scholarly journals Development of Small Bowel Volvulus on Barbed V-Loc™ Suture: A Rare Complication after Laparoscopic Ventral Rectopexy

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Giovanni Terrosu ◽  
Vittorio Cherchi ◽  
Umberto Baccarani ◽  
Gian Luigi Adani ◽  
Dario Lorenzin ◽  
...  
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Small Bowel ◽  
Female Patient ◽  
Rare Complication ◽  
Ventral Rectopexy ◽  
Small Bowel Volvulus ◽  
Off Label ◽  
Label Indication

In this case report, we share our experience with an emerging complication in laparoscopic surgery caused by the use of barbed sutures for an off-label indication. We describe a postoperative volvulus caused by the adhesion of the small bowel and V-Loc suture after a ventral laparoscopic rectopexy in a 48-year-old female patient. We also suggest cutting flush the end of the V-Loc and extending the follow-up of these patients.

scholarly journals A227 UMBILICAL HERNIA INCARCERATION IN LIVER CIRRHOSIS: A RARE COMPLICATION OF PARACENTESIS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 263-265
Author(s):  
A LAGROTTERIA ◽  
A Aruljothy ◽  
K Tsoi
Keyword(s):  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Large Volume ◽  
Umbilical Hernia ◽  
Rare Complication ◽  
Abdominal Wall Hernia ◽  
Refractory Ascites ◽  
Large Volume Paracentesis

Abstract Background Patients with decompensated liver cirrhosis with ascites frequently have umbilical hernias with a prevalence of 20% and are managed with large volume paracentesis (LVP). Common complications of LVP include hemorrhage, infection, and bowel perforation that occur infrequently with a frequency of less than 1%. However, incarceration of umbilical hernias has been reported as a rare complication of LVP and is speculated to be from ascitic fluid decompression that reduces the umbilical hernia ring diameter resulting in entrapment of the hernia sac. It is unclear whether the quantity or the fluid removal rate increases the herniation risk. Based on case series, this rare complication occurs within 48 hours of the LVP and requires emergent surgical repair and involves a high risk of morbidity and mortality due to potential infection, bleeding, and poor wound healing. Aims We describe a case report of an incarcerated umbilical hernia following a bedside large-volume paracentesis. Methods Case report Results A 59-year-old Caucasian male presented to the emergency department with a 24-hour history of acute abdominal pain following his outpatient LVP. His medical history included Child-Pugh class C alcoholic liver cirrhosis with refractory ascites managed with biweekly outpatient LVP and a reducible umbilical hernia. He reported the onset of his abdominal pain 2-hours after his LVP with an inability to reduce his umbilical hernia. Seven liters of clear, straw-coloured asitic fluid was drained. Laboratory values at presentation revealed a hemoglobin of 139 g/L, leukocyte count of 4.9 x109 /L, platelet count of 110 xo 109 /L, and a lactate of 2.7 mmol/L His physical exam demonstrated an irreducible 4 cm umbilical hernia and bulging flanks with a positive fluid wave test. Abdominal computed tomography showed a small bowel obstruction due to herniation of a proximal ileal loop into the anterior abdominal wall hernia, with afferent loop dilation measuring up to 3.4 cm. He was evaluated by the General Surgery consultation service and underwent an emergent laparoscopic hernia repair. There was 5 cm of small bowel noted to be ecchymotic but viable, with no devitalized tissue. He tolerated the surgical intervention with no post-operative complications and was discharged home. Conclusions Ultrasound-guided bedside paracentesis is a common procedure used in the management of refractory ascites and abdominal wall hernia incarceration should be recognized as a potential rare complication. To prevent hernia incarceration, patients with liver cirrhosis should be examined closely for hernias and an attempt should be made for external reduction prior to LVP. A high index of suspicion for this potential life-threatening condition should be had in patients who present with symptoms of bowel obstruction following a LVP. Funding Agencies None

scholarly journals Chemotherapy-Induced Oesophageal Stricture in a Child with Osteosarcoma: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3
Author(s):  
Daichi Ishimaru ◽  
Takatoshi Ohno ◽  
Masato Maeda ◽  
Yutaka Nishimoto ◽  
Katsuji Shimizu
Keyword(s):  
Case Report ◽  
Balloon Dilatation ◽  
Distal Femur ◽  
Rare Complication ◽  
Oesophageal Stricture ◽  
Solid Foods ◽  
Paediatric Case

