scholarly journals Spontaneous Postmenopausal Urethral Prolapse Treated Surgically and Successfully

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
I. Klein ◽  
Y. Dekel ◽  
A. Stein
Keyword(s):  
African American ◽  
Surgical Management ◽  
Surgical Approach ◽  
Medical Management ◽  
Rare Condition ◽  
Caucasian Woman ◽  
Urethral Prolapse ◽  
External Meatus

Urethral prolapse (UP) is a circular complete eversion of the distal urethral mucosa through the external meatus. It is a rare condition seen mostly in African-American premenarcheal girls. Both a medical and a surgical approach to this condition have been described. We present a case of a spontaneous urethral prolapse in a 60-year-old postmenopausal Caucasian woman, who failed medical management and underwent successful surgical management. The patient is asymptomatic 18 months following the procedure.

Free-Floating Thrombus in the Distal Internal Carotid Artery Causing a Stroke

2020 ◽  
Author(s):  
Spyros Papadoulas ◽  
Konstantinos Moulakakis ◽  
Natasa Kouri ◽  
Petros Zampakis ◽  
Stavros K. Kakkos
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Medical Management ◽  
Internal Carotid ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Residual Stenosis ◽  
Floating Thrombus ◽  
Distal Internal Carotid Artery ◽  
Carotid Bulb

AbstractWe present a patient suffering from a stroke with a free-floating thrombus extending up to the distal internal carotid artery. The thrombus was totally resolved after a 2-week anticoagulation regimen without leaving behind any severe residual stenosis in the carotid bulb. The optimal treatment of this rare condition remains uncertain. We report some important treatment strategies that have been used in the literature, emphasizing the anticoagulation as the mainstay of therapy. Immediate surgical and interventional manipulations carry the risk of thrombus dislodgement and embolization and should be considered if there are recurrent symptoms despite medical management.

scholarly journals Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001440
Author(s):  
Shameer Khubber ◽  
Rajdeep Chana ◽  
Chandramohan Meenakshisundaram ◽  
Kamal Dhaliwal ◽  
Mohomed Gad ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Surgical Management ◽  
Medical Management ◽  
Cox Regression ◽  
Artery Bypass ◽  
Management Strategies ◽  
Coronary Artery Aneurysms ◽  
Kaplan Meier

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

Tracheoinnominate fistula: surgical management of an iatrogenic disaster

2006 ◽  
Vol 120 (8) ◽  
pp. 676-680 ◽  
Author(s):  
R W Ridley ◽  
J B Zwischenberger
Keyword(s):  
Operating Room ◽  
Surgical Management ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Rare Condition ◽  
Innominate Artery ◽  
Significant Potential ◽  
High Index Of Suspicion

Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.

Medical management of coral reef aorta through optimised diuretic use and angiotensin receptor blockade

2021 ◽  
Vol 14 (6) ◽  
pp. e242724
Author(s):  
Nicodemus Edrick Oey ◽  
Haresh Tulsidas ◽  
Krithikaa Nadarajan
Keyword(s):  
Coral Reef ◽  
Medical Management ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Receptor Blockade ◽  
Angiotensin Receptor ◽  
Endovascular Stenting ◽  
Refractory Hypertension ◽  
First Case ◽  
Angiotensin Receptor Blockade

Coral reef aorta (CRA) is a rare condition with potentially devastating complications. It is characterised by atherosclerotic calcification and stenosis of the visceral part of the aorta, usually occurring at the juxtarenal or suprarenal locations, and causing refractory hypertension and renal dysfunction. Surgical intervention, which is the recommended definitive treatment, is associated with significant morbidity and mortality. Endovascular stenting has been reported to be an alternative management option. To the best of our knowledge, this is the first case report to describe medical management of a patient with CRA with diuretics and angiotensin receptor blockade without surgical treatment.

scholarly journals Surgical management of congenital foetal hydrocephalus in a crossbred cow

2021 ◽  
Vol 52 (2) ◽  
Author(s):  
P. Dangi ◽  
S. Ruhil ◽  
H. Singh ◽  
A. Samdhyan ◽  
S. Potliya
Keyword(s):  
Surgical Management ◽  
Surgical Approach ◽  
Rare Case ◽  
Ventral Midline ◽  
Crossbred Cow

A rare case of dystocia due to external congenital hydrocephalic foetus with ankylosis of forelimbs managed by ventral midline surgical approach in a crossbred cow is reported.

