11/204. Therapy of iatrogenic subglottic stenosis: a steroid/antibiotic regimen.The authors have evaluated the efficacy of a medical regimen, consisting of systemic antibiotics and steroids, in the management of acute iatrogenic subglottic stenosis. The study consisted of the infliction of a standardized subglottic injury to three groups of five dogs: Group I animals were placed on prednisone 1 mg/kg/24 hours and potassium phenoxymethyl penicillin 50 mg/kg/24 hours from the day of the trauma. Group II were placed on a similar regimen from the eighth day after subglottic trauma. Group III received no medical therapy at all. Therapy was continued in treated Groups I and II for five weeks. At the end of the study the dogs were sacrificed and the final degree of subglottic stenosis evaluated, at which time the laryngotracheal complexes were submitted for pathological evaluation. A significant difference was found between the degree of stenosis attained in the three groups. The study suggests that the introduction of a steroid/antibiotic regimen has a beneficial effect in developing subglottic stenosis and that the timing of such therapy is of importance.- - - - - - - - - - ranking = 1keywords = injury, trauma (Clic here for more details about this article) |
12/204. subclavian artery injury following percutaneous insertion of dialysis catheter.Iatrogenic subclavian artery injury is a rare but recognized complication of central venous catheterization. The lesion is more severe and complex to treat when produced by large catheters such as dialysis catheters. A case is presented below with a discussion of vascular access for renal replacement therapy and the principles of treating penetrating arterial trauma at this location.- - - - - - - - - - ranking = 4.9526578205327keywords = injury, trauma (Clic here for more details about this article) |
13/204. Iatrogenic ulnar nerve injury after percutaneous cross-pinning of supracondylar fracture in a child.Supracondylar fracture of the humerus is the most common fracture of the elbow in children and has been treated by a variety of methods. Recently, stabilization of reduced fractures with percutaneous pin fixation has become the accepted method of treatment. ulnar nerve injury is a complication of percutaneous pinning of supracondylar fractures, although many authors have reported that it resolves spontaneously after removal of the pin.- - - - - - - - - - ranking = 4.9473975783696keywords = injury (Clic here for more details about this article) |
14/204. Emergency portacaval shunt for control of hemorrhage from a parenchymal fracture after adult-to-adult living donor liver transplantation.As more adults undergo transplantation with partial liver grafts, the unique features of these segments and their clinical significance will become apparent. A patient presented with life-threatening hemorrhage from an iatrogenic laceration to a right lobe graft 11 days after transplantation. The creation of a portacaval shunt effectively controlled the bleeding, allowing more elective replacement of the organ with another right lobe graft. The regeneration process combined with increased portal blood flow and relative outflow limitation may have set the stage for this complication. Any disruption of the liver parenchyma during transplantation should be securely repaired and followed cautiously. Portacaval shunting is an option for controlling hemorrhage from the liver in transplant recipients. The timely availability of a second organ was likely the ultimate determinant of survival for this patient.- - - - - - - - - - ranking = 0.32515399325134keywords = laceration (Clic here for more details about this article) |
15/204. Laparoscopic repair of a chronic diaphragmatic hernia.Diaphragmatic injuries that remain undetected after an acute traumatic event may lead to the formation of a diaphragmatic hernia. Symptoms of a chronic diaphragmatic hernia are related to the incarceration of abdominal contents in the defect or to impingement of the lung, heart, or thoracic esophagus by abdominal viscera. A 49-year-old woman with a symptomatic chronic diaphragmatic hernia from an unrecognized iatrogenic injury to the left hemidiaphragm sought treatment. The diaphragmatic injury occurred 2 years earlier when a low, left-sided chest tube was placed for a persistent pleural effusion 2 weeks after a lower lobectomy for an aspergilloma. The patient's diaphragmatic hernia was diagnosed after an upper gastrointestinal series and an esophagogastroduodenoscopy. Approximately 75% of her stomach was incarcerated in the diaphragmatic defect. The diaphragmatic hernia was repaired laparoscopically using a 9 cm x 10-cm polytetrafluoroethylene patch sewn with nonabsorbable, interrupted, horizontal mattress sutures. Improvement of video technology, laparoscopic instruments, and surgical skills has allowed surgeons to expand the boundaries of advanced therapeutic laparoscopy. These factors facilitated the authors' standard tension-free prosthetic repair of a chronic diaphragmatic hernia using minimally invasive techniques.- - - - - - - - - - ranking = 1.9842192735109keywords = injury, trauma (Clic here for more details about this article) |
