scholarly journals Apple Peel Small Bowel, A Review of Four Cases: Surgical and Radiographic Aspects

2011 ◽  
Vol 31 (3) ◽  
pp. 227-234 ◽  
Author(s):  
RA Akinola ◽  
RL Osuoji
Keyword(s):  
Surgical Management ◽  
Radiographic Finding ◽  
Case Series ◽  
Intestinal Atresia ◽  
Retrospective Case ◽  
Radiographic Findings ◽  
Mortality And Morbidity ◽  
Resource Limited ◽  
Apple Peel ◽  
Operative Findings

Background: Although apple peel intestinal atresia is rare and is associated with a high mortality and morbidity, there is a dearth of its report in African literature. This study reviews four of the cases seen in a state teaching hospital in Lagos, considering the radiographic findings, surgical management and outcome. A brief review of literature is also undertaken. Aims and Objectives: To correle the plain radiographic findings with the surgical findings of neonates gathered over a six year period and to evaluate their surgical management, hoping to further help improve management of such neonates’ in future in resource limited regions such as ours. Methodology: It was a retrospective case series of four neonates who were brought in over a period of six years and operated after an initial plain abdominal X-ray. They were done as emergency cases, consent was obtained from their parents and the study was approved by the research and ethics committee. Operative findings were subsequently correlated with their radiographic findings and the surgical outcomes and follow up were documented. Conclusion: This study revealed that “the triple bubble sign” is a common radiographic finding in Apple Peel deformities, as well as gangrene of the jejunum and ileum at surgery. Key words: Apple peel atresia; Jejunoileal atresia; Plain Abdominal Radiography; Parenteral nutrition; Short Bowel Syndrome. DOI: http://dx.doi.org/10.3126/jnps.v31i3.5037 J Nep Paedtr Soc 2011;31(3): 227-234  

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

2021 ◽  
pp. 107110072110060
Author(s):  
Michael F. Githens ◽  
Malcolm R. DeBaun ◽  
Kimberly A Jacobsen ◽  
Hunter Ross ◽  
Reza Firoozabadi ◽  
...  
Keyword(s):  
Case Series ◽  
High Energy ◽  
Ankle Fractures ◽  
Posttraumatic Arthritis ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Radiographic Findings ◽  
Posttraumatic Arthrosis ◽  
Patient Reported

Background: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. We hypothesize that plafond malreducton and talar body impaction is associated with early posttraumatic arthrosis. Methods: A retrospective cohort of skeletally mature patients with SAD ankle fractures at 2 level 1 academic trauma centers who underwent operative fixation were identified. Patients with a minimum of 1-year follow-up were included. The presence of articular impaction identified on CT scan was recorded and the quality of reduction on final intraoperative radiographs was assessed. The primary outcome was radiographic ankle arthrosis (Kellgren-Lawrence 3 or 4), and postoperative complications were documented. Results: A total of 175 SAD ankle fractures were identified during a 10-year period; 79 patients with 1-year follow-up met inclusion criteria. The majority of injuries resulted from a high-energy mechanism. Articular impaction was present in 73% of injuries, and 23% of all patients had radiographic arthrosis (Kellgren-Lawrence 3 or 4) at final follow-up. Articular malreduction, defined by either a gap or step >2 mm, was significantly associated with development of arthrosis. Early treatment failure, infection, and nonunion was rare in this series. Conclusion: Malreduction of articular impaction in SAD ankle fractures is associated with early posttraumatic arthrosis. Recognition and anatomic restoration with stable fixation of articular impaction appears to mitigate risk of posttraumatic arthrosis. Investigations correlating postoperative and long-term radiographic findings to patient-reported outcomes after operative treatment of SAD ankle fractures are warranted. Level of Evidence: Level IV, retrospective case series.

scholarly journals Isolated middle ear anomalies: unfamiliar causes of conductive hearing loss: a case series

