THE HARMFUL COMPLICATIONS OF PERIPHERAL NERVES IN NEUROSURGICAL PRACTICE

Проведено исследование 93 пациентов с ятрогенными повреждениями периферических нервов, 11,7% по отношению ко всем оперированным пациентам. Женщин было 51, мужчин 42. Пациенты трудоспособного возраста составили 88%. Позднее обращение за специализированной нейрохирургической помощью составило 53,7%. Чаще всех повреждался седалищный нерв - 29,1%, затем лучевой нерв - 22,6%. Наиболее частые причины ятрогенных осложнений - это операции на опорно-двигательном аппарате (79 - 84,9%). Представлены виды оперативных вмешательств, предложены меры по профилактике и своевременному специализированному лечению больных с ятрогенными повреждениями нервов. Research has been done of 93 patients with iatrogenic injuries of peripheral nerves. It amounted to 11,7 per cent of all patients, who received surgical treatment. In the absolute value, there were 51 men and 42 women in gender equivalent. The significant quantity of working age patients amounts to 88%. 53.7% - it is late referral to specialized neurosurgical care. The volume of sciatic nerve injuries was the largest and amounted to 29,1%, the next a radial nerve - 22,6%. Most common causes of harmful complications there are operations on the musculoskeletal system (79 - 84,9%).The article shows the types of surgery, preventive measures and timely specialized treatment of patients with iatrogenic nerve injuries were proposed

CORRECCIÓN DEL DESPLAZAMIENTO ABOMASAL IZQUIERDO POR VIDEOLAPAROSCOPÍA

Correction of left abomasal displacement by video laparoscopy. This article reviews the benefits of the laparoscopic abomasopexy used for correction and fixation of the left abomasal displacement in dairy cows. The first steps are similar to the conventional technique, with sedation, analgesia and antisepsis. Two small flank incisions were made, the first one is about 10 centimeters ventral to the lumbar transverse processes in the cranial aspect of the left paralumbar fossa, and the second one, more cranial than the other and is located 7 cm ventral to the transverse processes of the lumbar vertebrae in the left 11th intercostal space, these two are the entry points of instruments and optics. This technique allows us to shorten the surgical time, reducing the tissue exposure time, the possibility of intra and post-surgical infections and iatrogenic injuries. Therefore, we saw that the recovery time was shorter; and a quick return to production is guaranteed due to the low use of antibiotics.

Pediatric Sciatic Neuropathy Secondary to Subacute Ischial Osteomyelitis: A Case Report

Sciatic neuropathy (SN) is rarely encountered in the pediatric population. The causes of this mononeuropathy are either infectious, immune mediated, toxic, or infiltrative (tumoral). In this article, we presented the case of a 7.5-year-old male child who presented to the emergency department with a painful right lower limb. Magnetic resonance imaging confirmed the diagnosis of subacute osteomyelitis of the ischium, which extended toward the external hip rotators and infiltrated the tissues around the sciatic nerve. Treatment with intravenous antibiotics (flucloxacillin 50 mg/kg/d and gentamicin 10 mg/kg/d) rapidly improved the child's condition and relieved neurological symptoms within a few days. Traumatic and iatrogenic injuries are the most common causes for SN. To our knowledge, this presented case is the first to describe SN due to an infectious process following subacute osteomyelitis.

Iatrogenic Injuries in Manual and Mechanical Cardiopulmonary Resuscitation

Purpose Mechanical chest compression has been shown to be equivalent to manual chest compression in providing survival benefits to patients experiencing cardiac arrest. There has been a growing need for a contemporary review of iatrogenic injuries caused by mechanical in comparison with manual chest compression. Our study aims to analyze the studies that document significant life-threatening iatrogenic injuries caused by mechanical and manual chest compression. Methods A systematic review of PubMed and Embase was performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. All studies published after January 1st, 2000 were reviewed using inclusion/exclusion criteria and completed by May 2020. A total of 7202 patients enrolled in 15 studies were included in our meta-analysis. Results Significant life-threatening iatrogenic injuries had higher odds of occurring when mechanical chest compression was used compared to manual chest compression, especially for hemothorax and liver lacerations. Mechanical chest compression involves consistently deeper compression depths compared to manual chest compression, potentially resulting in more injuries. In the mechanical chest compression cohort, chest wall fractures had the highest incidence rate (55.7%), followed by sternal fracture (28.3%), lung injuries (3.7%), liver (1.0%), and diaphragm (.2%) lacerations. Conclusions Mechanical chest compression was associated with more iatrogenic injuries as compared to manual chest compression. Further research is needed to define the appropriate application of mechanical in comparison with manual chest compression in different scenarios. Levels of provider training, different mechanical chest compression device types, patient demographics, and compression duration/depth may all play roles in influencing outcomes.

