Gluteal protuberance as a first symptom of branched pilonidal sinus with anal fistula – case report

Nowa Medycyna ◽  
2019 ◽  
Vol 26 (4) ◽  
Author(s):  
Katarzyna Krasińska ◽  
Szymon Głowacki ◽  
Tomasz Pokładowski ◽  
Feliks Orchowski
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Anal Fistula ◽  
Pilonidal Sinus ◽  
Fistula Tract ◽  
Anal Sphincters ◽  
Postoperative Course ◽  
Complete Cure ◽  
Left Buttock

The authors present the case of a patient who underwent a surgery due to a branched pilonidal sinus with branching to anal sphincters and a purulent cistern in the left buttock. The lesion was diagnosed accidentally. The patient’s main ailments were non-specific buttock pains experienced for several months, which were followed by periodic febrile states. Advanced diagnostics of this region was planned and carried out. The patient was qualified for Bascom II procedure with simultaneous excision of the anal fistula tract and opening of the left buttock fluid cistern. No complications were observed in the postoperative course. The follow-up after 2 months showed no recurrence. The authors emphasize the fact that the lesions of the gluteal cleft are difficult to diagnose, diagnosed late and often asymptomatic. Proper diagnostics and proper surgical technique allow for complete cure.

scholarly journals Urrets-Zavalia Syndrome Following Cataract Surgery

2021 ◽  
pp. 659-663
Author(s):  
Shimon Kurtz ◽  
Maayan Fradkin
Keyword(s):  
Intraocular Pressure ◽  
Case Report ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Inflammatory Reaction ◽  
Intraocular Lens Implantation ◽  
Postoperative Course ◽  
Lens Implantation ◽  
The Right

We describe a case of Urrets-Zavalia syndrome (UZS) in a healthy 56-year-old woman who underwent femtosecond-assisted phacoemulsification with intraocular lens implantation in both eyes. One month after an uneventful postoperative course in the left eye, the right eye was operated. Dilated pupil which was nonreactive to light appeared on day 21 postoperatively. This was discovered upon examination following anterior chamber inflammatory reaction which occurred 2 weeks following her surgery. Our case report emphasizes the importance and danger in developing UZS even if the reaction in the anterior chamber does not occur immediately after surgery. In addition, the importance of intraocular pressure follow-up in the period after UZS is acknowledged.

scholarly journals A novel template for anorectal fistula reporting in anal endosonography and MRI – a practical concept

2019 ◽  
Vol 21 (4) ◽  
pp. 483
Author(s):  
Iwona Sudoł-Szopińska ◽  
Małgorzata Kołodziejczak ◽  
Giulio Santoro Aniello
Keyword(s):  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
Fistula Tract ◽  
Anal Endosonography ◽  
Anorectal Fistula ◽  
Resonance Imaging ◽  
Anal Sphincters ◽  
Fistula Surgery ◽  
Magnetic Resonance Imaging Mri

Anorectal fistula surgery is associated with risks of recurrence and/or faecal incontinence due to anal sphincter injuries. In order to minimise these complications, preoperative evaluation of the anatomy of the fistula tract and morphology of the anal sphincters is mandatory. Anal endosonography (AES) and Magnetic Resonance Imaging (MRI), due to high resolution of images and ability to identify a number of fistula elements which are important for surgeons in treatment planning, are the methods of choice in the diagnosis of anorectal fistulas.In this paper, a new template for endosonographic and MRI report, systematically describing all anorectal fistula’s characteristics, is presented. This template provides practical information for the surgeon, useful in preoperative assessment and postoperative follow-up.

scholarly journals MANAGEMENT OF RECURRENT PILONIDAL SINUS WITH KSHARALEPA: A CASE REPORT

2020 ◽  
Vol 11 (6) ◽  
pp. 4-6
Author(s):  
Poornima Jalawadi ◽  
Aiyanna PP
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Male Patient ◽  
Pilonidal Sinus ◽  
Prevalence Rate ◽  
Surgical Practice ◽  
High Prevalence Rate ◽  
High Prevalence

Pilonidal Sinus (PNS) is a commonest presentation in surgical practice with a high prevalence rate at more than 1 million cases per year in India, where as incidence is about 26 per 1,00,000 population. A 30-year-old male patient presented with PNS after an unsuccessful excision followed by antibiotic therapy. The challenge in this case was not only to excise the tract but also preventing its recurrence. Adopting the principles of Vranopakramas using Ksharakarma, Utsadana karma described in Ayurveda helped to manage the PNS effectively without any recurrence after 32 months of follow-up.

