1/2926. Recurrent abdominal abscess secondary to a dropped laparoscopic clip: CT imaging. Since being introduced in 1987, laparoscopic cholecystectomy has quickly become the treatment of choice for symptomatic gallstone disease. Computed tomography is an excellent method to evaluate the laparoscopic patient in whom postoperative complication is suspected. ( info) |
2/2926. Intraluminal duodenal diverticulum in a child: incidental onset possibly associated with the ingestion of a foreign body. Funnel-type intraluminal duodenal diverticulum (windsock web) is a rare congenital malformation. A 4-year-old boy with vomiting and abdominal pain for several weeks was referred to the hospital. A plain abdominal X-ray on admission disclosed a double bubble sign. Abdominal echography and CT disclosed a foreign body lodged in the alimentary tract. After the foreign body was removed with a fibrescope, endoscopy showed a stenotic descending portion where the foreign body was located. An upper gastro-intestinal contrast study demonstrated a post-bulbar duodenal stenosis with a barium-filled pear-shaped sac in the descending portion of the duodenum. Surgical exploration was done under the diagnosis of windsock web of the duodenum. A simple excision of the web at its base was carried out. A hole 7 mm in diameter was found at the edge of the web. The microscopic appearance of the resected specimen was characterized by the duodenal mucosa with an extensive chronic inflammation lining both sides of the diverticulum and the lack of muscular layer of mucosa. CONCLUSION: If an ingested material is not excreted in the stool, possible clogging in the intestinal tract should always be considered and a further intensive examination is warranted. ( info) |
3/2926. liver abscess secondary to fish bone penetration of the gastric wall: a case report. An unusual case of liver abscess caused by fish bone perforation of the stomach is presented in this report. A 65-year-old woman was admitted to the Far Eastern Memorial Hospital for abdominal pain, fever and chills. physical examination revealed anemia and tenderness in the epigastrium. Laboratory data showed leukocytosis and abnormal liver function. Computerized tomography of the abdomen disclosed a huge abscess in the left lobe of the liver. Exploratory laparotomy was performed and a fish bone, 3.7 cm in length, was found perforating the stomach with penetration into the left lobe of the liver, resulting in a hepatic abscess. drainage of the liver abscess with removal of the fish bone and simple closure of the gastric perforation were performed. The patient recovered uneventfully. ( info) |
4/2926. Caterpillars: an unusual source of ingestion. PURPOSE: To describe a series of patients seen in a pediatric emergency department with adverse effects following an ingestion of a caterpillar. methods: Case series. RESULTS: Ten patients presented to the emergency department following ingestion of a caterpillar. Adverse effects ranged from drooling and refusal to drink to diffuse urticaria. Six patients were admitted and five underwent direct laryngoscopy and bronchoscopy in the operating room. None of the 10 patients had an adverse outcome. CONCLUSIONS: Previously not described, significant adverse effects can occur following ingestion of a caterpillar. In addition, although not previously reported, the caterpillar of the Hickory Tussock moth can cause adverse effects in humans. ( info) |
5/2926. Technique of removal of an impacted sharp object in a penetrating head injury using the lever principle. Penetrating head injuries can be difficult to manage as the extensive surgery which may be required can result in severe morbidity and mortality in some patients. A conservative surgical approach with a "pull and see" policy was adopted successfully in a described case. Extraction can be achieved by using the mechanical advantage of the lever principle. By this method while removing the object any movements of sharp edges which will cause secondary damage can be reduced to a minimum. ( info) |
6/2926. Shortening of a unit rod protruding into the hip joint: case report and description of a surgical technique. A unit rod is a well-accepted method of posterior spinal instrumentation in patients with cerebral palsy (CP). Several types of complications after the use of a unit rod were reported, including penetration through the medial wall of the pelvis. A patient who underwent anterior and posterior spinal fusion with unit-rod instrumentation was found to have penetration of the unit rod into a dysplastic hip joint. The pelvic limb of the rod was shortened with a burr through an anterolateral approach to the iliac bone. This procedure was associated with a lower blood loss than was previously reported for revisions of unit rods. There was no need for hardware removal and therefore no loss of correction. The unit rod may be shortened before surgery to prevent this problem. The described procedure is a simple way of correcting penetration of a unit-rod limb into the hip joint. ( info) |
7/2926. Unusual case of Munchausen's syndrome: factitious vesical lithiasis. We report an uncommon case of a 38-year-old woman who admitted for bladder lithiasis undergoing repeated surgical management and being apparently recurrent. The intravenous pyelography and retrograde urethrocystography clear the urinary tract. Biologic evaluation eliminates any metabolic or endocrine cause. The confirmation of a factitious origin is given by fluorescence X analysis of the extracted stones which conclude to calcium carbonate structure and psychiatric care. The self-intromission of these calculi into the bladder is due to the personality disorder being in the frame of Munchausen's syndrome. Two years later, no recurrence is noted and an excellent psychiatric care is achieved. ( info) |
8/2926. Hepatic abscess due to gastric perforation by ingested fish bone demonstrated by computed tomography. Perforation of the gastrointestinal tract by ingested foreign bodies is rare. Preoperative diagnosis of complications due to foreign bodies in the gastrointestinal tract can rarely be achieved because the conventional radiographic appearance is nonspecific. This report describes a 69-year-old woman who presented with vague clinical manifestations, intermittent abdominal pain, and low-grade fever. Hepatic abscess, secondary to a foreign body penetrating the gastric wall, was diagnosed preoperatively using computed tomography findings. On exploration, the foreign body turned out to be a fish bone. The abscess was confirmed and drained during surgery and a partial gastrectomy was performed. This case illustrates the value of CT in the evaluation of this condition. ( info) |
9/2926. Cervical spondylodiscitis after removal of a fishbone. A case report. STUDY DESIGN: A case report of cervical spondylodiscitis after removal of a lodged fishbone. OBJECTIVES: To present a rare case of cervical spondylodiscitis and to inform the readers that a lodged fishbone can give rise to this complication after its removal. SUMMARY OF BACKGROUND DATA: In the literature, only one mention of this complication was found. methods: The literature, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Prolonged antibiotic treatment and immobilization of the cervical spine resulted in a cure of the spondylodiscitis. CONCLUSIONS: After removal of a lodged fishbone, a cervical spondylodiscitis is possible, but this is a very rare complication. In this patient, conservative treatment resulted in a cure of the infection. Successive magnetic resonance imaging investigations showed the extent of the destruction of the vertebral bodies and disc very well, as well as the curation of the spondylodiscitis after 5 months. ( info) |
10/2926. Use of rigid hysteroscope for extraction of foreign bodies embedded in lower urinary tract. PURPOSE: To introduce the use of the 20F rigid hysteroscope in urologic procedures. MATERIALS AND methods: The 20F hysteroscope was used to remove deeply embedded foreign bodies from the lower urinary tract of three patients in whom previous attempts with standard cystoscopic equipment were unsuccessful. RESULTS: In all three cases, the hysteroscope easily passed into the urethra and with the use of rigid instruments was able to remove the foreign bodies without complication. CONCLUSION: Situations may arise when the removal of embedded foreign bodies is not possible with standard cystoscopic equipment. The hysteroscope, which is available in most operating rooms, was able to extirpate even deeply embedded foreign bodies. ( info) |