2020 ◽  
Vol 7 (1) ◽  
pp. 130
Author(s):  
Honnurappa Vijayendra ◽  
Somashekhar Abhilasha ◽  
Vinay Vijayendra ◽  
Nilesh Mahajan
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Case Series ◽  
Retrospective Case ◽  
Case Series Study ◽  
Ear Anomalies ◽  
Operative Findings ◽  
Hearing Outcomes ◽  
Conductive Hearing ◽  
Series Study

<p class="abstract">In this paper, we highlighted on the various types of isolated congenital middle ear ossicular anomalies we had seen and managed. This is significant as these are rare and go undiagnosed for long period of time. The mainstay of managing these conditions includes proper and timely diagnosis and correction of conducting hearing loss. This was a retrospective case series study done over period of 3 years from July 2016 to June 2019 at a tertiary referral otology centre. The study comprised of 9 patients diagnosed with isolated middle ear anomalies and in total 11 operated ears for the same as two patients underwent bilateral treatment. Each case was handled differently according to the intra operative middle ear findings. We found that in all of our cases the HRCT findings were in correlation with our intra operative findings. All cases had excellent post-operative hearing outcomes. Isolated middle ear deformity even though rare to identity, with recent advancement it is possible to diagnose and treat it on time and hence reduce the disability experienced by the patient. Whatever the type of abnormalities, most of them could be corrected with appropriate ossicular reconstruction by preserving the normal existing anatomy and bypassing the anomalous part.</p><p> </p>

scholarly journals Tibial Sesamoidectomy: Indications and Outcomes

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0020
Author(s):  
Jun Kit He ◽  
Matthew Christie ◽  
Joseph Robin ◽  
Haley McKissack ◽  
Ashish Shah
Keyword(s):  
Case Series ◽  
Retrospective Chart Review ◽  
Metatarsal Head ◽  
Complete Healing ◽  
Safe Procedure ◽  
Retrospective Case ◽  
Plantar Surface ◽  
Radiographic Measurements ◽  
Fracture Nonunion ◽  
Operative Findings

Category: Midfoot/Forefoot Introduction/Purpose: Tibial sesamoidectomy has been reported to be a safe and effective procedure of treating a range of sesamoid pathologies including chronic sesamoiditis and fracture nonunion. The purpose of this retrospective case series was to determine common clinical indications for tibial sesamoidectomy and to evaluate the postoperative clinical course and outcomes. Methods: A retrospective chart review was conducted on patients who had isolated tibial sesamoidectomy after failed conservative treatment from 2009 to 2018. Demographics, comorbidities, physical exam variables, operative findings, radiographic measurements including hallux valgus angle (HVA) and intermetatarsal angle (IMA), and clinical outcomes including visual analog score (VAS), Foot Function Index (FFI), and complications were gathered. Results: Twenty-six patients (13 males and 13 females) were identified who have undergone tibial sesamoidectomy with a mean age of 49.8±18.5 years. For those 21 non-ulceration patients, VAS was significantly improved from 5.27±2.41 pre-operatively to 0.91±1.14 post-operatively (p<0.01). There was no statistically significant change in IMA (8.35±1.87º to 8.29±1.79º, p=0.93) or HVA (14.94±6.82º to 14.28±7.78º, p=0.79). Postoperative FFI was obtained for 10 patients with a mean of 132.75±50.68. For those five patients who had chronic ulceration on the plantar surface of the medial metatarsal head, four had complete healing at a mean of 15.6±5.37 weeks post-operatively. There was a 17% incidence of complications including neuritis, transfer metatarsalgia, and persistent cock-up deformity. Conclusion: When utilized judiciously and with the right indications, isolated tibial sesamoidectomy is a safe procedure which can improve pain and ulcer healing. HVA and IMA remained unchanged at final follow-up.