Aberrant Feeding Artery Mutilation Treatment of Pulmonary Sequestration: A Case Report

2020 ◽  
Author(s):  
Yukang Liu ◽  
Wei Han ◽  
Ruoyao Wang ◽  
Peng Xiao ◽  
Yan Hu ◽  
...  
Keyword(s):  
Case Report ◽  
Physical Condition ◽  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Feeding Artery ◽  
Postoperative Course ◽  
Lower Lung ◽  
Scope Of Application

Abstract Background: Pulmonary sequestration (PS) is a rare congenital pulmonary pulmonary malformation. In this study, we reported a case of PS treated with aberrant feeding artery mutilation in our center.Case Presentation: A 29 –year-old female patient presented to our center in March 2020 due to repeated hemoptysis for more than 15 years, she received CTA examination which showed an aberrant feeding artery from the thoracic aorta into the left lower lobe of the lung and was therefore diagnosed with left lower lung pulmonary sequestration. Given that she complained with no infectious symptoms, she was treated with thoracoscopic feeding artery mutilation in June 2020 . She and experienced an uneventful postoperative course and was discharged 2 days postoperatively. On the postoperative follow-up of 4 months, thise patient’s physical condition was excellent and free of any symptoms such as hemoptysis or cough.Conclusion: Surgery is still the first choose for the treatment of PS. When pulmonary lesion is small-sized,for PS patients with non-infectious symptoms, aberrant feeding artery mutilation can be attempted as an alternative to intravascular technology for the treatment of PS. Future large studies are required to further verify its long-term efficacy and scope of application.

Early Recurrence of an Infantile Endodermal Oculomotor Nerve Cyst following Surgical Fenestration: A Case Report

2021 ◽  
Vol 56 (2) ◽  
pp. 157-162
Author(s):  
Victor M. Lu ◽  
Aditya Raghunathan ◽  
Michael J. Link ◽  
David J. Daniels
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Early Recurrence ◽  
Oculomotor Nerve ◽  
Rare Entity ◽  
Oculomotor Palsy ◽  
Case Presentation ◽  
Postoperative Course

Introduction: Infantile endodermal oculomotor nerve cyst (EONC) is an extremely rare entity. There are very few pediatric cases reported in the literature, and as expected, oculomotor palsy is the most common presenting symptom. To date however, the risk of recurrence of these lesions following surgical intervention is unclear due to a lack of long-term radiological follow-up. Case Presentation: We present a case of a 13-month-old male patient with an EONC and detail his surgical fenestration and postoperative course. Somewhat surprisingly, re-expansion occurred within 6 months and remained stable 2 years later. Discussion: A surgical approach to fenestration of an EONC in an infant is possible and should be performed by an expert neurosurgeon. Early recurrence is underreported in the current literature, and we encourage longer term radiological surveillance of these lesions after surgery to optimize primary and recurrent management in the future.

scholarly journals Ex-vivo repair for multiple and intraparenchymal renal artery aneurysms

2021 ◽  
Vol 20 ◽  
Author(s):  
Prashant Jain ◽  
Anil L Naik ◽  
Azharuddin Ansari ◽  
Lileshwar Kaman ◽  
Cherring Tandup ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Renal Artery ◽  
Saphenous Vein ◽  
Ex Vivo ◽  
Saphenous Vein Graft ◽  
Cold Preservation ◽  
Postoperative Course ◽  
The Right ◽  
Successful Repair

Abstract A 45-year-old woman with known hypothyroidism and no other comorbidities was incidentally found to have multiple right renal artery aneurysms. The largest aneurysm measured 5 x 4.5 cm and arose from an inferior segmental branch while two smaller aneurysms arose from an upper segmental branch of the right renal artery. We performed an ex-vivo repair with reverse saphenous vein graft under cold preservation followed by orthotopic kidney auto-transplantation. Her postoperative course was unremarkable and at 1-year follow-up her right kidney is preserved. In this article, we report successful treatment of complex multiple right renal artery aneurysms and describe the surgical technique used for successful repair.

Hip Arthrodesis: Present Evaluations

1993 ◽  
Vol 3 (1) ◽  
pp. 17-25
Author(s):  
A. Andreacchio ◽  
F. Bassi
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Surgical Procedure ◽  
Hip Surgery ◽  
Hip Arthrodesis ◽  
Advantages And Disadvantages

Authors examine the case-report of hip arthrodesis of the Istituto Ortopedico Galeazzi of Milan. 32 cases have been examined with mid follow-up of more than 31 years. Authors reconsider advantages and disadvantages of a surgical technique that now is almost abandoned, emphasizing the possible effectiveness of this surgical procedure in the light of knowledges of the prosthetic hip surgery.

