scholarly journals EUS-guided recovery of colonic continuity after complete anastomotic stenosis with a nitinol self-expanding stent

2020 ◽  
pp. 163-166
Author(s):  
E. G. Solonitsyn ◽  
I. N. Danilov ◽  
Sh. U. Kireev ◽  
A. A. Kovalev
Keyword(s):  
Abdominal Surgery ◽  
Balloon Dilatation ◽  
Clinical Case ◽  
Intestinal Anastomosis ◽  
Anastomotic Stenosis ◽  
Metal Stent ◽  
Benign Diseases ◽  
Anatomical Structures ◽  
Complex Issue ◽  
Intestinal Continuity

Recovery of intestinal continuity is remaining a complex issue in abdominal surgery. Previous operations, such as Hartmann's procedure, are usually done in the emergent setting, often in frail and septic patients. As a result, severe adhesions occur, and recognition of various anatomical structures becomes more difficult.The article describes a clinical case of EUS-guided recovery of rectum's continuity after complete anastomotic stenosis. The operation “EUS-guided formation of rectosigmoid anastomosis using Lumen-Apposing Metal Stent” was performed.In order to obtain a stable anastomosis within 6 months, a session of bougienage and 4 sessions of balloon dilatation were performed. Currently, the diameter of the colon at the stricture level is about 14 mm, clinically stricture is not significant.EUS-guided enterostomy can be used to form an intestinal anastomosis in patients with benign diseases. However, this method alone is not the final method of treatment and requires further supervision of patients.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

scholarly journals Utilization potential of intraluminal optical coherence tomography for the Eustachian tube

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hayoung Byun ◽  
Yeon Hoon Kim ◽  
Jingchao Xing ◽  
Su-Jin Shin ◽  
Seung Hwan Lee ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Eustachian Tube ◽  
Balloon Dilatation ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Complex Anatomy ◽  
Before And After ◽  
Tubal Lumen ◽  
Oct Image

AbstractImaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. A customized OCT system and an imaging catheter, termed the Eustachian OCT, were developed for visualizing the Eustachian tube. Three male swine cadaver heads were used to study OCT image acquisition and for subsequent histologic correlation. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. The OCT images were acquired from the superior to the nasopharyngeal opening before and after Eustachian tube balloon dilatation. The histological anatomy of the Eustachian tube was compared with corresponding OCT images, The new, Eustachian OCT catheter was successfully inserted in the tubal lumen without damage. Cross-sectional images of the tube were successfully obtained, and the margins of the anatomical structures including cartilage, mucosa lining, and fat could be successfully delineated. After balloon dilatation, the expansion of the cross-sectional area could be identified from the OCT images. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment.

scholarly journals Choledochoduodeninė fistulė: literatūros apžvalga ir klinikinio atvejo aprašymas

2013 ◽  
Vol 12 (4) ◽  
pp. 189-1950
Author(s):  
Giedrė Krištopaitytė ◽  
Edita Kazėnaitė ◽  
Vitalijus Sokolovas
Keyword(s):  
Abdominal Surgery ◽  
Clinical Case ◽  
Treatment Options ◽  
Short Review ◽  
Type Ii ◽  
Ulcer Disease ◽  
Nosological Entity ◽  
Choledochoduodenal Fistula ◽  
Report Presentation ◽  
Upper Gastrointestinal