Routine Hysterectomy in the Surgical Management of Ovarian Cancer: A Retrospective Case Series, Physician Opinion Survey, and Review of the Literature

2011 ◽  
Vol 21 (9) ◽  
pp. 1579-1584 ◽  
Author(s):  
Michael W. Bunting ◽  
Ken S. Jaaback ◽  
Orla M. McNally
Keyword(s):  
Ovarian Cancer ◽  
Surgical Management ◽  
Residual Disease ◽  
Case Series ◽  
Review Of The Literature ◽  
Opinion Survey ◽  
Limited Evidence ◽  
Retrospective Case ◽  
Endometrial Cancers

AbstractCurrent international guidelines recommend routine hysterectomy in the initial surgical management of epithelial ovarian cancer. However, there seems to be limited evidence to support these recommendations. We examined the data for a series of women undergoing hysterectomy as part of surgical management of ovarian cancer. Most of the women who underwent hysterectomy had no macroscopic uterine involvement in the ovarian cancer. However, almost half of them had macroscopic residual disease at completion of cytoreductive surgery. The incidence of synchronous primary endometrial cancers was 5%, and preoperative ultrasound had a sensitivity of 82% for predicting endometrial pathology. We also surveyed the members of the Australian Society of Gynaecological Oncologists (ASGO) regarding the role of hysterectomy in the management of ovarian cancer. Most of the respondents indicated that they believe hysterectomy should be routinely performed in the management of ovarian cancer but acknowledge that there is a lack of evidence to support the practice.

scholarly journals Outcomes following surgical management of inguinal-related groin pain in athletes: a case series

2020 ◽  
Vol 7 (1) ◽  
pp. 103-108
Author(s):  
Michael Gerhardt ◽  
Josh Christiansen ◽  
Benjamin Sherman ◽  
Alejandro Miranda ◽  
William Hutchinson ◽  
...  
Keyword(s):  
Groin Pain ◽  
Surgical Intervention ◽  
Case Series ◽  
Return To Sport ◽  
Scar Tissue ◽  
Nerve Entrapment ◽  
Return To Play ◽  
Retrospective Case ◽  
Operative Findings

Abstract To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Fifty-one athletes treated surgically for inguinal-related groin pain from 2009 to 2015. Limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement based on intra-operative findings. Ability to return to sport at the same level, time to return to play. Fifty-one athletes were included in the study with an average follow-up of 4.42 years (range 2.02–7.01). The average age was 24.2 years (range 16–49) and consisted of 94.0% males and 6.0% females. Nerve entrapment was demonstrated in 96.2% of cases with involvement of the ilioinguinal in 92.5%, the iliohypogastric in 30.8% and the genitofemoral in 13.2%. Attenuation of the posterior inguinal wall was present and repaired in 79.3% of cases. Scar tissue was present around the adductor origin and required debridement in 56.7% of cases. Forty-nine (96.1%) athletes returned to sport at the same level of play at an average of 5.9 weeks. Two athletes required a revision surgery. High rates of return to sport were achieved after surgery for inguinal-related groin pain that addresses the varying pathology and associated nerve entrapment.

Treatment of Sagittal Band Injuries and Extensor Tendon Subluxation: A Systematic Review

Hand ◽  
2020 ◽  
pp. 155894471989562
Author(s):  
Kitty Wu ◽  
Geoffrey Masschelein ◽  
Nina Suh
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Surgical Management ◽  
Nonoperative Management ◽  
Case Reports ◽  
Surgical Techniques ◽  
Case Series ◽  
Extensor Tendon ◽  
Retrospective Case ◽  
Level Of Evidence

Background: This systematic review assesses the current literature and reviews the clinical outcomes of treatment for sagittal band injuries and extensor tendon instability. Materials: A systematic search of MEDLINE, EMBASE, and the Cochrane databases was performed for English-language articles on the treatment of nonrheumatoid adult sagittal band injuries between 1969 and 2019. Two independent reviewers were involved in screening, data extraction, and critical appraisal. The level of evidence was assigned using the Sackett scale, and the methodological quality of the studies was evaluated using the Structured Effectiveness Quality Evaluation Scale (SEQES). Outcome measures were persistent pain, extensor lag, and recurrent tendon subluxation. Results: In all, 1653 abstracts were identified, with 43 articles reviewed in full text and 17 articles (429 treated digits) included in the final systematic review. There were 10 studies on surgical management, 3 on nonoperative management, and 4 on both. There were 4 retrospective case series and 13 retrospective case reports (Sackett level 4) with an average SEQES score of 15 (low quality). Studies on nonoperative management had on average more digits per study and higher SEQES scores (n = 27.7, SEQES = 19) compared with studies on surgical management (n = 11.8, SEQES = 13.8). Variability in reported outcome measures precluded meta-analysis. Conclusion: Qualitative synthesis of available literature suggests that acute sagittal band injuries can be successfully treated by splinting the injured digit in neutral or hyperextension. Patients with chronic injuries or those failing nonoperative management may benefit from surgical exploration. A lack of consistent outcome measures precluded comparison of surgical techniques.