Treatment with a combination of chemotherapy and radiotherapy is known to be associated with oesophageal stricture in both children and adults with malignancies. However, oesophageal stricture resulting from chemotherapy alone is a rare complication, with few reports on it. We experienced a rare paediatric case of oesophageal stricture caused by chemotherapy for osteosarcoma of the left distal femur. After completion of the chemotherapy course, the patient showed dysphagia caused by the oesophageal stricture and underwent balloon dilatation for the oesophageal stricture. After balloon dilatation, he was able to ingest solid foods, and the oesophagus was normal without any strictures at the last follow-up (20 months after ballooning). Therefore, oesophageal stricture should be considered as a complication of treatment with chemotherapy alone in children with malignancies.

scholarly journals Long-Term Follow-up of a Recurrent Multifocal Desmoid Tumour Treated with Tamoxifen: A Case Report

2005 ◽  
Vol 13 (2) ◽  
pp. 174-177 ◽  
Author(s):  
DP Gwynne-Jones ◽  
JC Theis ◽  
AK Jeffery ◽  
NA Hung
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Tamoxifen Treatment ◽  
Desmoid Tumour ◽  
Pelvic Tumour ◽  
Local Recurrences ◽  
Long Term Follow Up

We report a long-term follow-up of a female patient with a multifocal extremity desmoid tumour. She had 3 local recurrences after excision and developed a second unresectable pelvic tumour that has remained unchanged in size for 14 years since starting tamoxifen treatment.

scholarly journals Intrasplenic Pancreatic Pseudocyst after Chemoradiation of a Pancreatic Adenocarcinoma Mimicking Progressive Disease: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Thomas Benter ◽  
Oliver Roehr ◽  
Lutz Moser ◽  
Philipp Kiewe ◽  
Leopold Hentschel ◽  
...  
Keyword(s):  
Case Report ◽  
Pancreatic Adenocarcinoma ◽  
Pancreatic Pseudocyst ◽  
Progressive Disease ◽  
Rare Complication ◽  
Locally Advanced ◽  
Review Of The Literature ◽  
Locally Advanced Pancreatic Adenocarcinoma ◽  
Advanced Pancreatic Adenocarcinoma

Chemoradiation is one of the therapeutic options in palliative treatment of locally advanced pancreatic adenocarcinoma, with a well-known safety profile. In this case report, we describe the treatment-related occurrence of an intrasplenic pancreatic pseudocyst which was successfully removed by gastrocystic drainage. This rare complication should be considered in the follow-up and clinical management of patients, particularly if left-sided complaints occur.

Direct Laminate Veneers with Resin Composites: Two Case Reports with Five-Year Follow-ups

2010 ◽  
Vol 11 (4) ◽  
pp. 56-62 ◽  
Author(s):  
Yusuf Ziya Bayindir ◽  
Yahya Orcun Zorba ◽  
Cagatay Barutcugil
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Composite Laminate ◽  
Case Reports ◽  
Treatment Plan ◽  
Resin Composites ◽  
Enamel Hypoplasia ◽  
Anterior Teeth ◽  
Laminate Veneers