16/204. Permanent iatrogenic vocal cord paralysis after I-131 therapy: a case report and literature review.A patient who underwent I-131 therapy for a solitary toxic thyroid nodule subsequently experienced vocal cord paralysis, a rare complication. The patient was examined because of hoarseness 1 week after treatment. Indirect laryngoscopy at the time confirmed right vocal cord paralysis. When the examination was repeated in 6 months, no improvement was noted; vocal cord paralysis was then declared permanent. Surprisingly, 11 months after the onset of symptoms, the patient observed improvement in her voice. At 14 months, she experienced complete vocal recovery. However, a computed tomography performed after this showed that her right vocal cord paralysis was unresolved. The apparent complete recovery of her voice is believed to be a result of adaptive compensatory mechanisms. patients who recover from hoarseness after injury to the recurrent laryngeal nerve should have cord function documented by indirect laryngoscopy or other means before the physician performs a procedure that could harm the contralateral nerve, because damage to this nerve could result in devastating consequences.- - - - - - - - - - ranking = 0.98947951567392keywords = injury (Clic here for more details about this article) |
17/204. Iatrogenic arteriovenous fistula in a renal allograft: the result of a TAD guidewire injury.A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed.- - - - - - - - - - ranking = 3.9579180626957keywords = injury (Clic here for more details about this article) |
18/204. Iatrogenic burn caused by an alcohol lamp.Iatrogenic injury is an intrinsic risk of all medical procedures. Various kinds of iatrogenic complications have been extensively reported and recognized. Two patients were referred to the Prince of wales Hospital for iatrogenic flame burn caused by the breakage of an alcohol lamp during ENT examination. They were 8 and 9 years old and sustained 12 and 17% intermediate to deep dermal burns respectively. There was no eye or inhalation injury. They were treated initially at the referring hospital. Despite having the best possible treatment, the parents were hostile to and demanding of the medical attendants and the patients were uncooperative throughout the whole treatment period. rehabilitation of the two children was jeopardized. The situation was very difficult when they were first seen at the Prince of wales Hospital. The burn surgeon at the Prince of wales Hospital, as a third party, managed to act as a bridge between the referring hospital and the patients and their families. Several meetings were held and the best interests of the two patients was addressed. The compensation issue was also settled without formal legal prosecution.- - - - - - - - - - ranking = 1.9789590313478keywords = injury (Clic here for more details about this article) |
19/204. Iatrogenic lesions of the colon and rectum.Our ability to document a number of examples of iatrogenic lesions of the colon and rectum in three general hospitals confirms the multiplicity of these lesions as presented in the literature. It appears that the careful surgeon and his associates would well heed the old admonition known as Murphy's law, that "Anything that can go wrong will go wrong." In the daily practice of the general surgeon and proctologist, it is apparent that gentleness in approaching any anal-rectal examination for either diagnostic or therapeutic purposes is mandatory. The insertion of any foreign object, be it an examining finger, a thermometer, enema tip, or proctoscope, may subject the patient to an inadvertent injury of significant proportion. The dangers inherent in the evaluation and treatment of patients with recognized disease processes is significantly greater than that associated with routine and screening examinations. morbidity and mortality have been shown to be associated with the barium enema as well as with the barium enema as well as with some of the newer radiologic procedures such as mesenteric angiography. The use of tap water for enemas has produced morbidity both from thermal injuries and from electrolyte depletion. Antibiotics and chemotherapeutic drugs frequently result in colon and rectal disease, and therapeutic procedures directed at organs adjacent to the colon and rectum have resulted in a number of iatrogenic lesions. This reviews confirms reports of others that iatrogenic lesions of the colon and rectum are not solely due to the physician's inexperience, as significant numbers of these lesions were the result of the diagnostic or therapeutic efforts of men of considerable experience and skill. Advanced age of the patient and diseases leading to changes in the character of the bowel wall frequently were factors in the production of these lesions. A poorly prepared bowel has led to increased morbidity and mortality associated with iatrogenic perforations. The early recognition of these lesions and prompt medical and surgical management diminishes both the morbidity and mortality associated with such injuries.- - - - - - - - - - ranking = 0.98947951567392keywords = injury (Clic here for more details about this article) |
20/204. Litigation of laparoscopic major vessel injuries in canada.This study is a review of conditions and circumstances associated with 15 injuries to great vessels during laparoscopic surgery. Thirteen cases were litigated in canada and two occurred in the author's operating room. Body habitus may have been an underlying factor in the injuries. Most injuries were entry related and independent on complexity of surgery. One was caused by the Veress needle and one by a secondary trocar, and three occurred during dissection of adhesions. Ten were primary trocar injuries, 9 after pneumoperitoneum and 1 at direct trocar insertion. Of these, five were caused by reusable and five by disposable trocars with so-called safety shields. In 6 of 15 cases recognition of the injury was delayed; 5 in the recovery room. Eleven women had uncomplicated recovery. Of 13 litigated cases, 8 (62%) resulted in settlement.- - - - - - - - - - ranking = 0.98947951567392keywords = injury (Clic here for more details about this article) |
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