scholarly journals Large Duodenal Hematoma Causing an Ileus after an Endoscopic Duodenal Biopsy in a 6-Year-Old Child: A Case Report

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 12
Author(s):  
Benjamin Schiller ◽  
Michael Radke ◽  
Christina Hauenstein ◽  
Carsten Müller ◽  
Christian Spang ◽  
...  
Keyword(s):  
Conservative Therapy ◽  
Pediatric Patients ◽  
Rare Complication ◽  
Feeding Tube ◽  
Magnetic Resonance Imaging Examination ◽  
Resonance Imaging ◽  
Nasogastric Feeding ◽  
Duodenal Hematoma ◽  
Gastric Decompression ◽  
Bowel Rest

Intramural duodenal hematoma (IDH) in children is a rare complication after esophagogastroduodenoscopy. It is commonly described in patients with additional disorders or risk factors, such as coagulopathy. We present a case of a previously healthy 6-year-old boy with a large obstructing intramural duodenal hematoma and concomitant pancreatitis after an elective esophagogastroduodenoscopy. The patient presented with typical symptoms of an IDH, such as abdominal pain and distension, nausea and vomiting. IDH was diagnosed using ultrasound and magnetic resonance imaging examination. Conservative management with gastric decompression using a nasogastric feeding tube, bowel rest, total parenteral nutrition and analgesia was performed. After three weeks, the patient was discharged from the hospital without any complaints. Interventional management of IDH in pediatric patients with a lack of response to conservative therapy or complicating IDH should be discussed in an interdisciplinary team.

scholarly journals Gastric Outlet Obstruction due to Intramural Duodenal Hematoma after Endoscopic Biopsy: Possible Therapeutic Role of Endoscopic Dilation

2018 ◽  
Vol 12 (3) ◽  
pp. 692-698
Author(s):  
Mahmud Samra ◽  
Tarek Al-Mouradi ◽  
Charles Berkelhammer
Keyword(s):  
Abdominal Pain ◽  
Gastric Outlet Obstruction ◽  
Rare Complication ◽  
Outlet Obstruction ◽  
Abdominal Ultrasound ◽  
Endoscopic Biopsy ◽  
Duodenal Hematoma ◽  
Bowel Rest ◽  
Diagnostic Modalities ◽  
Duodenal Lumen

Intramural duodenal hematoma (IDH) is an extremely rare complication after endoscopic biopsy. It typically presents with symptoms due to duodenal obstruction, which include abdominal pain and bilious vomiting. The hematoma may also expand and cause ampullary compression leading to pancreatitis and cholestasis. Computed tomography scan and abdominal ultrasound are the most common diagnostic modalities. Treatment is usually conservative, with bowel rest, nasogastric suctioning and total parenteral nutrition. Refractory cases have been described, requiring endoscopic therapy or surgical drainage. We describe a 28-year-old healthy male who presented with acute abdominal pain a few hours after a routine esophagogastrodudenoscopy with biopsies was performed. Following an otherwise uneventful endoscopy, he developed a gastric outlet obstruction and pancreatitis secondary to an IDH. The patient was managed conservatively. Resolution of his gastric outlet obstruction occurred immediately after gentle passage of the endoscope through the narrowed duodenal lumen.

Nonketotic Hyperglycemic Chorea in a 10-Year-Old Asian Boy with Diabetes Mellitus

2020 ◽  
Author(s):  
Julia Marian ◽  
Firdous Rizvi ◽  
Lily Q. Lew
Keyword(s):  
Diabetes Mellitus ◽  
Parietal Lobe ◽  
Rare Complication ◽  
Brain Magnetic Resonance Imaging ◽  
Food Allergies ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Resonance Imaging ◽  
Focal Lesions

AbstractNonketotic hyperglycemic chorea-ballism (NKHCB), also known as diabetic striato-pathy (DS) by some, is a rare complication of diabetes mellitus and uncommon in children. We report a case of a 10 11/12-year-old boy of Asian descent with uncontrolled type 1 diabetes mellitus (T1DM), Hashimoto's thyroiditis, and multiple food allergies presenting with bilateral chorea-ballism. His brain magnetic resonance imaging revealed developmental venous anomaly in right parietal lobe and right cerebellum, no focal lesions or abnormal enhancements. Choreiform movements resolved with correction of hyperglycemia. Children and adolescents with a movement disorder should be evaluated for diabetes mellitus, especially with increasing prevalence and insidious nature of T2DM associated with obesity.

