scholarly journals Endovascular Stenting for Traumatic Common Iliac Pseudoaneurysm as an Adjunct following Exploratory Laparotomy in a Stab Injury Patient

Author(s):  
Saptarshi Biswas ◽  
Nishaan Nagarakanti

ABSTRACT Traumatic iliac vessel injuries, especially secondary to penetrating wounds, are often associated with a very high mortality rate. The patients usually present to the trauma bay in profound hemorrhagic shock, which, in turn, triggers the vicious cycle of hypothermia, coagulopathy, and acidosis. Iliac artery injuries should be managed promptly because of the high incidence of late complications of pseudoaneurysm and arteriovenous fistulae and risks of subsequent arterial thrombosis and distal ischemia. We report a case of a 17-year-old female who was brought in following a stab wound in the right lower quadrant (RLQ). A postlaparotomy computed tomography (CT) scan performed revealed a pseudoaneurysm on the right common iliac. A pelvic angiography was performed, which was followed by an endovascular placement of a covered stent on the right common iliac artery. We discuss an interesting case along with discussion of relevant literature. How to cite this article Biswas S, Nagarakanti N. Endovascular Stenting for Traumatic Common Iliac Pseudoaneurysm as an Adjunct following Exploratory Laparotomy in a Stab Injury Patient. Panam J Trauma Crit Care Emerg Surg 2016;5(3):172-176.

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Saptarshi Biswas ◽  
Hadley Cadot ◽  
Sunil Abrol

Bullet embolism is a well-known but relatively uncommon complication of gunshot injuries. Their rarity and the potential lack of early symptoms lead to delays in diagnosis and often in inadequate early management that can potentially result in the loss of a limb or life. We present an interesting case in which a small caliber bullet to the upper anterior abdomen penetrated the thoracic aorta and traveled to the right popliteal artery embolizing the vessel. The exploratory laparotomy failed to locate neither the bullet nor the trajectory resulting in sudden deterioration and eventual death 5 hours into the postoperative period.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Arvind Sharma ◽  
Adarsh Kumar ◽  
Sheikh Imran ◽  
Pankaj Sood ◽  
Rajesh Kumar Asrani

The objective of this case report was to describe the ultrasonographic, surgical, and histopathological findings of a rare clinical case of uterine leiomyoma in a 5-year-old Holstein crossbred cow presented for diagnosis and treatment of infertility. Transrectal palpation revealed a large nonpainful mass suspected to be an abscess or a tumor in the caudal abdomen on the right side. Transabdominal ultrasonography revealed a round mass with irregular hypoechogenic/echogenic foci and a thin echogenic capsule around it. Ultrasonographic-guided centesis of the lesion under local analgesia did not yield any foul smelling aspirate leading to a tentative diagnosis of an intra-abdominal tumor. The lesion was later confirmed by exploratory laparotomy and histopathology as a case of uterine leiomyoma. The cow gave birth to a live normal calf 12 months following the surgery. Rectal examination after parturition revealed no evidence of the tumor at the surgical site. Ultrasonography enabled prompt, noninvasive diagnosis of uterine leiomyoma and proved to be a useful decision-making tool in the abdominal surgery of the cow. This is an interesting case which broadens the spectrum of the causes of infertility in cattle.


2019 ◽  
Vol 104 (11-12) ◽  
pp. 540-541
Author(s):  
Brandon H. Cherry ◽  
Denish Patel ◽  
Joseph E. Ronaghan

Introduction We present a case of a 24-year-old female who presented with the signs and symptoms of acute appendicitis. Case report When computed tomography and ultrasound were not definitive for the diagnosis, the decision was made to perform a laparoscopic appendectomy. The appendix showed no gross signs of inflammation, so intraoperative esophagogastroduodenoscopy was used to examine for a perforated peptic ulcer. When no perforations were found, exploratory laparotomy was performed and revealed purulent fluid in the right colic gutter and a pinhole perforation in the first part of the duodenum. The defect was repaired and the abdominal space was washed thoroughly and closed. The patient recovered well and was discharged from the hospital in good health. Conclusion Valentino's syndrome is an uncommon cause of right lower quadrant pain and symptoms mimicking acute appendicitis.


2012 ◽  
Vol 2012 (jun07 1) ◽  
pp. bcr0220125827-bcr0220125827 ◽  
Author(s):  
A. C. Siddiqui ◽  
S. Q. Lew ◽  
S. Sarin ◽  
A. C. Venbrux

2013 ◽  
Vol 7 (9-10) ◽  
pp. 645 ◽  
Author(s):  
Nicholas J Kuntz ◽  
Brant A Inman

A neobladder-arterial fistula is a very rare complication following cystectomy, with only 1 previously reported case. Delay in diagnosis can be rapidly fatal and requires prompt intervention. We report the case of a 63-year-old male who developed massive hematuria, and was found to have a fistula between the right external iliac artery and Studer neobladder during emergent exploratory laparotomy. Treatment success relies on a high index of suspicion and may include open operative intervention.


2022 ◽  
Vol 2022 ◽  
pp. 1-4
Author(s):  
Yousef S. Abuzneid ◽  
Hussam I. A. Alzeerelhouseini ◽  
Abdelrahman Rabee ◽  
Wafa Aqel ◽  
Rawan F. Ayyad ◽  
...  

