emergency room with symptoms and signs of septic shock; however, the decision making for diagnosis and treatment was difficult, as no clinical and radiological evidence supported key findings regarding the origin of sepsis. Although this patient eventually recovered after surgical drainage, we suggested that more straightforward diagnostic and treatment procedures were required in this patient to avoid possible critical complications. Through a retrospective review of operative findings, patient history, and microbiology, we found that the RA in this patient was caused by lumbar acupuncture, which is usually performed for the management of chronic back pain with long needles. Conclusion Early surgical intervention should be considered for RA whenever the patient does not respond to broad-spectrum antibiotic treatment. Acupuncture is a possible cause of otherwise unexplained soft tissue infections, such as RA, especially in Asian countries.

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