Cesarean scar defects: diagnosis and treatment in non-pregnant women

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 6-10
Author(s):  
Sergey A. Martynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Genital Tract ◽  
Conservative Therapy ◽  
Clinical Manifestations ◽  
Subsequent Pregnancy ◽  
Resonance Imaging ◽  
Diagnostic Features ◽  
Pregnancy And Childbirth

The aim of the review was to summarize information on clinical manifestations, diagnostic features, as well as methods for correction of scar defects after cesarean section (CS) outside pregnancy. Lack of the scar after CS, niche, isthmocele are a myometrium defect in the area of scar after CS, which is most often detected by ultrasound, sonohysterography or magnetic resonance imaging and is manifested by postmenstrual bleeding from the genital tract. In some cases, it can cause menorrhagia, dyspareunia, pelvic pain, infertility, uterine rupture during subsequent pregnancy and childbirth. Conservative therapy or surgical treatment with laparoscopy, laparotomy or vaginal approach is carried out depending on the symptoms, size of the defect, the thickness of the residual myometrium, as well as the womans reproductive plans.

scholarly journals Prenatal findings and postnatal follow-up of a midline dural sinus malformation

2021 ◽  
Vol 10 (4) ◽  
pp. 205846012110063
Author(s):  
Hana Shabana ◽  
Johannes Leidinger ◽  
Johan Wikström ◽  
Ove Axelsson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spontaneous Regression ◽  
Rare Condition ◽  
Present Knowledge ◽  
Magnetic Resonance Imaging Examination ◽  
Dural Sinus ◽  
Resonance Imaging ◽  
Prenatal Magnetic Resonance Imaging ◽  
Dural Sinus Malformation

Dural sinus malformation is a rare condition. We describe a prenatally detected case followed by repeated ultrasound scans and a prenatal magnetic resonance imaging examination. A substantial spontaneous regression was observed, which is associated with a favorable outcome. We believe that our observations, including a long postnatal follow-up, will add to the present knowledge of prenatally detected cases, and thus improve management of the pregnancies as well as our possibilities to counsel the parents-to-be.

scholarly journals Hepatic epithelioid hemangioendothelioma: a report from three university centers

2016 ◽  
Vol 49 (5) ◽  
pp. 288-294 ◽  
Author(s):  
Antonello Giardino ◽  
Frank H. Miller ◽  
Bobby Kalb ◽  
Miguel Ramalho ◽  
Diego R. Martin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epithelioid Hemangioendothelioma ◽  
Magnetic Resonance Images ◽  
Central Core ◽  
Magnetic Resonance Imaging Examination ◽  
High Signal ◽  
Resonance Imaging ◽  
Peripheral Ring ◽  
Venous Phase

Abstract Objective: To determine common imaging findings of hepatic epithelioid hemangioendothelioma on magnetic resonance images. Materials and Methods: A search was made of three institutional databases between January 2000 and August 2012. Seven patients (mean age, 47 years; range, 21-66 years; 6 women) with pathology-confirmed diagnosis of hepatic epithelioid hemangioendothelioma who had undergone magnetic resonance imaging were identified. None of the patients had received any treatment for hepatic epithelioid hemangioendothelioma at the time of the initial magnetic resonance imaging examination. Results: Hepatic epithelioid hemangioendothelioma tumors appeared as focal masses in 7/7 patients, greater than 5 in number, with a coalescing lesion in 1/5, and peripheral localization in 6/7. Capsular retraction was present in 4/7, and was associated with peripherally located lesions. Early ring enhancement was appreciated in the majority of lesions in 7/7 patients. Centripetal progressive enhancement was shown in 5/7 patients on venous phase that exhibited a distinctive thick inner border of low signal on venous phase images, and a central core of delayed enhancement. Small lesions did not show this. Conclusion: The combination of multifocal round-configuration lesions that are predominantly peripheral and exhibit early peripheral ring enhancement and late appearance of an inner thick border of low signal and central core of high signal may represent an important feature for hepatic epithelioid hemangioendothelioma.

