Amphetamine-induced small bowel ischemia - A case report.

Nonocclusive mesenteric ischemia is most common in elderly patients with multiple comorbidities. Nevertheless, there are some reports of acute bowel ischemia in young patients with a history of recreational drug abuse. We describe the case of a 33-year-old patient who presented with acute abdominal pain following amphetamine consumption. Multidetector computed tomography showed nonocclusive segmental ischemia of the distal ileum, and the patient underwent emergency surgery with ileocecal resection. The patient recovered quickly and was discharged without any postoperative complications. An early and precise diagnosis of patients with intestinal ischemia having a history of amphetamine abuse is of utmost importance for prompt and proper treatment. Especially in younger patients, multidetector computed tomography should be tailored to use with less radiation. A single portal venous scan proved sufficient in our case.

Percutaneous localization of pulmonary nodules prior to thoracoscopic surgery by CT-guided hook-wire.

BACKGROUND: When performing thoracoscopic surgery in patients with small pulmonary nodules, intraoperative localization can be difficult and time-consuming. The percutaneous localization of suspicious intrapulmonary lesions was evaluated pre-operatively to facilitate the resection of the lesion and to avoid thoracotomy. MATERIALS AND METHODS: Thoracoscopies were performed in 13 patients with intrapulmonary nodules previously localized by CT-scan and flagged percutaneously with a hook-wire. Immediately after the procedure, the patient was transferred to the operating room and thoracoscopic pulmonary wedge resection was performed. RESULTS: All the nodules were properly identified. The time to position the wire was 20-30 min and thoracotomy could be avoided in all patients. The nodules were 0.5 cm - 6 cm in size and situated 1 cm - 4 cm subpleurally. CONCLUSION: Guide-wire identification of an intrapulmonary nodule is a safe, elegant, time-saving and reliable method. The lack of manual examination of pulmonary parenchyma in thoracoscopy is compensated for by precise pre-operative localization.

Thoracoscopic-endoscopic and laparoscopic-endoscopic rendezvous for resection of esophageal myoma--report of two cases / 解放军医学杂志

Background Leiomyoma is the most common benign tumor of the esophagus; if malignancy can be ruled out preoperatively, minimally invasive treatment can be performed either thoraco-scopically or laparoscopically. Methods We report on two cases, where we resected a midesophagus tumor by a thoracoscopic and a distal esophageal tumor by a laparoscopic approach under endoscopic assistance during the resection procedure. By this thoracoscopic-endoscopic and laparoscopic-endoscopic rendezvous procedure uncomplicated resection was performed and perforation was avoided. Conclusion Minimally invasive surgical therapy is recommended for the resection of benign submucosal tumors of the esophagus. Tumors located in the middle and distal third can easily be resected. Endoscopic control with rendezvous technique during the operation is recommended to avoid mucosal injury.

Simplification of rat intubation on inclined metal plate.

Small-animal intubation is often necessary during inhalation anesthesia to allow steady-state conditions for large operations and in vivo experiments in all fields of experimental surgery. In rats, placing an orotracheal tube is technically difficult primarily because of the small size of the subject and the lack of equipment specifically designed for this task. We describe a simple rat intubation technique in which the animal is suspended in dorsal recumbency on an inclined metal plate. The animal, anesthetized with ether, is fixed to a 70 degrees-inclined metal plate in a dorsal position by means of a Mersilene ribbon hooked around the upper incisors. This method of positioning the animal is the most important step in the intubation process and further facilitates the technique already described by other authors. A human otoscope was used as a laryngoscope, intubation was performed using the Seldinger technique, and a 14-gauge intravenous catheter served as an endotracheal tube. This inexpensive technique is quickly learned and can be used in any laboratory. Safe and reliable airway management can thus be achieved, permitting in vivo examinations and operations.