scholarly journals Posttraumatic Atlantoaxial Rotatory Dislocation in a Healthy Adult Patient: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Giuseppe Maida ◽  
Eleonora Marcati ◽  
Silvio Sarubbo
Keyword(s):  
Ct Scan ◽  
Healthy Adult ◽  
Rare Complication ◽  
Radiographic Evaluation ◽  
Review Of The Literature ◽  
Rotatory Dislocation ◽  
Surgical Fusion ◽  
Cord Injury ◽  
Neurologically Intact ◽  
Atlantoaxial Rotatory Dislocation

Atlantoaxial rotatory dislocation (AARD) is a rare complication in adults usually leading to pain, spinal cord injury, or death. Clinical and radiological diagnosis is difficult and often delayed. We report a rare case of posttraumatic AARD in a neurological intact 27-year-old male in which initial radiographic evaluation was negative. A computed tomography (CT) scan was promptly done because the patient showed a severe torticollis. Therefore, early diagnosis, immobilisation, and surgical fusion and arthrodesis were performed. After surgery, cervical pain and torticollis were resolved and the patient remained neurologically intact with a CT scan documentation of fusion at the 3-year followup.

scholarly journals Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meta Analysis ◽  
Treatment Options ◽  
Palliative Surgery ◽  
Review Of The Literature ◽  
Colovesical Fistula ◽  
Level Of Evidence ◽  
Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

Delayed leukoencephalopathy from suspected polymer embolism after neuroendovascular procedures

2021 ◽  
pp. 197140092110291
Author(s):  
Thomas Mellemkjær ◽  
Ronil V Chandra ◽  
Lasse Speiser ◽  
Benedicte P Ulhøi ◽  
Claus Z Simonsen
Keyword(s):  
Polymer Material ◽  
Endovascular Procedures ◽  
Rare Complication ◽  
Diagnostic Process ◽  
Line Treatment ◽  
Review Of The Literature ◽  
First Line ◽  
Stroke Treatment ◽  
Oral Glucocorticoids ◽  
First Line Treatment

As the neurointervention field grows, a new side effect emerges. Delayed leukoencephalopathy (DL) is believed to be an inflammatory or allergic reaction to polymer material that is shed from catheters during endovascular procedures. We present four cases of DL after aneurysm treatment in two patients, endovascular stroke treatment and diagnostic arteriography. We present our diagnostic process, including biopsy results in two patients, our anti-inflammatory treatment and outcomes together with a review of the literature. In our series, prognosis was variable with ongoing seizures in two patients. Our literature review reveals that asymptomatic shedding of polymer material is common, occurring in a third of endovascular stroke procedures, whereas symptomatic DL occurs in <0.5% of therapeutic neuroendovascular procedures. Clinicians should be aware of this rare complication, and oral glucocorticoids seem to be a reasonable first-line treatment strategy.

Diurnal Blood Pressure Variation in Quadriplegic Chronic Spinal Cord Injury Patients

1991 ◽  
Vol 80 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Henry Krum ◽  
William J. Louis ◽  
Douglas J. Brown ◽  
Graham P. Jackman ◽  
Laurence G. Howes
Keyword(s):  
Blood Pressure ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Ambulatory Monitoring ◽  
Pressure Variation ◽  
Night Time ◽  
Cord Injury ◽  
Blood Pressure Variation ◽  
Neurologically Intact

1. Measurement of blood pressure and heart rate over a 24 h period was peformed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

Neuropathic pain syndrome as an occult manifestation of injury of the spinal cord after surgical repair of aortic coarctation

2000 ◽  
Vol 10 (4) ◽  
pp. 413-415 ◽  
Author(s):  
Luc M Beauchesne ◽  
Angela Mailis ◽  
Gary D Webb
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Rare Complication ◽  
Pain Syndrome ◽  
Neuropathic Pain Syndrome ◽  
Cord Injury ◽  
Unusual Symptoms ◽  
Arterial Branch

AbstractInjury to the spinal cord injury with paraplegia, is a rare complication of surgical repair of aortic coarctation recognized immediately post-operatively. We present the case of a 41-year-old male undergoing surgery for restenosis at the site of a repair. Intra-operatively, he suffered inadvertent injury to an intercostal arterial branch during isolation of the aorta below the graft. Over the following months, he developed unusual symptoms involving the legs and genitourinary tract which, only after extensive investigations, were attributed to ischemic damage to the spinal cord related to the surgery. We suspect that similar syndromes reflecting injury to the spinal cord injury may be unrecognized following surgical repair of coarctation.