Partly deepithelialised palatal graft for the treatment of deep-wide palatal recession defect: simplified protocol with 18-month follow-up

2020 ◽  
Vol 13 (11) ◽  
pp. e236954
Author(s):  
Amit Parashar ◽  
Indranil Deb Roy ◽  
Arpit Gupta
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Surgical Procedures ◽  
Healing Process ◽  
Root Coverage ◽  
Defect Site ◽  
Long Term Follow Up

Advances in periodontal plastic surgical procedures have led to achieve predictable root coverage outcomes for the recession defects. However, little has been reported and emphasised over management of palatal recession defects. The root coverage surgical procedures used for coverage of palatal recession defect are technically challenging in terms of accessibility and graft coverage. The purpose of this report is to describe a surgical technique used to manage deep-wide palatal recession defect. The technique uses partly deepithelialised palatal graft that is designed to approximately fit the defect site. This is employed for prolonged protection of the underlying healing process. This case report is unique in terms of treatment of deep (9.0 mm), wide (6.0 mm) palatal recession defect and its long-term follow-up for 18 months.

scholarly journals Endoscopic resection of scar tissues and bone graft with an intramedullary nail left in situ for distal femoral nonunion after nailing: A case report

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902095820
Author(s):  
Masaya Tsujii ◽  
Kazuya Odake ◽  
Akinobu Nishimura ◽  
Makoto Nishimura ◽  
Akihiro Sudo
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Social Activity ◽  
Femoral Shaft ◽  
Fracture Site ◽  
Diabetic Mellitus ◽  
Interlocking Nail ◽  
Nonunion Site

Femoral shaft nonunion after the intramedullary nailing has been successfully treated with advances in surgical technique. Nonetheless, the techniques cause morbidity to periosteum at the fracture site. We report the case of a 67-year-old man who underwent endoscopic surgery for refractory nonunion following the fracture of the distal femoral shaft, despite two fixations using an interlocking nail. In addition, the patient had uncontrolled diabetic mellitus. Endoscopy allowed us to acquire a clear view of the nonunion site, in which the resection of scar tissues and the packing of the cancellous bone were performed. At the final follow-up, bone healing was observed, and the patient was able to return to normal daily and social activity.

scholarly journals P614 Micro-fragmented autologous adipose tissue injection for fistula-in-ano (MAATIFA) in patients with Crohn’s disease: A prospective observational study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S511-S511
Author(s):  
A Sturiale ◽  
B Fabiani ◽  
D Cafaro ◽  
C Menconi ◽  
F Celedon Porzio ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Anal Fistula ◽  
Perianal Fistula ◽  
Advancement Flap ◽  
Fistula Tract ◽  
Time Interval ◽  
Internal Opening ◽  
Complex Anal Fistula ◽  
Related Complex

Abstract Background The use of adipose-derived mesenchymal stem cells showed great regenerative properties. They were used in several surgical fields such as plastic, orthopaedic and colorectal surgery with good results. It was recently published their efficacy to treat Crohn-related anal fistula but they were obtained through a laboratory process with significant costs. The aim of the study is to evaluate the effect of the micro-fragmented autologous adipose tissue injection associated with the advancement flap for the treatment of Crohn-related complex perianal fistula in one surgical step. Methods From January 2017 to February 2018 all the patients that fulfil the following criteria were enrolled in the study. Inclusion criteria were Crohn-related complex anal fistula confirmed by pelvic magnetic resonance or 3D-360° transanal ultrasound, fistula drained with a seton from 4 to 6w, first sphincter-saving procedure. The harvested fat from the abdominal wall was processed using the Lipogems® kit (Figure 1). The internal opening was closed through 2/0 PDS stiches with mucosal flap above it. The final product was then injected around the internal opening and fistula tract previously debrided (Figure 2 and 3). Outcomes were determined at 1-3-6-12 months follow-up assessing success rate, defined as clinical remission without any discharge. Results Ten patients underwent the procedure in the time interval between two biologic drug administration (6 infliximab –4 adalimumab). The homogenous follow-up was 12 months with an overall healing rate of 60%. No perioperative or postoperative complications were recorded. Conclusion Micro-fragmented autologous adipose tissue injection showed promising results to promote Crohn-related complex anal fistula healing. These good results are probably related to the reduction of inflammation and the activation of a reparative mechanisms.

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