Choledochoduodeninė fistulė (CDF) yra retas, dažniausiai atsitiktinis virškinimo trakto vaizdinių tyrimų ar intraoperacinis radinys, sudarantis apie 1–2 % visų bilioenterinių fistulių. Dažniausi etiologiniai veiksniai – opaligė (proksimalinės CDF) ir cholelitiazė(distalinės CDF). Simptominių fistulių gydymui taikomos endoskopinės procedūros – ERCP su PST ir stentavimu arba operuojama. Šiame straipsnyje pateikiama trumpa literatūros apie CDF etiologiją ir gydymo metodus apžvalga ir aprašomasklinikinis atvejis, kai ligonė tirta ir gydyta nuo simptominės distalinės II tipo (pagal Ikedos klasifikaciją) fistulės, kuri galėjo susidaryti cholelitiazės fone.Reikšminiai žodžiai: choledochoduodeninė fistulė (CDF), cholelitiazė, endoskopinė retrogradinė cholangiopankreatikografija (ERCP).Choledochoduodenal fistula: literature review and case report presentation Choledochoduodenal fistula (CDF) is a rare nosological entity, commonly encountered as an accidental finding while exploring the upper gastrointestinal tract or during abdominal surgery. They account for 1–2% of all bilioenteric fistulas, the mostcommon etiological causes being peptic ulcer disease (proximal ones) or cholelithiasis (distal ones). For treating symptomatic cases, endoscopic procedures such as endoscopic retrogradic cholangiopancreaticography with papillosphincterotomy andstentation are applied, or the patient undergoes abdominal surgery. This article provides a short review based on this pathology, its etiological causes and treatment options. A clinical case of symptomatic distal choledochoduodenal fistula of type II(Ikeda) due to cholelithiasis is described.Keywords: choledochoduodenal fistula (CDF), cholelithiasis, endoscopic retrogradic cholangiopancreaticography (ERCP).

EUS-guided recanalization of a complete rectal anastomotic stenosis by use of a lumen-apposing metal stent

2015 ◽  
Vol 82 (4) ◽  
pp. 752 ◽  
Author(s):  
Joan B. Gornals ◽  
Gino Albines ◽  
Loris Trenti ◽  
Richard Mast ◽  
Ricard Frago
Keyword(s):  
Anastomotic Stenosis ◽  
Metal Stent

Long-Term Impact of Bariatric Surgery

2017 ◽  
Author(s):  
Michael E. Hochman
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Abdominal Surgery ◽  
Vertical Banded Gastroplasty ◽  
Clinical Case ◽  
Long Term Impact ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in abdominal surgery. Does bariatric surgery in obese individuals reduce mortality? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible bariatric surgery, including gastric banding, vertical banded gastroplasty, or gastric bypass, for an obese man who has not had success with dieting.

Use of lumen apposing metal stent for pyloric stenosis refractory to balloon dilatation

2019 ◽  
Vol 20 (12) ◽  
pp. 663-664
Author(s):  
Prince Sethi ◽  
Smitha Narayana Gowda ◽  
Uma Motapothula ◽  
Brett Baloun ◽  
Muslim Atiq
Keyword(s):  
Pyloric Stenosis ◽  
Balloon Dilatation ◽  
Metal Stent

scholarly journals The Placement of Four Short Implants and Full-Arch Early Loading in the Edentulous Patient Suffering from Severe Mandibular Alveolar Ridge Atrophy

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Yuri Sedov ◽  
Oleg Mordanov ◽  
Sergei Grigoriev ◽  
Anatoly Avanesov ◽  
Kamil Khabiev
Keyword(s):  
Clinical Case ◽  
Edentulous Patient ◽  
Planning Stage ◽  
Incisive Canal ◽  
Anatomical Structures ◽  
Guided Surgery ◽  
Early Loading ◽  
Short Implants ◽  
Bone Atrophy ◽  
One Year

One of the treatments of patients with severe bone atrophy is short implants. It is important to position short implants taking into account the prosthetic loading and right position according to vital anatomical structures. In the presented case report, a seventy-one-year-old female patient underwent the rehabilitation with four short dental implants placed in the anterior mandibula with fully guided surgery to avoid mandibular incisive canal. It solves all the problems in the planning stage when you determine the osteotomy protocol in advance and the prognosis of future restoration according to patient requirements. This clinical case demonstrates the efficiency of patient rehabilitation with the use of short implants in difficult clinical situations.

scholarly journals Choledochoduodeninė fistulė: literatūros apžvalga ir klinikinio atvejo aprašymas

