Manual Physical Therapy for Non-Surgical Treatment of Adhesion-Related Small Bowel Obstructions: Two Case Reports

Background: Since the first report of a diaphragmatic hernia from Ambroise Paré’s necropsy in 1610, the Bochdalek hernia (BH) of the congenital diaphragmatic hernia (CDH) has been the most common types with high morbidity and mortality in the neonatal period. Due to the nature of the disease, CDH associated with pregnancy is too infrequent to warrant reporting in the literature. Mortality of obstruction or strangulation is mostly due to failure to diagnose symptoms early. Data sources and study selection: A systematic literature search of maternal BH during pregnancy was conducted using the electronic databases (PubMed and EMBASE) from January 1941 to December 2020. Because of the rarity of the disease, this review included all primary studies, including case reports or case series that reported at least one case of maternal BH in pregnant. Searches, paper selection, and data extraction were conducted in duplicate. The analysis was performed narratively regardless of the control groups’ presence due to their rarity. Results: The search retrieved 3450 papers, 94 of which were deemed eligible and led to a total of 43 cases. Results of treatment showed 16 cases in delayed delivery after hernia surgery, 10 cases in simultaneous delivery with hernia surgery, 3 cases in non-surgical treatment, and 14 cases in hernia surgery after delivery. Of 16 cases with delayed delivery after hernia surgery, 13 (81%) cases had emergency surgery and three (19%) cases had surgery after expectant management. Meanwhile, 10 cases underwent simultaneous delivery with hernia surgery, 6 cases (60%) had emergent surgery, and 4 cases (40%) had delayed hernia surgery after expectant management. 3 cases underwent non-surgical treatment. In this review, the maternal death rate and fetal/neonatal loss rate from maternal BH was 5% (2/43) and 16% (7/43), respectively. The preterm birth rate has been reported in 35% (15/43) of maternal BH, resulting from maternal deaths in 13% (2/15) of cases and 6 fetal loss in 40% (6/15) of cases; 44% (19/43) of cases demonstrated signs of bowel obstruction, ischemia, or perforation of strangulated viscera in the operative field, resulting from maternal deaths in 11% (2/19) of cases and fetal-neonatal loss in 21% (4/19) of cases. Conclusion: Early diagnosis and surgical intervention are imperative, as a gangrenous or non-viable bowel resection significantly increases mortality. Therefore, multidisciplinary care should be required in maternal BH during pregnancies that undergo surgically repair, and individualized care allow for optimal results for the mother and fetus.

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Non-Surgical Treatment Including Physical Therapy

Cervical Spondylosis and Similar Disorders ◽

10.1142/9789812812704_0014 ◽

1998 ◽

pp. 331-347

Author(s):

J. DVOŘÁK ◽

J. A. ANTINNES ◽

W. SCHNEIDER

Keyword(s):

Surgical Treatment ◽

Physical Therapy ◽

Non Surgical Treatment

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Osteopetrosis. Presentación de dos casos [Non-surgical management of osteopetrosis: two case reports an review of the literature]

Revista de la Asociación Argentina de Ortopedia y Traumatología ◽

10.15417/issn.1852-7434.2019.84.4.869 ◽

2019 ◽

Vol 84 (4) ◽

pp. 386-392

Author(s):

Juan Carlos Caruso ◽

Juan Martín Patiño

Keyword(s):

Surgical Treatment ◽

Case Reports ◽

Bone Dysplasia ◽

Invasive Treatment ◽

Non Invasive ◽

History Of ◽

Diaphyseal Fractures ◽

Non Surgical Treatment ◽

Delayed Consolidation

Las osteopetrosis (enfermedad de Albers-Schönberg) es un síndrome con cuatro tipos clásicos e instituye una displasia ósea secundaria a la falta de resorción de hueso por anormalidad de los osteoclastos, lo cual provoca un tejido óseo duro y quebradizo,propenso a fracturas difíciles de tratar quirúrgicamente. Se han publicado escasos artículos sobre el tema; por este motivo, decidimos presentar a dos pacientes con fracturas diafisarias de húmero con osteopetrosis, ambas tratadas en forma incruenta.Los objetivos son comunicar nuestra experiencia y el método de tratamiento de dicha afección y realizar una revisión bibliográfica acerca del tema. Creemos que el tratamiento de elección para las fracturas diafisarias de húmero en pacientes con osteopetrosises el incruento, ya que su tipo de tejido óseo dificulta la implementación de cualquier osteosíntesis. Además, la colocación de implantes puede provocar algunas complicaciones, como infecciones, retraso de la consolidación y seudoartrosis. La cirugía se reserva para ciertos casos, como en pacientes con riesgo de desarrollar deformidades incapacitantes, aquellos que han sufrido fracturas repetidas, con retraso de la consolidación, seudoartrosis, quienes no responden al tratamiento incruento o con unadeformidad previa.AbstractOsteopetrosis (also known as Albers-Schönberg disease) is a syndrome that includes four classic types and is characterized by bone dysplasia and lack of bone resorption due to abnormal osteoclastic activity and consequent development of brittle and hard bone that is prone to fractures that are difficult to treat surgically. Herein we present two cases of osteopetrosis with diaphyseal fractures of the humerus, both managed with non-surgical treatment. The objectives of our manuscript are to document our experience in the management of these cases and review the literature. The non-invasive treatment provides the best outcome for dyaphyseal fractures on the humerus in patients with osteopetrosis, given that the quality of the bone in these patients impairs the implementation of osteosynthesis. In addition, the placement of implants can lead to complications such as infections, delayed consolidation and pseudoarthrosis, among others. Surgical treatment should reserved for certain patients such as those with delayed consolidation, pseudoarthrosis, a history of repeated fractures, pre-existing deformity and those who are at risk for the development of disabling deformities or do not respond to non-surgical treatment.