Introduction. Foreign body ingestion is a common pediatric complain, and most can be passed spontaneously; however, magnetic object ingestion is rather rare, and they can cause severe complications when multiple magnets are ingested, as they lead to entrapment of bowel walls between them, causing ischemia, pressure necrosis, perforation, and fistula formation. Case Presentation. Herein, we present a case of a 16-month-old female patient presented to our department complaining of continuous vomiting for two days along with fever and irritability. X-ray revealed dilated bowel loops with a radioopaque foreign body in the right lower quadrant. After discussing with the parents, exploratory laparotomy was done, showing two bowel perforations at the site of the magnets. Affected bowel was resected with anastomosis. The patient was discharged after 3 days with an uneventful recovery. Discussion. The diagnosis and management of magnet ingestion differ from those of small foreign bodies, which are usually managed conservatively by watchful waiting. Usually, the diagnosis is done due to complications such as peritonitis and death. On the other hand, management depends on the number, size, magnetic field, and shape of the magnet, and whether it has passed the pylorus or not. Conclusion. It is important to establish the diagnosis of this condition as early as possible to prevent complications. Despite the efforts that were made to try to prevent and minimize the risk of magnet ingestion, more investigations are required to reach a common and united strategy for management of such conditions.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1477-1481
Author(s):  
Ishwari Gaikwad ◽  
Priyanka Shelotkar

The current world situation is both frightening and alarming due to the massive disruption caused by the Covid-19 pandemic. The next few days are censorious as we need to be very precautious in our daily regimen as well as dietary habits. Ayurveda offers knowledge about food based on certain reasoning. Indecent food custom is the chief cause for the rising development of health disorders in the current era. In classical texts of Ayurveda, the concept of diet explained well, ranging from their natural sources, properties and specific utility in pathological as well as physiological manner. In this work, the review of the relevant literature of Ahara (Diet) was carried out from Charak Samhita and other texts, newspapers, articles, web page related to the same.  Every human being is unique with respect to his Prakriti (Physical and mental temperament), Agni (Digestive capacity), Koshtha  (Nature of bowel) etc. For that reason, the specificity of the individual should be kept in mind. Ahara, when consumed in the appropriate amount at the right moment following all Niyamas (Guidelines) given in Ayurveda texts, gives immunity and keeps the body in a healthy state during pandemics such as Covid-19. Ultimately, this will help the human body to maintain its strength for life. This article reviews the concept of diet viz. combination of foods, their quantity and quality, methods of preparation and processing, which are to be followed during pandemics and are essential in maintenance and endorsement of health and preclusion of diseases.


2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Irina A. Shurygina ◽  
Мichael G. Shurygin ◽  
Lubov V. Rodionova ◽  
Nataliya I. Ayushinova

AbstractObjectivesTo study the expression of growth factors in the regulation of tissue repair after peritoneal damage tissue response to peritoneal damage.MethodsExperimental study in 35 male Wistar rats determining the evolution over time of the tissue response to aseptic peritoneal damage. A standardized bowel and peritoneal lesions were created in the right lower quadrant by laparotomy. Then, tissular expression of growth factors was evaluated by multiplex polymerase chain reaction at seven timepoints between 6 h and 30 days, postoperatively.ResultsTissular responses of granulocyte-stimulating factors (Csf2, Csf3), connective tissue growth factor (Ctgf), epidermal growth factors and receptor (Egf, Egfr), fibroblast growth factors (Fgf2, 7 and 10), heparin binding EGF-like growth factor (Hbegf), hepatocyte growth factor (Hgf), insulin-like growth factor-1 (Igf1), mitogenic transforming growth factors (Tgfa, Tgfb1, Tgfbr3), and vascular endothelial growth factor A (Vegfa) were biphasic with a first expression peak at day 3, followed by a more pronounced peak at day 14.ConclusionsWe observed a long-lasting, widespread response of tissular growth factors for at least two weeks after peritoneal damage. To be clinically effective, the prophylaxis of postoperative adhesions might be needed for an extended period of time.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Swamad ◽  
M K Quraishi ◽  
S Ahmed

Abstract We present an interesting case of a 70-year-old female who presented with haematuria on the suspected cancer pathway. Renal ultrasound showed a vascular renal mass on her right kidney measuring 8x7cm with an unremarkable left kidney. She underwent a laparoscopic radical nephrectomy following confirmation of an 8cm renal mass in the right kidney on the contrasted staging CT scan with a repeat review at the multidisciplinary meeting. Post-operatively a subsequent review of the pre-operative CT and ultrasound scan, showed an incidental large left(contralateral) upper quadrant retroperitoneal fatty mass sized 15x10cm, displacing the stomach and spleen. Further investigation in the form of an MRI Abdomen excluded features of a liposarcoma, resulting in the diagnosis of a large retroperitoneal lipoma. This case highlights the significance of selective attention in imaging interpretation. We believe this to be a prime example of the level of meticulousness required as fat-rich tissues have low attenuation on CT-scans, which can be easily missed out. A cautious multi-clinician interpretation of scans should be performed to avoid missing potentially sinister pathology which would impact patient care dramatically. This case has led to more thorough review of future pre-operative imaging by the operating surgical team.


2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Floris B Poelmann ◽  
Ewoud H Jutte ◽  
Jean Pierre E N Pierie

Abstract Intestinal obstruction caused by pericecal internal herniation are rare and only described in a few cases. This case describes an 80-year-old man presented with acute abdominal pain, nausea and vomiting, with no prior surgical history. Computed tomography was performed and showed a closed loop short bowel obstruction in the right lower quadrant and ascites. Laparoscopy revealed pericecal internal hernia. This is a viscous protrusion through a defect in the peritoneal cavity. Current operative treatment modalities include minimally invasive surgery. Laparoscopic repair of internal herniation is possible and feasible in experienced hands. It must be included in the differential diagnoses of every patient who presents with abdominal pain. When diagnosed act quick and thorough and expeditiously. Treatment preference should be a laparoscopic procedure.


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