RESUMO
Brachial arterial aneurysm is a rare entity. We present a case of multiple serial aneurysms of the brachial artery with associated multiple arteriovenous malformations of the forearm, along with symptoms of distal ischemia and its surgical management.
Assuntos
Aneurisma/etiologia , Malformações Arteriovenosas/complicações , Artéria Braquial , Antebraço/irrigação sanguínea , Isquemia/etiologia , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Implante de Prótese Vascular , Artéria Braquial/diagnóstico por imagem , Artéria Braquial/cirurgia , Feminino , Humanos , Isquemia/cirurgia , Pessoa de Meia-Idade , Radiografia , Resultado do TratamentoRESUMO
The reconstruction of large skeletal defects of the chest wall is considered complex and difficult. A simple technique for this repair, using polymethylmethacrylate ribs that are prefabricated in a prosthodontic laboratory using heat cure polymer, is presented. These ribs are used as bone substitutes while reconstructing the chest wall defect. The prefabricated polymethylmethacrylate ribs have been used to reconstruct the large chest wall defects after resection of chest wall tumors in three patients. There was risk of severe paradoxical movement of the chest wall without the skeletal defect reconstruction. In all of the cases, there was no need for postoperative mechanical ventilation and there was no paradoxical movement. Cosmetically, it was highly satisfactory. In one patient, the stainless steel wire caused a sinus after 1 year of reconstruction, requiring removal of the wire and the rib, but it did not compromise the stability of the chest wall. We conclude that reconstruction of large chest wall defects with prefabricated polymethylmethacrylate ribs is simple, cost-effective, and easy to plan and execute.
Assuntos
Polimetil Metacrilato , Próteses e Implantes , Costelas/cirurgia , Adulto , Neoplasias Ósseas/cirurgia , Fios Ortopédicos , Condrossarcoma/cirurgia , Feminino , Humanos , Masculino , Osteossarcoma/cirurgia , Complicações Pós-Operatórias/cirurgia , Desenho de Prótese , Ajuste de Prótese , Reoperação , Resultado do TratamentoRESUMO
The role of infundibular resection in cases of pure valvar pulmonary stenosis is much debated. Some advocate aggressive approach especially in cases of supra systemic right ventricular pressures. Some consider it unnecessary, and feel that it is secondary hypertrophy which will regress in due course following a successful valvotomy. But all agree that the dynamic right ventricular outflow obstruction plays a very crucial role in the immediate post operative period which can cause significant morbidity and mortality. We advocate the use of beta blocker to relieve the infundibular spasm in the immediate post operative period, thereby relieving the dynamic outflow obstruction. We herewith present two cases to exemplify this.
Assuntos
Baixo Débito Cardíaco/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Propranolol/uso terapêutico , Estenose da Valva Pulmonar/cirurgia , Adolescente , Antagonistas Adrenérgicos beta/uso terapêutico , Criança , Feminino , HumanosRESUMO
A case of superior vena caval obstruction resulting from filariasis is presented.
Assuntos
Filariose/complicações , Linfadenite/complicações , Doenças do Mediastino/complicações , Síndrome da Veia Cava Superior/etiologia , Filariose/diagnóstico por imagem , Humanos , Linfadenite/diagnóstico por imagem , Masculino , Doenças do Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade , Derrame Pleural/etiologia , RadiografiaRESUMO
Sixteen patients with gastric cicatrization due to ingestion of corrosive agents were treated over a 7 year period at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Hospital, Pondicherry. Fifteen patients developed gastric outlet obstruction due to ingestion of corrosives, while another had midgastric stenosis due to formalin intake. An associated oesophageal stricture was present in 62.5% of the cases. Partial gastrectomy was found to be the most satisfactory procedure and carried out in 60% of the cases. Pyloroplasty done in one patient was found inadequate within 1 year of surgery. Gastrojejunostomy carried out in two patients was associated with prolonged hospitalization due to malfunction of the anastomotic site.