RESUMO
The objectives of this study are to determine the removal rates of orthognathic plates used during orthognathic surgery at James Cook University Hospital and describe the reasons for plate removal. 202 consecutive orthognathic cases were identified between July 2004 and July 2012. Demographics and procedure details were collected for these patients. Patients from this group who returned to theatre for plate removal between July 2004 and November 2012 were identified and their notes were analysed for data including reason for plate removal, age, smoking status, sex and time to plate removal. 3.2% of plates were removed with proportionally more plates removed from the mandible than the maxilla. 10.4% of patients required removal of one or more plate. Most plates were removed within the first post-operative year. The commonest reasons for plate removal were plate exposure and infection. The plate removal rates in our study are comparable to those seen in the literature.
Assuntos
Placas Ósseas , Remoção de Dispositivo , Procedimentos Cirúrgicos Ortognáticos/instrumentação , Adolescente , Adulto , Fatores Etários , Placas Ósseas/efeitos adversos , Parafusos Ósseos/efeitos adversos , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos , Fatores de Tempo , Adulto JovemRESUMO
An 86-year-old woman presented three years after laparoscopic cholecystectomy with right upper quadrant pain and raised inflammatory markers. Liver function tests were normal; however, a previous ultrasound scan suggested a common bile duct stone so she was treated for cholangitis secondary to choledocholithiasis. Repeat ultrasound scan again showed a common bile duct (CBD) stone and also a subdiaphragmatic abscess. CT scan confirmed the abscess, associated with a surgical clip from her previous surgery. There was no evidence of a persistent CBD stone on the CT scan. She was treated conservatively with intravenous antibiotics and her symptoms improved. Follow-up MRI did not show any choledocholithiasis. Surgical clips causing delayed abscess formation are very unusual. We discuss the presentation, investigations and treatment of this interesting case. Existing relevant literature is reviewed, and management strategies to treat such rare complications are suggested.
Assuntos
Colecistectomia Laparoscópica , Complicações Pós-Operatórias/diagnóstico , Abscesso Subfrênico/diagnóstico , Instrumentos Cirúrgicos/efeitos adversos , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Complicações Pós-Operatórias/tratamento farmacológico , Abscesso Subfrênico/tratamento farmacológicoRESUMO
A 73-year-old man presented acutely with upper gastrointestinal (GI) haemorrhage. Upper GI endoscopy was suggestive of a pancreatic or submucosal duodenal neoplasm invading the stomach. He underwent laparoscopically assisted distal gastrectomy. Histopathological examination showed the rare entity of primary gastric squamous cell carcinoma. He underwent adjuvant chemotherapy and remains disease free at 6 months.