scholarly journals Intramural haematoma and penetrating aortic ulcer -outcome and treatment modalities: Report of four cases

2011 ◽  
Vol 139 (5-6) ◽  
pp. 380-385 ◽  
Author(s):  
Igor Koncar ◽  
Lazar Davidovic ◽  
Momcilo Colic ◽  
Marko Dragas ◽  
Nikola Ilic ◽  
...  

Introduction. Intramural haematoma (IMH) and penetrating aortic ulcers (PAU) are the frequent cause of acute aortic syndrome that is disclosed with a rising frequency due to the development of new diagnostic methods. Different symptoms contribute to clinical misdiagnosis, while changeable locations and unpersuasive diameter can lead the radiologists to underestimate such changes. The outcome of PAU and IMH differs, and for the time being there are no data on prognostic factors. The diversity of symptoms and disease course is presented in four cases with different manifestations, treatment and outcome. Outline of Cases. Two patients with IMH were treated conservatively due to the process extensiveness and its morphology. One patient had a complete restitution, while the other had progression of the disease. Other two patients with PAU were treated by surgery (stent graft implantation) according to the morphology and diameter of the aorta. Conclusion. IMH and PAU should be suspected in patients with unclear clinical presentation (back and abdominal pains). Although outcome and complications of these diseases are well known, their incidence has not been fully studied. Endovascular treatment is less invasive and followed by a potentially lower rate of complications. However, usage of this method is justifiable only in patients with associated complications.

2015 ◽  
Vol 47 (3) ◽  
pp. 849-859 ◽  
Author(s):  
Claudius Werner ◽  
Martin Lablans ◽  
Maximilian Ataian ◽  
Johanna Raidt ◽  
Julia Wallmeier ◽  
...  

Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder leading to chronic upper and lower airway disease. Fundamental data on epidemiology, clinical presentation, course and treatment strategies are lacking in PCD. We have established an international PCD registry to realise an unmet need for an international platform to systematically collect data on incidence, clinical presentation, treatment and disease course.The registry was launched in January 2014. We used internet technology to ensure easy online access using a web browser under www.pcdregistry.eu. Data from 201 patients have been collected so far. The database is comprised of a basic data form including demographic and diagnostic information, and visit forms designed to monitor the disease course.To establish a definite PCD diagnosis, we used strict diagnostic criteria, which required two to three diagnostic methods in addition to classical clinical symptoms. Preliminary analysis of lung function data demonstrated a mean annual decline of percentage predicted forced expiratory volume in 1 s of 0.59% (95% CI 0.98–0.22).Here, we present the development of an international PCD registry as a new promising tool to advance the understanding of this rare disorder, to recruit candidates for research studies and ultimately to improve PCD care.


Author(s):  
Dr. Sunil Kumar Mehra, Dr. Dinesh Kumar Barolia, Dr. Arun Kumar Gupta, Dr. Vinita Chaturv

Intussusception is the most common cause of intestinal obstruction in infants and children in < 1yr of age (1). Intussusception cases usually reported late therefore operative procedure was inevitable and results in significant morbidity and mortality. By this study we emphasized on timely transfer of intussusception case to a pediatric surgical center so as to decrease surgical risk. The surgical morbidity was low in those who were admitted early or directly to our center.  Methods - We retrospectively reviewed cases of intussusception in children <15 years. Children were treated from October 2015 to December 2107 at pediatric surgery department of SMS medical college Jaipur Rajasthan. Age, sex, month of admission, symptom with duration, diagnostic methods, and treatment modalities were recorded and analyzed.  Results - We studied 300 patients with intussusception.272 (90%) were treated surgically. We recently started ultrasonography guided pneumatic reduction and 24(85.7%) out of 28 treated successfully by it. Out of the patients requiring surgery 202 (67.34%) patients were reduced by per-operative manual reduction and in 60(22%) patients resection and anastomosis with 10(3.6%) treated with resection and ileostomy. 25.34% cases have delayed diagnosis and lately  transferred from peripheral hospitals requiring resection and diversion. Conclusion - In conclusion, Intussusception cases usually reported late therefore high likelihood of surgical management. The patients who underwent resection have longer duration of hospital stay.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 934-937
Author(s):  
Tasneem M. Lakkadsha ◽  
Kiran Kumar ◽  
Waqar M. Naqvi ◽  
Pratik Phansopkar

