scholarly journals Gas in the Inferior Mesenteric Vein – successful non operative management of a rare complication of diverticulitis

Author(s):  

Septic phlebitis (also known as pyelephlebitis) because of diverticulitis is a rare but important complication. Many previous cases have mandated urgent surgical management for fear of further deterioration. This case report details one of the first cases where septic phlebitis was successfully managed conservatively, and details important clinical lessons clinicians should be aware of.

2021 ◽  
Vol 9 (7) ◽  
Author(s):  
Mohammed S. Foula ◽  
Mohammed Sharroufna ◽  
Zahra H. Alshammasi ◽  
Omar S. Alothman ◽  
Bayan A. Almusailh ◽  
...  

2018 ◽  
Vol 5 (4) ◽  
pp. 1350
Author(s):  
Ramachandra M. L. ◽  
Krishna S. R.

Background: Trauma remains the most common cause of death for all individuals between the ages of 1 and 44 years. 10% of these fatalities are attributable to abdominal injury. The Indian fatality rates for trauma are 20 times that for developed countries. The management of patients with blunt abdominal injury has evolved greatly over the last few decades from complete surgical management historically to present non operative management in most of the cases. In view of increasing number of road traffic accidents, rampant increase in construction work, accidental fall from height, this study is conducted to look into the causes of such incidents and also to strengthen the already established rules of non operative management in cases of blunt trauma abdomen.Methods: This is a prospective study of 53 patients who presented to K. R. Hospital, Mysuru, Karnataka, for management of blunt trauma abdomen over the period of January 2016 to June 2017. Unstable patients with initial resuscitation underwent Focused Assessment Sonography for Trauma. Failed resuscitation with free fluid in abdomen confirmed by FAST immediately shifted to operation theatre for laparotomy and proceed. Hemodynamically stable patients underwent computerized tomography of abdomen. Organ injuries were scaled according to the American Association for the Surgery of Trauma and these patients were managed conservatively after ruling out hollow viscus perforation.Results: Majority of the patients belonged to male sex (85%) and of the age group 21-40 years constituting 58.3% of patients. Road traffic accident was the most common mode of injury which included 35 patients (66%). A total of 19 cases had splenic injury out of which 13 (68.5%) underwent non operative management and 6 (31%) underwent emergency Splenectomy. liver injury was present in 15 patients and all were managed conservatively. In total non operative management was done in 73.5% of cases and surgical management was done in 26.5% of cases.Conclusions: The presence of free fluid with organ injury always does not mandate laparotomy. Patient selection, early diagnosis and repeated clinical examination and use of appropriate investigations forms the key in non operative management of blunt trauma abdomen. RTA being the most common mode of injury, adequate measures should be taken to prevent road traffic accidents by strict action and traffic norms and citizen education.


2018 ◽  
Vol 10 (1) ◽  
pp. 94-97
Author(s):  
Sahil Thakur ◽  
Parul Ichhpujani ◽  
Suresh Kumar

Background: Pseudophacocele is a rare complication of blunt trauma in pseudophakic eyes.Case: We present a case of 60-year-old male who presented with pseudophacocele after injury from a bicycle handle. On presentation, visual acuity in the right eye was perception of light (PL) in 2 quadrants (superior and temporal) and left eye was 20/20. A PCIOL was seen superonasally in the right subconjunctival space with total hyphaema. Ultrasound demonstrated vitreous haemorrhage with membranes in right eye. We describe the surgical management and further clinical course of the patient.Conclusion: It is imperative to surgically manage these challenging cases. Despite optimum care visual outcomes are guarded in patients with severe blunt trauma.


2016 ◽  
Vol 4 (2) ◽  
pp. 205-208 ◽  
Author(s):  
Kunio Hamanaka ◽  
Yuusuke Hirokawa ◽  
Tsuyoshi Itoh ◽  
Mitsuhiro Fujino ◽  
Kenichi Kano ◽  
...  

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mohd Fahmi AAziz ◽  
NE Mahno ◽  
Siti Kamariah CM ◽  
Mohd Nazli MZ

We aim to report a rare case of colonic perforation post percutaneous nephrolithotomy (PCNL) and its conservative management. We report a 63-year-old Malay, thalassemia carrier male who underwent an uncomplicated left PCNL for a left renal stone. On second postoperative day, clinically evidence of subcutaneous emphysema. Serial CXR imaging confirmed presence of air under diaphragm. Small colonic perforation was diagnosed which subsequently developed localized collection retroperitoenally. He was successfully treated with non-operative management including intravenous antibiotic, surgical drainage and good nutrional has successfully support healed the collection. Serial CT renal protocol showed a healed retroperitoneal collection and patient made a good clinical recovery. PCNL has promising stone clearance rate. However, it carries complications. A rare yet important complication; colonic perforation is a serious complication that if detected earlier, good clinical recovery can be achieved conservatively.


2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Abdul Malek Mohamad ◽  
Azrin Waheedy Ahmad ◽  
Junaini Kasian

Introduction: We aim to report an uncommon case of post ERCP perforation that effectively managed conservatively in non-hepatobiliary surgery centre. Case report: A 46-year-old man diagnosed to have obstructive jaundice secondary to distal common bile duct (CBD) stone. He underwent ERCP at a private centre, sphincterotomy was performed, but, the operator had failed to insert the stent and complicated with post ERCP perforation evidenced by contrast extravasation beyond 1/3rd of the CBD and referred to our centre. Patient was subjected for re ERCP. There were difficulties in cannulating the CBD and stent was inserted. Cholangiogram revealed contrast leak around the pancreatic duct and bifurcation of hepatic duct. There was no evidence of CBD stone. Computed Tomography (CT) of the abdomen revealed extensive subcutaneous emphysema on the right side of the abdomen to right inguinal region, extensive retroperitoneal free air and pneumoperitoneum, but there were no free fluid or contrast extravasation. The patient subjected for non-operative management (NOM) for the complication and kept fasting with total parenteral nutrition and intravenous antibiotic. He recovered well with the opted management. Patient was programmed with Gastrograffin study after 10 days that showed no evidence of contrast leak to suggest free bowel injury. He was allowed orally after that and was discharged well after 15 days with stent in situ. During follow up, he was well, and the stent removed after 3 months. Patient planned for laparoscopic cholecystectomy and on table cholangiogram. Conclusion:  Post ERCP perforation is uncommon but lethal. Early recognition of the complication is crucial hence appropriate management can be arranged to avoid death. To date, surgery is not the only choice available to manage this complication.


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