Abstract Aim The aim of this report is to present five-year follow-ups of two different applications for the use of direct laminate resin-based composite veneers to improve esthetics. Background Defects in the maxillary anterior teeth, such as enamel hypoplasia and peg lateral, can present esthetic challenges. Furthermore, a treatment plan that can be completed in a single appointment is highly desirable. This case report presents two different clinical cases involving the use of direct laminate resin-based composite veneers with five-year follow-ups. Case Report Case 1: A 17-year-old female patient was referred for treatment of her anterior teeth, which were unesthetically altered due to enamel hypoplasia and dental caries. A treatment plan was developed that included restoring the affected teeth with direct resin-based composite laminate veneers to improve the patient's appearance. The six maxillary anterior teeth were prepared for and restored with direct resinbased composite laminate veneers. At the fiveyear follow-up, the patient was satisfied with the restorations both esthetically and functionally. Case 2: A 15-year-old female patient also was referred for treatment to improve the appearance of her maxillary anterior teeth. A treatment plan was developed with two objectives: (1) to restore the undersized supernumerary crown in the area of the maxillary right lateral incisor and (2) to close the anterior diastemas. The facial surfaces were conservatively prepared and resin-based composite was applied with the aid of transparent crown forms. After completion of the treatment, the patient was recalled at six-month intervals. At the five-year follow-up appointment, the restorations were intact, no adverse effects were noted, and the resultant appearance was highly satisfactory for the patient. Summary The use of direct resin-based composite laminate veneers and adhesive bonding systems has been shown to provide an esthetic alternative to metal-ceramic or all-ceramic crowns for the rehabilitation of anterior teeth. This treatment option offers another advantage, namely a lower cost compared to an indirect technique. Other more complex and costly treatment options in the future are not ruled out. Clinical Significance In the present two cases, the initial and five-year follow-up results support the use of direct resin-based composite laminate veneers with minimal altering of healthy tooth structure. Such results should encourage clinicians to seek a cost-effective technique such as direct resin restorations to improve a patient's esthetic appearance in a single appointment. Citation Zorba YO, Bayindir YZ, Barutcugil C. Direct Laminate Veneers with Resin Composites: Two Case Reports with Five-Year Follow-ups. J Contemp Dent Pract [Internet]. 2010 July; 11(4):056-062. Available from: http://www. thejcdp.com/journal/view/volume11-issue4-zorba

A Rare Cause of Anemia in Inflammatory Bowel Diseases: A Case Report and Review of Literature

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5385-5385
Author(s):  
Waqas Ahmed ◽  
Kevin Monroe ◽  
James Essell ◽  
E. Randolph Broun
Keyword(s):  
Case Report ◽  
Hemolytic Anemia ◽  
Inflammatory Bowel Diseases ◽  
Autoimmune Hemolytic Anemia ◽  
Blood Smear ◽  
Rare Complication ◽  
Peripheral Blood Smear ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Abstract Introduction: Anemia is a common problem in patients with inflammatory bowel diseases (IBD), and its etiology is usually multifactorial. It can be produced by chronic blood loss, nutritional deficiencies, and drugs such as salazopyrine; however it can also due to auto immune hemolysis, which is a rare complication of IBD. We report a case of coombs positive autoimmune hemolytic anemia associated with ulcerative colitis both diagnosed at the same presentation. Case Report: A 32 year old man with no significant past medical history presented with complaint of dark colored urine, jaundiced skin and fatigue for 4 weeks. He also reported diarrhea mixed intermittently with blood for last few months. Physical exam was consistent with jaundice and anemia (pallor and icterus) with slightly palpable spleen. Initial lab work up showed Hb of 3.8 with normal platelet and WBC count, high reticulocytes count of 7% .LFT showed serum bilirubin of 3.6 (direct 0.4) with normal serum ALT and AST levels .Serum LDH was high (1032 U/l) while serum haptoglobin was low (0.11 mg/dl). Peripheral smear showed anisopoikilocytosis & spherocytosis. (See Figure 1) Further investigations revealed a positive direct Coombs test consistent with diagnosis of autoimmune hemolytic anemia. CT abdomen and pelvis showed mild splenomegaly & non-specific enlarged mesenteric lymph nodes. Colonoscopy revealed ulcerative pancolitis confirmed by histological findings of biopsies taken. Patient received PRBC transfusions and was started on steroids and mesalamine and was discharged on maintenance dose. His symptoms resolved in 4 weeks and Hb remained stable with no evidence of further hemolysis at 4 month follow up .Repeated CT abdomen & pelvis showed resolution of the lymphadenopathy. Figure 1: Peripheral Blood smear showing anisopoikilocytosis & spherocytosis. Figure 1:. Peripheral Blood smear showing anisopoikilocytosis & spherocytosis. Discussion: Autoimmune hemolytic anemia (AIHA) is a rare complication of IBD. The exact underlying pathogenesis of this association remains obscure; however it has been attributed to the production of cross reacting anti erythrocyte antibodies. In AIHA associated with IBD, corticosteroids are considered to be first line therapy and often cause remission of hemolysis along with treatment for IBD Immunomodulators and splenectomy has been used for patients with refractory AIHA. Colectomy done for fulminant colitis has also been reported to induce remission of AIHA. Further studies for long term follow up and pathogenesis of this association are warranted.

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