Blister Aneurysm of the Internal Carotid Artery

2019 ◽  
pp. 5-13
Author(s):  
Peter Nakaji ◽  
Michael R. Levitt
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Surgical Management ◽  
Medical Management ◽  
Internal Carotid ◽  
Conventional Imaging ◽  
Catheter Angiography ◽  
Intraoperative Rupture ◽  
Open Management

Abstract: Blister aneurysms are a rare cause of subarachnoid hemorrhage. They are easily overlooked on conventional imaging and catheter angiography due to their small size and unusual anatomic location. Whereas the medical management of subarachnoid hemorrhage is similar to that of saccular aneurysms, the surgical management of blister aneurysms is more challenging due to their unique pathology and higher risk of intraoperative rupture. Special consideration should be made for open management such as preparation of the option of bypass or the emerging use of endovascular techniques such as flow diversion. This chapter reviews the diagnosis and medical and surgical management of blister aneurysms.

Epilepsy Surgery Evaluation

2016 ◽  
pp. 196-208
Author(s):  
Joseph F. Drazkowski
Keyword(s):  
Surgical Resection ◽  
Surgical Approach ◽  
Medical Management ◽  
Gold Standard ◽  
Evaluation Process ◽  
Precise Localization ◽  
Intracranial Eeg ◽  
Seizure Focus ◽  
Surgical Evaluation ◽  
Medically Refractory Epilepsy

Epilepsy can be a devastating illness for those afflicted. Unfortunately, approximately one-third of people diagnosed with epilepsy are not effectively treated with standard medical management. People with medically refractory epilepsy can be treated and possibly cured of their disease utilizing a surgical approach. The electroencephalogram currently remains the “gold standard” for characterizing and localizing the ictal onset zone. Standard surface and sometimes intracranial EEG, when appropriate, are typically utilized in the evaluation process. The epilepsy surgical evaluation is sometimes enhanced with the utilization of SPECT/SISCOM imaging to further help confirm the seizure focus. Data gathered during the evaluation process guide the surgical resection, with improved remission rates correlating with precise localization of the ictal onset zone. This chapter describes the current presurgical epilepsy evaluation using the EEG and SPECT scanning.

Delineating the Mosaic Trisomy 15 Phenotype Using a Serendipitous Mechanism as a Clue

2015 ◽  
Vol 146 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Federica Natacci ◽  
Giulia Melloni ◽  
Francesca Motta ◽  
Rosamaria Silipigni ◽  
Fabio Doniselli ◽  
...  
Keyword(s):  
Rare Condition ◽  
Diagnostic Process ◽  
Caucasian Woman ◽  
Balanced Translocation ◽  
Fetal Autopsy ◽  
Chorionic Villi ◽  
Short And Long Term ◽  
Mosaic Trisomy

Parental balanced translocation is one of the traditional indications for invasive prenatal diagnosis. Usually, the diagnostic process is straightforward. Sometimes, however, results are not entirely clear and may reveal unexpected biological processes. We performed chorionic villi sampling for a paternal 8;15 reciprocal translocation in the sixth pregnancy of a Caucasian woman. Cytogenetic analysis of chorionic villi, after both short- and long-term cultures, revealed the presence of the same rearrangement found in the father as well as a trisomy 15. Surprisingly, the trisomy, which was initially expected to derive from aberrant segregation during paternal meiosis, resulted instead from maternal nondisjunction. Although a sonogram of the fetus appeared to be normal, follow-up amniocentesis demonstrated a low-level mosaic trisomy 15 in cells extracted from the amniotic fluid, while 10% of cells from fetal tissues sampled after termination of the pregnancy were also found to be trisomic. Fetal autopsy showed dysmorphic features, confirming the diagnosis of mosaic trisomy 15 and enabled deeper insight into the prenatal phenotype of this rare condition.

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