2013 ◽  
Vol 12 (4) ◽  
pp. 189-1950
Author(s):  
Giedrė Krištopaitytė ◽  
Edita Kazėnaitė ◽  
Vitalijus Sokolovas
Keyword(s):  
Abdominal Surgery ◽  
Clinical Case ◽  
Treatment Options ◽  
Short Review ◽  
Type Ii ◽  
Ulcer Disease ◽  
Nosological Entity ◽  
Choledochoduodenal Fistula ◽  
Report Presentation ◽  
Upper Gastrointestinal

Choledochoduodeninė fistulė (CDF) yra retas, dažniausiai atsitiktinis virškinimo trakto vaizdinių tyrimų ar intraoperacinis radinys, sudarantis apie 1–2 % visų bilioenterinių fistulių. Dažniausi etiologiniai veiksniai – opaligė (proksimalinės CDF) ir cholelitiazė(distalinės CDF). Simptominių fistulių gydymui taikomos endoskopinės procedūros – ERCP su PST ir stentavimu arba operuojama. Šiame straipsnyje pateikiama trumpa literatūros apie CDF etiologiją ir gydymo metodus apžvalga ir aprašomasklinikinis atvejis, kai ligonė tirta ir gydyta nuo simptominės distalinės II tipo (pagal Ikedos klasifikaciją) fistulės, kuri galėjo susidaryti cholelitiazės fone.Reikšminiai žodžiai: choledochoduodeninė fistulė (CDF), cholelitiazė, endoskopinė retrogradinė cholangiopankreatikografija (ERCP).Choledochoduodenal fistula: literature review and case report presentation Choledochoduodenal fistula (CDF) is a rare nosological entity, commonly encountered as an accidental finding while exploring the upper gastrointestinal tract or during abdominal surgery. They account for 1–2% of all bilioenteric fistulas, the mostcommon etiological causes being peptic ulcer disease (proximal ones) or cholelithiasis (distal ones). For treating symptomatic cases, endoscopic procedures such as endoscopic retrogradic cholangiopancreaticography with papillosphincterotomy andstentation are applied, or the patient undergoes abdominal surgery. This article provides a short review based on this pathology, its etiological causes and treatment options. A clinical case of symptomatic distal choledochoduodenal fistula of type II(Ikeda) due to cholelithiasis is described.Keywords: choledochoduodenal fistula (CDF), cholelithiasis, endoscopic retrogradic cholangiopancreaticography (ERCP).

scholarly journals Stenting of esophageal anastomosis

2018 ◽  
Keyword(s):  
Anastomotic Leakage ◽  
Balloon Dilatation ◽  
Anastomotic Stricture ◽  
Intestinal Anastomosis ◽  
Cancer Of The Stomach ◽  
Esophageal Anastomosis ◽  
Invasive Method ◽  
Methods Of Treatment ◽  
Gastric Anastomosis

This study based on the experience of treatment of 57 patients who previously were operated at the clinic for cancer of the stomach and esophagus. These patients had complications in the form of esophageal anastomotic leakage and esophageal anastomotic stricture. There were 9 patients with esophageal-gastric anastomotic leakage , 11 patients with esophageal - intestinal anastomotic leakage, 20 patients with a stricture of esophageal - gastric anastomosis, 17 patients with a stricture of esophageal - intestinal anastomosis. All the patients were undergone stenting of esophageal anastomosis. The results of using this method of treatment were estimated. Stenting of the esophagus with self-expandable stents with a coating is a method of choice for the treatment of patients with insolvency of esophageal anastomosis and avoids traumatic surgery, especially in weakened patients, as well as helps to save lives in patients with these severe complications. When scarring strictures of esophageal anastomosis, especially when other methods of treatment (boughing, balloon dilatation) fail, stenting is also a very effective minimally invasive method that can restore the passage of the gastrointestinal tract and improve the quality of life of the patient, as well as an alternative to traumatic surgery to correct stricture of esophageal anastomosis.

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