RESUMO
A number of different materials are available for incisional hernia repair. Benefits of the various types are controversial and are partly dependent on the anatomical placement of the mesh. Composite mesh has been introduced to provide tissue ingrowth for strength and a non-adherent side to protect the bowel, these layers being laminated together. This report is on the separation of layers in an infected mesh and adherence of the expanded polytetrafluoroethylene layer to the small bowel.
Assuntos
Hérnia Ventral/cirurgia , Telas Cirúrgicas/efeitos adversos , Hérnia Ventral/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Polipropilenos , Politetrafluoretileno , Falha de Prótese , Recidiva , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/cirurgia , Staphylococcus aureus/isolamento & purificação , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/cirurgiaAssuntos
Fasciite/etiologia , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Incontinência Urinária por Estresse/cirurgia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Polimialgia Reumática/diagnósticoRESUMO
Severe symptoms of heartburn and retrosternal pain consistent with gastro-esophageal reflux (GER) developed in a patient following placement of a conventional self-expanding 16-24-mm-diameter x 12-cm-long esophageal stent across the gastroesophageal junction to treat an obstructing esophageal carcinoma. A second 18-mm-diameter x 10-cm-long esophageal stent with anti-reflux valve was deployed coaxially and reduced symptomatic GER immediately. Improvement was sustained at 4-month follow-up. An anti-reflux stent can be successfully used to treat significant symptomatic GER after conventional stenting.
Assuntos
Estenose Esofágica/cirurgia , Refluxo Gastroesofágico/cirurgia , Falha de Prótese , Implantação de Prótese/instrumentação , Stents , Idoso , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Estenose Esofágica/diagnóstico por imagem , Estenose Esofágica/etiologia , Estenose Esofágica/patologia , Refluxo Gastroesofágico/diagnóstico por imagem , Refluxo Gastroesofágico/etiologia , Humanos , Masculino , Cuidados Paliativos , Desenho de Prótese , Radiografia , ReoperaçãoRESUMO
A ten year review of penetrating thoracic and abdominal trauma examined pattern of injury, patient management and outcome. Ninety-six patients were included in the study, 55 with injury to the abdomen, 31 the thorax and 10 with injury to both areas. Fifty-eight cases were managed non-operatively; 5 combined abdominal and thoracic injuries, 26 thoracic and 27 abdominal. Two cases went on to require operative management for intra-abdominal injury. Thirty-eight cases were managed operatively; 5 combined cavity injuries, 5 thoracic and 28 abdominal. Injuries were found in all of the combined cavity and thoracic cavity cases. Of the 28 abdominal cases, nine were found on laparotomy to have no significant visceral or vessel injury, one, however, was performed for omentum protruding through the wound. While a negative laparotomy was a relatively safe procedure, non-operative management had the advantages of a shorter hospital stay without wound-related morbidity. Selective non-operative management was found to be a relatively safe approach in this series.
Assuntos
Traumatismos Abdominais/epidemiologia , Traumatismos Abdominais/terapia , Traumatismos Torácicos/epidemiologia , Traumatismos Torácicos/terapia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/terapia , Traumatismos Abdominais/mortalidade , Traumatismos Abdominais/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Austrália do Sul/epidemiologia , Traumatismos Torácicos/mortalidade , Traumatismos Torácicos/cirurgia , Fatores de Tempo , Violência/estatística & dados numéricos , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos por Arma de Fogo/mortalidade , Ferimentos por Arma de Fogo/cirurgia , Ferimentos por Arma de Fogo/terapia , Ferimentos Penetrantes/mortalidade , Ferimentos Penetrantes/cirurgia , Ferimentos Perfurantes/epidemiologia , Ferimentos Perfurantes/mortalidade , Ferimentos Perfurantes/cirurgia , Ferimentos Perfurantes/terapiaRESUMO
A case of systemic lupus erythematosus (SLE) is reported in which chorea was the dominant clinical feature, and which presented following a spontaneous mid-trimester abortion. The diagnosis, natural history and management of this uncommon manifestation of CNS lupus is discussed, as well as the influence of pregnancy on disease activity in SLE.