scholarly journals 782 A Rare Complication in A Post-Operative Bariatric Patient: COVID-19 Induced Mesenteric Venous Thrombosis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Winstanley ◽  
M Goodfellow
Keyword(s):  
Gastric Bypass ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Acute Abdominal Pain ◽  
Myeloproliferative Neoplasms ◽  
Rare Complication ◽  
Nasopharyngeal Swab ◽  
Thrombotic Complications ◽  
Tract Infections ◽  
Mesenteric Thrombosis

Abstract Introduction The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has provided enormous challenges in the delivery of surgical care. In addition to respiratory tract infections, coronavirus disease 2019 (COVID-19) is associated with both arterial and venous thrombotic complications. Case Details: We present a case of acute superior mesenteric venous (SMV) thrombosis in a 36-year-old female patient who underwent Roux-en-Y gastric bypass three years previously. Her presentation with acute abdominal pain occurred 6 days after a positive nasopharyngeal swab. An admission CT scan demonstrated an abrupt cut off in the proximal SMV with resultant small bowel oedema. Subsequent thrombophilia screening and mutation testing for myeloproliferative neoplasms were all negative. She had also previously carried three pregnancies to term without any thrombotic complications. Hence, the high suspicion of acute COVID-19 induced mesenteric thrombosis. Conclusions In patients who have previously undergone Rouy-en-Y gastric bypass and lost significant weight, acute abdominal pain normally raises a high suspicion of internal hernia. However, as the pandemic progresses surgeons need to be mindful of COVID-19 induced mesenteric thrombosis as a differential diagnosis during the workup of acute abdominal pain. This was well demonstrated on a CT scan with intravenous contrast.

PS01.105: PANCREATITIS IN THE ESOPHAGEAL ECTOPIC PANCREAS: A RARE CONDITION WITH DIFFERENT PRESENTATIONS! TREATMENTS AND REVIEW OF THE LITERATURE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 79-79
Author(s):  
Sergio Szachnowicz ◽  
Rubens Sallum ◽  
Hilton Libanori ◽  
Edno Bianchi ◽  
Andre Duarte ◽  
...  
Keyword(s):  
Chest Pain ◽  
Ct Scan ◽  
Acute Inflammation ◽  
Conflicts Of Interest ◽  
Gastroesophageal Junction ◽  
Elevated Serum ◽  
Pancreatic Tissue ◽  
Ectopic Pancreas ◽  
Esophageal Wall ◽  
Review Of The Literature

Abstract Background Ectopic pancreas is an extremely rare genetic malformation in the esophagus. It is defined by pancreatic tissue outside the pancreas and usually presents as a subepithelial lesion in the esophagus. To date, there are fewer than 15 patients reported in the literature. Methods We present 2 cases of pancreatitis in the esophageal ectopic pancreas with different presentation, treatment and development, as well as a review of the literature. Results 1. A 48-year-old woman admitted to the ER with acute dysphagia and chest pain. There were elevation of amylasemia and lipasemia, as well as presence of a tumor in the Gastroesophageal junction with hypersignal at the CT scan, suggesting acute inflammation. An echoendoscopy with biopsy, diagnosed ectopic pancreas in the distal esophagus. The patient was then submitted to laparoscopic resection of subepithelial tumor of the cardia, recovered by a fundoplication. The specimen confirmed pancreatic tissue with acute inflammation. 2. A 33-year-old woman with a history of episodic chest pain confused with GERD, nausea and vomiting pain episodes accompanied by elevated serum amylase and lipase levels. She was submitted to an ERCP without alterations to investigate the clinical complains. After some crisis she was hospitalized with a septic condition, where a CT scan revealed a cystic lesion in the lower mediastinum in the esophageal wall. Endoscopy was performed, showing a drainage orifice with purulent secretion in the cardia. She was treated with antibiotics and fasting. She had two more crises and was referred to our specialized service. Thoracoscopic subtotal esophagectomy with cervical anastomosis was performed for treatment of a suspected esophageal duplication cyst with recurrent infections. The specimen showed the presence of organized pancreatic tissue characterizing ectopic pancreas complicated with chronic pancreatitis. Conclusion The ectopic esophageal pancreas can be present as a differential of these lesions. The second case, was first admitted at a secondary care unit and the diagnosis was delayed, probably leading to a worse development and necessity of a esophagectomy. In the literature, there is only one description of 1 case of recurrent pancreatitis. We have shown that complications can range from dysphagia to abscess, requiring more invasive treatment. Disclosure All authors have declared no conflicts of interest.

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