RESUMEN
Thoracic outlet syndrome (TOS) poses a difficult diagnostic entity with varied etiology and clinical presentation. We present a 35-year-old gentleman with unilateral long thoracic nerve palsy and contralateral subscapular paralysis caused by aberrant scalenus medius anatomy. TOS ought to be considered in patients presenting with isolated nerve palsies.
Asunto(s)
Parálisis/etiología , Enfermedades del Sistema Nervioso Periférico/etiología , Nervios Torácicos/fisiopatología , Síndrome del Desfiladero Torácico/complicaciones , Adulto , Descompresión Quirúrgica , Diagnóstico Diferencial , Evaluación de la Discapacidad , Humanos , Angiografía por Resonancia Magnética , Masculino , Parálisis/diagnóstico , Parálisis/fisiopatología , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Valor Predictivo de las Pruebas , Recuperación de la Función , Síndrome del Desfiladero Torácico/diagnóstico , Síndrome del Desfiladero Torácico/fisiopatología , Síndrome del Desfiladero Torácico/cirugía , Resultado del TratamientoRESUMEN
The management of an infected aortic endograft can be challenging both operatively and clinically. Although aortic endograft infection is rare, the incidence is likely to increase in the coming years because of ever rising numbers of endovascular aneurysm repairs. Definitive management involves the removal of the endograft through laparotomy. Removal of the graft is technically challenging; no manufacturer's device is available to assist in disengagement of barbed hooks that hold the endograft in position. We present a new technique using the disposable proctoscope as a device to facilitate safe removal of the endograft with minimal damage to the aortic wall.