scholarly journals New System for the Classification of Epiphyseal Separation of the Coracoid Process: Evaluation of Nine Cases and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Takamitsu Mondori ◽  
Yoshiyuki Nakagawa ◽  
Shimpei Kurata ◽  
Shuhei Fujii ◽  
Takuya Egawa ◽  
...  
Keyword(s):  
Surgical Management ◽  
Case Series ◽  
Shoulder Girdle ◽  
Coracoid Process ◽  
Type I ◽  
Retrospective Case ◽  
Type Iii ◽  
Associated Injury ◽  
Ac Dislocation ◽  
New System

Objectives and Design. Epiphyseal separation of the coracoid process (CP) rarely occurs in adolescents. In this retrospective case series, we reviewed the data of nine patients treated at our center and those of 28 patients reported in the literature. This injury can be classified into three types according to the injured area: Type I, base including the area above the glenoid; Type II, center including the coracoclavicular ligament (CCL); and Type III, tip with the short head of the biceps and coracobrachialis, as well as the pectoralis minor. Patients/Participants. A total of 37 patients were included in the analysis. Data on sex, age, cause and mechanism of injury, separation type, concomitant injury around the shoulder girdle, treatment, and functional outcomes were obtained. Main Outcome Measurements and Results. Type I is the most common type. The cause of injury and associated injury around the shoulder girdle were significantly different between Type I, II, and III fractures. The associated acromioclavicular (AC) dislocation and treatment were significantly different between Type I and III fractures. Our new classification system reflects the clinical features, imaging findings, and surgical management of epiphyseal separation of the CP. Type I and II fractures are mostly associated with AC dislocation and have an associated injury around the shoulder girdle. Type III fractures are typically caused by forceful resisted flexion of the arm and elbow. Although the latter are best managed surgically, whether conservative or surgical management is optimal for Type I and II fractures remains controversial. Conclusions. We noted some differences in the clinical characteristics depending on the location of injury; therefore, we aimed to examine these differences to develop a new system for classifying epiphyseal separation of the CP. This would increase the clinicians’ awareness regarding this injury and lead to the development of an appropriate treatment.

scholarly journals Traumatic Cyclodialysis Cleft Surgical Management Using Encirclage and Cryotherapy : A Novel Approach

2020 ◽  
Vol 3 (1) ◽  
pp. p1
Author(s):  
Gitanjli Sood ◽  
Vinata Rajendran ◽  
Tarun Sharma ◽  
Rajiv Raman
Keyword(s):  
Blunt Trauma ◽  
Surgical Management ◽  
Case Series ◽  
Posterior Segment ◽  
Retrospective Case ◽  
Intra Ocular Pressure ◽  
Retrospective Case Series ◽  
Novel Approach ◽  
Ocular Pressure ◽  
Cyclodialysis Cleft

This is a retrospective case series of 4 patients with traumatic cyclodialysis cleft (CC) with features of hypotony and posterior segment manifestations of blunt trauma who were treated using encirclage and trans scleral cryoptherapy along with vitrectomy. Encirclage was placed anteriorly in order to support the cleft. There was closure of cleft and improvement in Intra ocular pressure (IOP) in all cases. Thus the identification and treatment of CC with encirclage in cases with varied posterior manifestation of trauma can lead to good anatomical and visual restoration.

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