scholarly journals Mechanical Duodenal Perforation Due to Complications of Pancreatic Pseudocysts

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 10
Author(s):  
Jayan George ◽  
Chrysoula Fysaraki ◽  
Heather J. Harris ◽  
Krishnamurthy Ravi ◽  
Timothy J. White
Keyword(s):  
Hospital Admission ◽  
Surgical Intervention ◽  
Pancreatic Pseudocysts ◽  
Duodenal Perforation ◽  
Gallstone Pancreatitis ◽  
Hollow Viscus ◽  
Emergency Surgical Intervention

Pancreatic pseudocysts are a known complication of pancreatitis. There are a multitude of complications which have been described in relation to pancreatic pseudocysts. Perforation of a gastrointestinal hollow viscus is rare but has previously been reported. We report a case of a 72-year-old female with the development of three pancreatic pseudocysts four weeks post gallstone pancreatitis. The patient deteriorated and was found to have a duodenal perforation due to compression forces from the underlying pseudocysts. The patient required emergency surgical intervention and recovered fully following hospital admission.

Fascicular torsions of the anterior and posterior interosseous nerve in 4 cases: neuroimaging methods to improve diagnosis

2020 ◽  
Vol 132 (6) ◽  
pp. 1925-1929 ◽  
Author(s):  
Jennifer Kollmer ◽  
Paul Preisser ◽  
Martin Bendszus ◽  
Henrich Kele
Keyword(s):  
Magnetic Resonance ◽  
Surgical Intervention ◽  
Case Series ◽  
Diagnostic Methods ◽  
Posterior Interosseous Nerve ◽  
Nerve Ultrasound ◽  
Magnetic Resonance Neurography ◽  
Surgical Exploration ◽  
Hyperintense Signal ◽  
Emergency Surgical Intervention

Diagnosis of spontaneous fascicular nerve torsions is difficult and often delayed until surgical exploration is performed. This case series raises awareness of peripheral nerve torsions and will facilitate an earlier diagnosis by using nerve ultrasound (NUS) and magnetic resonance neurography (MRN). Four patients with previously ambiguous upper-extremity mononeuropathies underwent NUS and 3T MRN. Neuroimaging detected proximal torsions of the anterior and posterior interosseous nerve fascicles within median or radial nerve trunks in all patients. In NUS, most cases presented with a thickening of affected nerve fascicles, followed by an abrupt caliber decrease, leading to the pathognomonic sausage-like configuration. MRN showed T2-weighted hyperintense signal alterations of fascicles at and distal to the torsion site, and directly visualized the distorted nerves. Three patients had favorable outcomes after being transferred to emergency surgical intervention, while 1 patient with existing chronic muscle atrophy was no longer eligible for surgery. NUS and MRN are complementary diagnostic methods, and both can detect nerve torsions on a fascicular level. Neuroimaging is indispensable for diagnosing fascicular nerve torsions, and should be applied in all unclear cases of mononeuropathy to determine the diagnosis and if necessary, to guide surgical therapies, as only timely interventions enable favorable outcomes.

EMERGENCY SURGERY DURING COVID 19 AT K.A.P.V GOVERNMENT MEDICAL COLLEGE AND MGMGH , TRICHY

2021 ◽  
pp. 6-9
Author(s):  
Sumathi Ravikumar ◽  
Yeganathan Rajappan ◽  
Durairajan Vaithiyanathan ◽  
Catherine Sindhuja
Keyword(s):  
Surgical Intervention ◽  
District General Hospital ◽  
Favourable Outcome ◽  
Emergency General Surgery ◽  
Emergency Admissions ◽  
Medical College ◽  
Prolonged Duration ◽  
Current Impact ◽  
Emergency Surgical Intervention ◽  
The Impact

