RESUMO
Purpose of the study: To assess the outcome and recurrence rates of frozen shoulder treated by hydrodilatation in an independent hospital setting. Method: Patients presenting to a shoulder clinic from August 2019 to July 2021 with a diagnosis of frozen shoulder were offered hydrodilatation. Data included primary or secondary frozen shoulder, length of symptoms, and diabetic status. An Oxford Shoulder Score was completed prior to hydrodilatation. Using ultrasound guidance, 40â mg Triamcinolone and local anaesthetic (10-25â mL depending on patient tolerance) were injected into the rotator interval. At a mean of 9 months, patients recorded their tolerance of the procedure, subsequent progress, the need for further treatment, and their current Oxford Shoulder Score. Results: From 55 shoulders, six patients had a failure to improve and 10 patients had a transient improvement followed by recurrence (29%). 2/21 (9.5%) patients had 25â mL injected compared to 14/34 (41%) who had < = 20â mL (p = 0.012). 14/43 (33%) of primary frozen shoulder patients had a recurrence, compared with 2/12 (16%) secondary frozen shoulder patients, p = 0.019. Conclusion: Further treatment was indicated in 14/34 (41%) of patients who underwent hydrodilatation in the frozen stage of frozen shoulder and could not tolerate more than 20â mL of injection, and was more commonly required in primary (33%) versus secondary (16%) frozen shoulder.
Assuntos
Adenocarcinoma/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Neoplasias Duodenais/cirurgia , Infarto/diagnóstico , Fígado/irrigação sanguínea , Adenocarcinoma/diagnóstico por imagem , Idoso , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Duodenais/diagnóstico por imagem , Feminino , Artéria Hepática/diagnóstico por imagem , Humanos , Infarto/diagnóstico por imagem , Infarto/etiologia , Fígado/diagnóstico por imagem , Veia Porta/diagnóstico por imagem , RadiografiaRESUMO
Stercoral perforation of the colon is rare but carries with it significant morbidity and mortality. Stercoral perforation usually occurs in elderly, immobile patients with chronic constipation. In this manuscript, we report the case of stercoral perforation in a patient due to chronic heroin dependence. We report the case of a 56-year-old male patient with stercoral perforation, diagnosed by computed tomography, secondary to heroin dependence, requiring proctocolectomy and an end ileostomy. There are very few reports in the literature describing cases of stercoral perforation and questions have been asked about the importance of preoperative cross-sectional imaging. In our case, the diagnosis of stercoral perforation was made only on CT. Although this is not the first such case to be reported, it is significant as preoperative CT imaging was influential not only in determining the aetiology of the abdominal distension seen on the plain film, but also in detecting the pneumoperitoneum which was not evident clinically or on plain radiographs.