ENDOSCOPIC CORRECTION OF IATROGENIC TRACHEA INJURIES IN SMALL PETS

Today, the veterinarian is increasingly in veterinary practice began to use new modern technologies for the treatment of small pets, using modern equipment for medical manipulations. At present, a modern operating room can no longer be imagined without a ventilator and a device for giving inhalation anesthesia. But, even new modern equipment and modern drugs for performing anesthesia cannot protect against medical errors. One of the most important manipulations is the ability to correctly place the endotracheal tube to perform resuscitation or give inhalation anesthesia. The percentage of iatrogenic injuries during this procedure reaches 2.5 % and is complicated by bleeding and blood aspiration, which requires emergency assistance, primarily with the use of endosoepic technologies.

Rupture of a superficial temporal artery pseudoaneurysm following craniotomy

Pseudoaneurysm of the superficial temporal artery (STA) is a rare entity that has been reported in the literature after trauma or iatrogenic injuries. We describe a unique case of STA pseudoaneurysm rupture and the clinical sequelae associated with its rupture. We report a case of pseudoaneurysm rupture of the STA that occurred 14 days after craniotomy for cerebrospinal fluid leak repair. We also review the literature, diagnosis and treatment of external carotid artery aneurysms. Rupture of a STA pseudoaneurysm is a previously unreported and serious complication that must be quickly recognized in order to control hemorrhage that may have life threatening complications.

Litigation in Anesthesia and Intensive Care Units: An Italian Retrospective Study

Anesthesiologists consider professional insurance and its medico-legal problems as a remarkable aspect of their job. “Associazione Anestesisti Rianimatori Ospedalieri Italiani—Emergenza ed Area Critica” (AAROI-EMAC) is the Italian professional association of anesthesiologists and intensivists that works to train its subscribers on safety measures. This is a retrospective observational study on an insurance complaints database for anesthetic accidents that result in injuries to patients. The analyzed period runs from 1 January 2014 to 31 December 2016. A total of 1309 complaints related to 873 insurance claims were analyzed. Criminal complaints comprised 805 (64.4%) of the total, and civil complaints were 445 (35.6%). The iatrogenic damage claimed included: death (58% of the cases); peripheral nerve damage (8%); spinal cord injuries (5%); unspecified injuries (7%); dental damage (4%); infections (3%); needing second surgical procedure (2%); and other injuries (13%). There is a statistical significance between the size of the hospital and the number of the claims: small hospital complaints comprised 40.1% of the cases, while complaints against medium-sized and large hospitals constituted 20.6% of the cases (χ2GL = 8 = 39.87, p = 0.00). In Italy, anesthesiologists and intensivists are often involved in litigation even when they are not directly responsible for iatrogenic injuries, and the most frequent claims in ICU are related post-operative complications.

Intraperitoneal migration of a hookwire following wide local excision of a breast lesion presenting as a spontaneous pneumothorax

Hookwire migration is a rare complication of wide local excision surgery for breast neoplasia. We report the case of a 64-year-old woman who presented to hospital with acute on chronic left upper quadrant and left scapular pain. She had undergone a hookwire-guided wide local excision of a right breast neoplasm 5 years previously. Her vital signs, clinical examination and blood test were unremarkable. A CT scan revealed a left-sided pneumothorax and a 20 cm metallic intraperitoneal foreign body transpiercing the diaphragm. A review of the patient’s clinical record revealed that she experienced a vagal collapse during hookwire implantation. This article underlines the importance of clear communication between members of a multidisciplinary team involved in a staged surgical intervention and exemplifies that foreign bodies can migrate across large distances, sometimes against gravity, to cross multiple anatomical compartments and cause iatrogenic injuries multiple years after an index intervention

ANATOMY OF ANSA CERVICALIS AND ITS VARIATIONS

BACKGROUND: The ansa cervicalis is usually used to re-innervate the larynx following recurrent laryngeal nerve paralysis in thyroid cancer, oesophageal cancer following lymphadenectomy. Variations have previously been reported on the formation and branching pattern of the ansa cervicalis loop. Objectives: The present study aimed to record anatomical variations of the formation of loop and branches of ansa cervicalis. The study was done in Anatomy depa METHODS: rtment, Assam Medical College, Dibrugarh, Assam. 30 numbers (15 cadaver x 2) of ansa cervicalis were studied. A thorough morphological study was done and the results were recorded. RESULTS: Normal anatomy & variations, if any, of the ansa cervicalis were noted and discussed with previous studies. CONCLUSION: Surgical procedures such as thyroplasty, arytenoid adduction, nerve-muscle pedicle implantation had been reported to cause iatrogenic injuries to the ansa cervicalis. Knowledge of the arrangement of loops and branches of the ansa cervicalis will be helpful for planning a safe surgery in the neck region.