COVID 19 pandemic was declared by WHO as public health emergency on January 30,2020. Health system was reorganised with the aim to cope with the new disease and maintain essential health service. Many patients suffered from ARDS which lead to the modication of clinical and surgical activity. Current impact of COVID 19 outbreak on emergency surgical practice is still not developed. Varied presentation, diagnostic uncertainity, lack of guidelines present challenges to surgeons. AIM: The aim of our study was to evaluate the impact of the COVID-19 pandemic on emergency general surgery admissions and operations in our institution METHODS: We conducted a retrospective study in K.A.P.V.G.M.C. and M.G.M.G.H., Trichy from march 2020 to December 2020. All general surgical emergency admissions to KAPVGMC and MGMGH, district general hospital were included from march to December 2020.The details of diagnosis and subsequent management were retrieved from records. CONCLUSION: It was observed thatclinical decisions were made based on urgency of each case while simultaneously evaluating their COVID 19 status. The number of surgicalcases during COVID 19 period were signicantly reduced. Recognising asymptomatic carriers and need of emergency surgical intervention were the challenges faced by the surgeons. Effective communication between microbiologist, radiologist, anaesthetist and surgeon was necessary to attain a favourable outcome. .Inspite of challenges faced 80% had postoperative uneventful period other than prolonged duration of stay and were discharged and followed up. Covid 19 pneumonia and ARDS attributed to majority of death among the 20 % of deceased , other than septicemia

scholarly journals Emergency Surgical Intervention by Mobile Surgical Team in the NICU

2014 ◽  
Vol 04 (02) ◽  
pp. 162-168
Author(s):  
R.-B. Trobs ◽  
A. Stein ◽  
U. Felderhoff ◽  
L. Hanssler
Keyword(s):  
Surgical Intervention ◽  
Surgical Team ◽  
Emergency Surgical Intervention

scholarly journals Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2021 ◽  
Vol 14 (3) ◽  
pp. 85-88
Author(s):  
Jok Thikuiy Gang ◽  
Sisay Kirba Kea ◽  
Samson Gebremedhin
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Records ◽  
Selection Criteria ◽  
Surgical Intervention ◽  
Addis Ababa ◽  
Safe Alternative ◽  
Medical College ◽  
Endometrial Cavity ◽  
Emergency Surgical Intervention ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

scholarly journals Meconium peritonitis in a preterm infant: a surgical emergency

2021 ◽  
Vol 8 (4) ◽  
pp. 753
Author(s):  
Priyanka Yadav ◽  
Ankit Agarwal
Keyword(s):  
Intestinal Perforation ◽  
Surgical Intervention ◽  
Bowel Resection ◽  
Postnatal Period ◽  
Meconium Peritonitis ◽  
Clinical Presentations ◽  
Good Clinical Condition ◽  
Severe Peritonitis ◽  
Emergency Surgical Intervention ◽  
Chemical Peritonitis

Meconium peritonitis is sterile chemical peritonitis that occurs after intestinal perforation resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The clinical presentations after birth can range from completely sealed-off peritonitis without any symptoms, to severe peritonitis requiring emergency surgical intervention. We describe a case of meconium peritonitis in a premature infant following intestinal perforation. In the immediate postnatal period, the patient was intubated and a peritoneal drain was placed. Laparotomy with bowel resection was performed the following day. The postoperative course was uneventful and the patient was discharged home in good clinical condition.

Bilateral isolated mylohyoid groove fracture progressing as submandibular abscess: an usual fracture pattern of mandible

2021 ◽  
Vol 14 (3) ◽  
pp. e239542
Author(s):  
Jothi Raamahlingam Rajaran ◽  
AJ Nazimi
Keyword(s):  
Surgical Intervention ◽  
Fracture Pattern ◽  
Fracture Site ◽  
Bone Fragment ◽  
Necrotic Bone ◽  
Mylohyoid Muscle ◽  
Mandibular Molar ◽  
Emergency Surgical Intervention ◽  
Anterior Mandible ◽  
Molar Region