In January 2020, we met with COVID-19 (aka SARS-Co-V-2 and/or Corona virus) on our news channels all the way from china. Little did we know that it would shake up our lives in such a manner that we had heard only in a movie or read in history books. Currently we are all in some sort of lockdown, be it in hospital/home or in our minds. Being there, most of us are facing certain kind of misery, be it emotional, mental, physical or social. To be expansive the most common stresses that have been addressed by people on mass media platform are feeling of depression and isolation caused by being away from family and friends, some are complaining of losing their enthusiasm, some of gaining weight, some of losing it and many more. Going through a pandemic is also helping people in some or the other way, one of which is being concerned about their health and habits to keep themselves fit and away from serious comorbidities which can stem out from physical inactivity and heightened stress levels. There are many ways to stay fit at home without any complex gym equipment, but far less is known about it. Thus, an understanding of methods through which one can become physically active with least complexity, easy availability, and appropriate utilization is need of the hour.


Author(s):  
ÖMER FARUK ELMAS ◽  
NECMETTİN AKDENİZ

Background and Aim: Verrucous epidermal nevi are cutaneous hamartomas having many clinical variants. Dermoscopic features of verrucous epidermal nevus have rarely been investigated. We aimed to identify dermoscopic findings of the entity which will facilitate the diagnostic process by reducing the use of invasive diagnostic methods. Material and Methods: The study included the patients with histopathologically approved verrucous epidermal nevus. Clinical, dermoscopic and histopathological features of the patients were retrospectively reviewed and the findings identified were recorded. Dermoscopic examination was performed with a polarized-light handheld dermoscope with 10-fold magnification. Results: The most common dermoscopic features were thick brown circles, thick brown branched lines and terminal hairs. The most common vessel pattern was dotted vessels. Branched thick brown lines, brown globules, brown dots forming lines, serpiginous brown dots, white and brown exophytic papillary structures, fine scale, thick adherent scale and cerebriform structures were the other findings. Conclusion: We observed many vascular and non-vascular dermoscopic findings which have not been described previously for the entity. Dermoscopic examination of the verrucous epidermal nevi may lead more reliable clinical interpretation and thus it may reduce the need for histopathological investigation. Keywords: dermoscopy, large brown circles, verrucous epidermal nevus


2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  

Purpose: To outline the complications encountered after endoluminal treatment in patients with type B aortic dissection. Methods: Between 1999 and 2001, 14 patients (12 men; mean age 60.3 years, range 39–79) with isolated type B aortic dissection (13 chronic, 1 acute) underwent aortic stent-grafting. Three patients with chronic dissection presented an acute clinical picture and were managed emergently. The left subclavian artery was intentionally covered by the prosthesis in 9 patients. Follow-up studies were performed at 6-month intervals. Results: Stent-graft implantation was technically successful in all patients, but incomplete sealing (endoleak) of the entry site required additional proximal stent-graft implantation in 4. The left subclavian artery remained patent in 5 patients. Secondary conversion was required in 3 patients: 2 for acute type A dissection resulting from injury to the aortic arch by Talent endografts and a sustained hemorrhage (left hemothorax). In another patient, a secondary intramural hematoma subsided spontaneously. Anterior spinal artery syndrome in 1 patient persisted at 1 month. No bypass was necessary for the 9 patients with the covered left subclavian arteries. Mean follow-up was 14 months (range 1–23). Conclusions: Stent-grafting is feasible in patients with type B aortic dissection, although it is associated with a considerable rate of complications. Frank reporting of these sequelae for a variety of stent-grafts is of paramount importance to clarifying the limitations of the method.


1995 ◽  
Vol 36 (4-6) ◽  
pp. 491-496 ◽  
Author(s):  
R. Dullerud ◽  
J. G. Johansen ◽  
U. L.-H. Johnsen ◽  
B. Magnæs

Aims: The investigation was carried out in order to compare the accuracy of CT and MR imaging in depicting whether disk hernias were contained by the posterior longitudinal ligament (PLL). This is crucial in the evaluation of patients who are possible candidates for percutaneous nucleotomy, which is considered effective only in contained hernias. Results: Of 124 pathologic disks examined in 114 patients, CT was more accurate than MR imaging in 7 patients due to misinterpretation of the integrity of the PLL by MR. These hernias were therefore erroneously classified as noncontained. There was consistency between the classification by CT and MR imaging in the other 117 disks, of which 109 were correct. Both methods overstaged a large hernia that was contained by the PLL, and failed to demonstrate that 7 others were noncontained. Conclusions: CT, which has higher sensitivity in depicting calcifications, representing further contraindications to percutaneous nucleotomy, is therefore recommended as the primary examination in these patients. Additional MR imaging should be considered if the results of CT are equivocal or at variance with the clinical presentation.


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