Tetraplegia after Coronary Artery Bypass Surgery in a Patient with Cervical Herniation

2010 ◽  
Vol 5 (2) ◽  
pp. 134-135 ◽  
Author(s):  
Alper Gorur ◽  
Numan Ali Aydemir ◽  
Nurgül Yurtseven ◽  
Mehmet Salih Bilal
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Rare Complication ◽  
Artery Bypass ◽  
Surgical Decompression ◽  
Cervical Disc ◽  
Resonance Imaging ◽  
Cervical Magnetic Resonance Imaging

Tetraplegia is a rare complication after coronary artery bypass surgery. The authors present a case of tetraplegia after uncomplicated coronary artery bypass surgery because of cervical disc herniation. No distinct abnormality was found in the preoperative neurologic examination although the postoperative cervical magnetic resonance imaging revealed a huge hernia at C5–C6 level presenting with tetraplegia. Surgical decompression was performed on the second postoperative day of bypass surgery, and neurologic deficits gradually improved.

scholarly journals Selecting pH cut-offs for the safe verification of nasogastric feeding tube placement: a decision analytical modelling approach

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018128 ◽  
Author(s):  
Melody Zhifang Ni ◽  
Jeremy R Huddy ◽  
Oliver H Priest ◽  
Sisse Olsen ◽  
Lawrence D Phillips ◽  
...  
Keyword(s):  
Care Pathway ◽  
Feeding Tube ◽  
Tube Placement ◽  
X Rays ◽  
Clinical Environment ◽  
Nasogastric Feeding ◽  
Relative Safety ◽  
Checking Procedure ◽  
The Impact ◽  
Modelling Approach

ObjectivesThe existing British National Patient Safety Agency (NPSA) safety guideline recommends testing the pH of nasogastric (NG) tube aspirates. Feeding is considered safe if a pH of 5.5 or lower has been observed; otherwise chest X-rays are recommended. Our previous research found that at 5.5, the pH test lacks sensitivity towards oesophageal placements, a major risk identified by feeding experts. The aim of this research is to use a decision analytic modelling approach to systematically assess the safety of the pH test under cut-offs 1–9.Materials and methodsWe mapped out the care pathway according to the existing safety guideline where the pH test is used as a first-line test, followed by chest x-rays. Decision outcomes were scored on a 0–100 scale in terms of safety. Sensitivities and specificities of the pH test at each cut-off were extracted from our previous research. Aggregating outcome scores and probabilities resulted in weighted scores which enabled an analysis of the relative safety of the checking procedure under various pH cut-offs.ResultsThe pH test was the safest under cut-off 5 when there was ≥30% of NG tube misplacements. Under cut-off 5, respiratory feeding was excluded; oesophageal feeding was kept to a minimum to balance the need of chest X-rays for patients with a pH higher than 5. Routine chest X-rays were less safe than the pH test while to feed all without safety checks was the most risky.DiscussionThe safety of the current checking procedure is sensitive to the choice of pH cut-offs, the impact of feeding delays, the accuracy of the pH in the oesophagus, as well as the extent of tube misplacements.ConclusionsThe pH test with 5 as the cut-off was the safest overall. It is important to understand the local clinical environment so that appropriate choice of pH cut-offs can be made to maximise safety and to minimise the use of chest X-rays.Trial registration numberISRCTN11170249; Pre-results.

scholarly journals Iatrogenic Supravalvular Aortic Stenosis

Aorta ◽  
2016 ◽  
Vol 04 (05) ◽  
pp. 172-174 ◽  
Author(s):  
Paolo Bosco ◽  
Antonella Ferrara ◽  
Samer Nashef
Keyword(s):  
Aortic Stenosis ◽  
Aortic Wall ◽  
Rare Complication ◽  
Suture Line ◽  
Anastomotic Site ◽  
Resonance Imaging ◽  
Sandwich Technique ◽  
Type A Aortic Dissection ◽  
Preoperative Magnetic Resonance ◽  
Aortic Anastomosis

AbstractWe describe a case of hemolytic anemia and proximal anastomotic site stenosis following emergency repair of a Type A aortic dissection. This rare complication led to a reoperation to correct the iatrogenic aortic stenosis and cure the consequent hemolysis. A “sandwich” technique (with two Teflon strips on the outside and inside of the aortic wall) was used in the initial repair to reinforce the suture line and prevent bleeding from the aortic anastomoses. At the time of reoperation, the inner Teflon strip at the proximal aortic anastomosis was found to have inverted into the aortic lumen, as suggested by the preoperative magnetic resonance imaging. Surgical treatment consisted of resecting the portion of inner Teflon that had turned in and tacking the remaining part back onto the aortic wall. The observed hemolysis was likely due to the turbulent flow associated with the supra-aortic stenosis and the collision of red cells with the internal Teflon strip. The patient made an uncomplicated recovery with no further hemolysis and was discharged on postoperative day 8.

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