Diaphragmatic hernia - Case series and Literature review

Objectives: Infrapopliteal arterial pseudoaneurysms (IAP) following blunt trauma with associated orthopedic injuries are uncommon, often present in a delayed fashion, and encompass a diagnostic and therapeutic dilemma. Herein, we present a series of IAPs that were diagnosed following blunt trauma and their management. Methods: Case series consisting of 3 patients and a review of the international literature. Results: Our case series included 3 patients presenting with IAPs following blunt trauma with associated orthopedic injuries. They were all identified in a delayed manner (>3 weeks) after the orthopedic injuries were treated. All patients presented with pain and a pulsatile mass while one concurrently had neurologic deficits. The pseudoaneurysms were diagnosed by duplex ultrasound and confirmed by angiography to be originating from the tibioperoneal trunk, anterior tibial, and posterior tibial arteries respectively. Two patients were treated with surgical excision. Of these, one required an arterial bypass procedure while the other underwent direct ligation only. The third patient was treated by endovascular coiling. A literature review from 1950 to the present found 51 reported cases of IAP resulting from blunt trauma. Ninety percent of trauma-related infrapopliteal injuries occurred in men with a mean delay in diagnosis of 5.6 months (median 1.8 months) after injury. Since 1950, management has shifted from primarily ligation to incorporating minimally invasive endovascular techniques when appropriate. Conclusions: Infrapopliteal artery pseudoaneurysms are rare following blunt skeletal trauma. A delay in diagnosis often occurs and can result in major morbidity and extensive surgical intervention. We recommend a high index of suspicion and a thorough vascular examination in patients with lower extremity skeletal trauma to help identify and treat these injuries early and effectively.

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Recurrence in long-term survivor of anti-MDA5 antibody-positive clinically amyopathic dermatomyositis: case series and literature review

Modern Rheumatology Case Reports ◽

10.1080/24725625.2021.1886666 ◽

2021 ◽

pp. 1-10

Author(s):

Satoshi Suzuki ◽

Keigo Ikeda ◽

Ken Yamaji ◽

Naoto Tamura ◽

Shinji Morimoto

Keyword(s):

Literature Review ◽

Case Series ◽

Amyopathic Dermatomyositis ◽

Clinically Amyopathic Dermatomyositis ◽

Term Survivor

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Clinical Spectrum of Uveitis Induced by Herpes Simplex Virus with Posterior Pole Involvement at Initial Presentation: A Case Series and Literature Review

Ocular Immunology and Inflammation ◽

10.1080/09273948.2021.1961814 ◽

2021 ◽

pp. 1-8

Author(s):

Feng Hu ◽

Haicheng She ◽

Xusheng Cao ◽

Jiawei Wang ◽

Caixia Lin ◽

...

Keyword(s):

Herpes Simplex Virus ◽

Herpes Simplex ◽

Literature Review ◽

Case Series ◽

Posterior Pole ◽

Initial Presentation ◽

Clinical Spectrum ◽

Simplex Virus

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Endovascular and medical therapy of May–Thurner syndrome: Case series and scoping literature review

JMV-Journal de Médecine Vasculaire ◽

10.1016/j.jdmv.2021.02.004 ◽

2021 ◽

Vol 46 (2) ◽

pp. 80-89

Author(s):

M.C. Montes ◽

J.P. Carbonell ◽

J.E. Gómez-Mesa

Keyword(s):

Literature Review ◽

Medical Therapy ◽

Case Series ◽

Scoping Literature Review

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Congenital Diaphragmatic Hernia: Demographics and 30-day Outcomes in Adults

The American Surgeon ◽

10.1177/0003134820960061 ◽

2020 ◽

pp. 000313482096006

Author(s):

Joseph G. Brungardt ◽

Quinn A. Nix ◽

Kurt P. Schropp

Keyword(s):

Postoperative Complications ◽

Congenital Diaphragmatic Hernia ◽

Diaphragmatic Hernia ◽

Pediatric Population ◽

Case Series ◽

National Database ◽

Improvement Program ◽

American College Of Surgeons ◽

Postoperative Diagnosis ◽

Acs Nsqip Database

Background Congenital diaphragmatic hernia (CDH) is a pathology most often affecting the pediatric population, although adults can also be affected. Few studies exist of adults undergoing repair of this defect. Using a national database, we sought to determine demographics and outcomes of this population. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015-2018) was performed, capturing patients with postoperative diagnosis of CDH, distinct from ventral hernia. Two groups were created based upon surgical approach of open or minimally invasive (MIS) repair. Baseline demographics and outcomes were compared. Results 110 patients undergoing surgical correction of CDH were captured in the database. We found rates of return to the operating room (4.55%), postoperative respiratory failure (5.45%), and reintubation (3.64%) with no difference between groups. There was no mortality and no difference between groups in length of operation, discharge to home, or postoperative complications. Patients undergoing open repair had a longer length of stay than patients in the MIS group (6.47 ± 10.76 days vs. 3.68 ± 3.74 days, P = .0471). Mesh was used in MIS more often than the open group (47.30% vs. 5.56%, P < .0001). Discussion This study describes rates of postoperative complications in patients undergoing repair of CDH, and suggests outcomes those are equivalent between patients receiving open or MIS approaches. Further case series or retrospective studies are needed to further describe this population of patients.

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