The mylohyoid ridges or lines are pairs of anatomical bony structures located on the internal or lingual surface of mandible. They are the origin for the mylohyoid muscle. These bony structures are distinct in the mandibular molar region, well protected and gradually become undiscernible towards anterior mandible. Bilateral, isolated fracture of the mylohyoid ridges without concomitant mandibular fracture is rare and, to the best of the authors knowledge, was never previously described. This case report describes an isolated bilateral mylohyoid groove fracture, where one side of a necrotic bone fragment at the fracture site progress to became a nidus of infection, which later caused submandibular space abscess requiring emergency surgical intervention. Diagnosis, possible theory to explain the occurrence of isolated mylohyoid groove fracture and management of these condition are explained in this report.

scholarly journals Endoscopic Drainage of Pancreatic Pseudocysts

1990 ◽  
Vol 4 (9) ◽  
pp. 568-571 ◽  
Author(s):  
Claude Liguory ◽  
Jean Francois Lefebvre ◽  
Gary C Vitale
Keyword(s):  
Pancreatic Duct ◽  
Surgical Intervention ◽  
The Body ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Acute Necrotizing ◽  
Head Of The Pancreas ◽  
Serial Scanning

Endoscopic drainage of pancreatic pseudocysts was attempted in 17 patients over an eight year period. There were nine cysts located in the head of the pancreas, six in the body and two in the tail. Endoscopic retrograde cholangiopancreatography was performed in all cases and the pancreatic duct satisfactorily opacified in 16 of the 17 patients. This study identified a communication with the pancreatic duct in seven cases. There were two cases in which multiple cysts were present; in each, one cyst was drained endoscopically and the others surgically. Endoscopic drainage of the cyst was immediately possible in 16 of 17 cases (94%). Late follow-up (mean 26 months) documented cyst disappearance in 11 cases (69%). None of the five patients with persistent cysts has required secondary surgical intervention, and the cysts are asymptomatic and stable or decreasing in size by serial scanning. There was one case (6%) in which a pseudocyst recurred following initial resolution. There were two complications (12%) requiring surgical intervention: gastrointestinal perforation with peritonitis in one patient and hemorrhage at the cyst margin from an arterial bleeder in another. There were no deaths at 30 days, but in one case a recurrent acute necrotizing pancrearitis occurred 36 days following endoscopic drainage and the patient died. This death was felt to be unrelated to the endoscopic procedure. In conclusion, internal drainage of pancreatic pseudocysts by endoscopic means can be proposed as an alternative to surgical drainage when the cyst can be identified as bulging into the stomach or duodenum. Immediate drainage is usually effective with a minimal long term recurrence rate.

scholarly journals Asymptomatic free gas post Endoscopic Mucosal Resection (EMR) - Is surgical intervention always necessary?

2020 ◽  
pp. 19-26
Author(s):  
Shafquat Zaman ◽  
Hayaka Amada ◽  
Pratik Bhattachayra ◽  
Stephen Stonelake ◽  
Mark Goldstein ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Surgical Intervention ◽  
Bowel Perforation ◽  
Case Series ◽  
Colonic Polyps ◽  
Cost Effective ◽  
Direct Result ◽  
Free Gas ◽  
Mucosal Resection ◽  
Emergency Surgical Intervention

Background& Objectives Endoscopic mucosal resection (EMR) is an efficient, cost-effective and minimally-invasive mode of treatment of colonic polyps. Colonic perforation post EMR is one of the potential complications associated with this procedure. Some patients may present with asymptomatic free gas on imaging and therefore not necessarily require intervention. Methods We present a case series of patients undergoing EMR who were found to have intra-abdominal free gas or ‘bowel perforation’ on imaging post procedure. They were all asymptomatic and did not warrant emergency surgical intervention. In addition, we aim to provide a review of the existing literature on ‘bowel perforation’ post EMR and discuss its management. Results & Conclusion Through this case series we highlight the importance of assessing patients clinically and not treating the radiological findings alone. Clinicians must be aware of the possibility of patients with asymptomatic free gas post EMR as a direct result of the injectate during the procedure or due to the passage of air or CO2 from the distended colon. As the popularity of this procedure increases, it is crucial that clinicians, surgeons and endoscopists are all aware of its associated complications.

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