RÉSUMÉ
This report discusses a premature complex newborn with persistent pulmonary difficulties following the clipping of the PDA. Bronchoscopy was critical in revealing a metallic clip obstructing the bronchus. Thoracothomy revealed that the clip had been placed across the bronchus. This case illustrates the importance of bronchoscopy in the face of persistent unexplained pulmonary symptoms as well as having clear intraoperative exposure of the anatomy in this region to assure accurate placement of PDA metallic clips.
Sujet(s)
Bronches/traumatismes , Persistance du canal artériel/chirurgie , Prématuré , Ligature/effets indésirables , Instruments chirurgicaux/effets indésirables , Paralysie des cordes vocales/étiologie , Adulte , Obstruction des voies aériennes/imagerie diagnostique , Obstruction des voies aériennes/chirurgie , Angiographie/méthodes , Bronchoscopie/méthodes , Césarienne , Persistance du canal artériel/imagerie diagnostique , Endoscopie/effets indésirables , Endoscopie/méthodes , Femelle , Études de suivi , Humains , Nouveau-né , Ligature/instrumentation , Complications postopératoires/imagerie diagnostique , Complications postopératoires/chirurgie , Grossesse , Grossesse multiple , Réintervention/méthodes , Appréciation des risques , Résultat thérapeutique , Triplés , Paralysie des cordes vocales/imagerie diagnostique , Paralysie des cordes vocales/thérapieRÉSUMÉ
Cardiovascular magnetic resonance imaging (CMR) plays an important role in the preoperative and postoperative evaluation of congenital heart disease with newer techniques enabling faster and more comprehensive evaluation of the pediatric patient. This article reviews the clinical applications of CMR before and after surgery in the most common congenital heart anomalies in pediatric patients.
Sujet(s)
Cardiopathies congénitales/anatomopathologie , Imagerie par résonance magnétique/méthodes , Soins postopératoires/méthodes , Soins préopératoires/méthodes , Adolescent , Enfant , Femelle , Humains , Mâle , Myocarde/anatomopathologieRÉSUMÉ
OBJECTIVES: To determine the prevalence of transient bacteraemia after CT colonography (CTC). METHODS: Blood cultures were obtained at 5, 10 and 15 min after CTC from 100 consecutive consenting patients. Blood samples were cultured in both aerobic and anaerobic media and positive blood culture samples were analysed by a microbiologist. RESULTS: Blood culture samples were positive for growth in sixteen patients. All positive blood culture samples were confirmed skin contaminants. There were no cases of significant bacteraemia. The estimated significant bacteraemia rate as a result of CTC is 0-3.7%, based on 95% confidence intervals around extreme results using Wilson's score method. CONCLUSIONS: American Heart Association and National Institute for Clinical Excellence guidelines advise that antibiotic prophylaxis before lower gastrointestinal endoscopy is not indicated in patients with at risk cardiac lesions (ARCL) as the risk of a transient bacteraemia leading to infective endocarditis is low. These data show that the prevalence of transient bacteraemia after CTC is also low. It follows that patients with ARCL do not require antibiotic prophylaxis before CTC.
Sujet(s)
Antibactériens/usage thérapeutique , Bactériémie/épidémiologie , Bactériémie/prévention et contrôle , Coloscopie virtuelle par tomodensitométrie/statistiques et données numériques , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Femelle , Humains , Incidence , Irlande/épidémiologie , Mâle , Adulte d'âge moyen , Appréciation des risques , Facteurs de risqueRÉSUMÉ
INTRODUCTION: Insertion of a percutaneous nephrostomy (PCN) catheter decompresses the upper urinary tract, thereby removing the hydroureteronephrosis upon which magnetic resonance (MR) urography is dependent for diagnosing the precise level and cause of ureteric obstruction. METHOD: We present the case of a young woman who required PCN insertion during pregnancy. RESULT: Only when unenhanced T2-weighted MR urography was repeated after the creation of an artificial hydronephrosis by an injection of sterile saline via the PCN catheter was the diagnosis of stone in the mid-ureter later made possible. CONCLUSION: This case highlights an easy solution to a limitation with the use of MR urography during pregnancy, when a physiological hydroureteronephrosis has been relieved by the insertion of a PCN catheter.