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Non-Surgical Treatment of Cesarean Scar Pregnancy: Two Case Reports

Jentashapir Journal of Health Research ◽

10.5812/jjhr.28703v2 ◽

2015 ◽

Vol 6 (3) ◽

Author(s):

Mojgan Barati ◽

Kobra Shojayi ◽

Farideh Moramezi ◽

Nafiseh Hoseiny Moghadam

Keyword(s):

Surgical Treatment ◽

Case Reports ◽

Cesarean Scar Pregnancy ◽

Cesarean Scar ◽

Non Surgical Treatment

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Os Acromiale in Professional Tennis Players

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118773723 ◽

2018 ◽

Vol 6 (5) ◽

pp. 232596711877372 ◽

Cited By ~ 1

Author(s):

Geoffroy Nourissat ◽

Michel Calò ◽

Bernard Montalvan ◽

Jacques Parier

Keyword(s):

Surgical Treatment ◽

Physical Therapy ◽

Developmental Process ◽

Case Reports ◽

National Level ◽

Case Series ◽

Recurrent Pain ◽

Tennis Players ◽

Os Acromiale ◽

Professional Tennis

Background: Os acromiale is a rare condition mostly reported in the literature through case reports, imaging studies, or reports of surgical treatment. This condition is the result of nonunion of growth plates of the acromion during the natural developmental process that occurs between 15 and 25 years of age. Its incidence is low, and few studies are available in the literature on athletes with high functional demands, and particularly on athletes within a specific sport. Purpose: To collect epidemiological data and to report the amount of time out of play as well as the type of treatment and its efficiency in professional tennis players. Study Design: Case series; Level of evidence, 4. Methods: We performed a retrospective study using the medical data of athletes within our national tennis league who complained about their shoulder between 2011 and 2016. Nine professional tennis players (mean age, 20 years) with painful shoulders were diagnosed with os acromiale; 3 of them played at an international level, with the other 6 playing at a national level. The diagnosis was confirmed using radiography, including the axillary view, and magnetic resonance imaging (MRI). One female player had associated subacromial bursitis. Results: All cases of os acromiale were classified as involving the mesoacromion, following the Lieberson classification. No patient underwent surgery, and no patient was treated with local or subacromial infiltration. Patients stopped competition and training throughout the rehabilitation period. All patients received medical treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), ice, and physical therapy with a specific rehabilitation program. All athletes returned to their former level of play after a mean of 37 days. No patient suffered from recurrent pain. One patient underwent MRI after 2 years, showing a normal bone signal and complete healing of the acromion. Conclusion: Conservative treatment including NSAIDs, rest, ice, and physical therapy allowed for good recovery and return to the former level of play. Surgical treatment is usually not indicated for os acromiale in the professional tennis player.

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Spontaneous Regression of a Radiculopathic Cervical Herniated Disc following Non-surgical Treatment: 3 case reports

The Korean Journal of Pain ◽

10.3344/kjp.2008.21.1.84 ◽

2008 ◽

Vol 21 (1) ◽

pp. 84

Author(s):

Hyeun Sung Kim ◽

Dae Hyun Jo ◽

In Ho Park ◽

Jae Kwang Rhu ◽

Kwang Jin Sun ◽

...

Keyword(s):

Surgical Treatment ◽

Spontaneous Regression ◽

Case Reports ◽

Herniated Disc ◽

Non Surgical Treatment

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4-year follow-up of ultrasound-based diagnosis and non-surgical treatment of developmental dysplasia of the hip in mongolia: a prospective cohort study

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587724 ◽

2016 ◽

Vol 37 (S 01) ◽

Cited By ~ 1

Author(s):

T Baumann ◽

B Munkhuu ◽

B Chuluunbaatar ◽

R Schmid ◽

S Essig

Keyword(s):

Cohort Study ◽

Surgical Treatment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Developmental Dysplasia ◽

Dysplasia Of The Hip ◽

Non Surgical Treatment

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Hemangiomatosis of the greater omentum – a case report

Perspectives in Surgery ◽

10.33699/pis.2019.98.4.178-180 ◽

2019 ◽

Vol 98 (4) ◽

pp. 178-180

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Histological Examination ◽

Case Reports ◽

Greater Omentum ◽

Surgical Removal ◽

Consumption Coagulopathy ◽

Cavernous Hemangiomas ◽

Mesodermal Origin ◽

Benign Tumours

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

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Surgical treatment of extensive perianal hidradenitis

Perspectives in Surgery ◽

10.33699/pis.2020.99.9.409-413 ◽

2020 ◽

Vol 99 (9) ◽

Keyword(s):

Surgical Treatment ◽

Hidradenitis Suppurativa ◽

Soft Tissues ◽

Case Reports ◽

Radical Excision ◽

Skin Flaps ◽

Perianal Area ◽

Apocrine Glands ◽

Patient Preparation ◽

Two Stages

Introduction: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurative, and fistulising disease of apocrine glands, adjacent anal canal and soft tissues. Perianal area is the second most common affected area after axilla. There are three grades of the disease. Hidradenitis suppurativa represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses, followed by the formation of sinus tracts and subsequent scarring. Perianal hidradenitis suppurativa is the last and the most serious grade of the disease and a specific access is needed for patient preparation and surgical treatment alone. The currently preferred method of treatment for patients with extensive perianal hidradentitis is excision and closure with combination of skin flaps, primary suture and skin graft in one or two stages. Case reports: There are three case reports of perianal hidradenitis suppurativa in this article. The local and overall initial treatment of patients followed by a radical excision and closure with a rotation skin flaps and skin grafts is described. The final results were satisfactory, with no recurrence or serious complication.

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