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1.
Artigo em Chinês | MEDLINE | ID: mdl-38297856

RESUMO

Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor(PPT). Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.


Assuntos
Sinusite Frontal , Tumor de Pott , Humanos , Tumor de Pott/complicações , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Endoscopia/efeitos adversos , Complicações Pós-Operatórias , Antibacterianos/uso terapêutico , Sinusite Frontal/complicações
2.
Medicine (Baltimore) ; 103(6): e37211, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38335374

RESUMO

We aimed to explore the therapeutic effects of endoscopically assisted surgical approaches for HICH. In this retrospective cohort study, we retrospectively analyzed the treatment status of 118 patients with HICH who underwent surgery for hematoma removal. Among them, 61 patients underwent endoscopically assisted hematoma removal surgery through the frontal lobe approach (frontal lobe group); 57 patients underwent endoscopic hematoma assisted via the temporal lobe approach (temporal lobe group). Treatment effects, cerebral hemodynamic status before and after treatment, postoperative prognosis at one month, and incidence of complications were compared between the 2 groups. We found that the total effective treatment rate in the frontal lobe group was higher than that in the temporal lobe group (P < .05). After surgery, the R during the contraction period of the common cerebral artery in both groups decreased compared to that before surgery, and the frontal lobe group was significantly lower than the temporal lobe group; the V and Q were higher than those before surgery, and the frontal lobe group was significantly higher than the temporal lobe group (P < .05). The prognosis of the frontal lobe group was better than that of the temporal lobe group (P < .05). Compared to the endoscopic-assisted temporal approach, the endoscopic-assisted frontal lobe approach for the treatment of HICH can improve cerebral hemodynamic status, enhance treatment efficacy, and improve prognosis.


Assuntos
Hemorragia Intracraniana Hipertensiva , Humanos , Estudos Retrospectivos , Hemorragia Intracraniana Hipertensiva/cirurgia , Endoscopia/efeitos adversos , Craniotomia , Resultado do Tratamento , Hematoma/etiologia
3.
Urolithiasis ; 52(1): 34, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38372797

RESUMO

The possible role of well-assessed radiological parameters in the prediction of ureteral stricture formation in cases with impacted obstructive ureteral calculi has been evaluated. 46 adult patients with or without ureteral stricture formation after ureteroscopic stone management were included. In addition to stone size and some certain radiological parameters including ureteral wall thickness (UWT) of the involved ureter at the impacted stone site was also measured and noted on computed tomography (CT) images. Parameters were evaluated in two subgroups of cases, namely: Group 1: patients in whom a ureteral stricture formed after endoscopic stone removal and Group 2: patients normal ureteral anatomy without any stricture formation. The possible relationship between the UWT values and degree of hydronephrosis (HN) with subsequent stricture formation was comparatively evaluated. All of the stones were proximal ureteral calculi in both groups. Both the degree of HN and proximal ureteral diameter (PUD) parenchymal was higher in cases with stricture formation. In addition, mean parenchymal thickness was lower and mean values of UWT measurements at the stone site were 3.70 ± 0.97 mm and 2.17 ± 0.26 mm in Groups 1 and 2, respectively. A cutoff value 2.49 mm for UWT was found to be highly predictive for stricture formation. UWT value calculated at the obstructing stone site was found to be predictive enough for the likelihood of ureteral stricture formation with high sensitivity and specificity . This evaluation along with some other radiological parameters may enable the urologists to follow such cases on this aspect with necessary measures taken.


Assuntos
Hidronefrose , Ureter , Cálculos Ureterais , Adulto , Humanos , Cálculos Ureterais/complicações , Cálculos Ureterais/diagnóstico por imagem , Cálculos Ureterais/cirurgia , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/etiologia , Endoscopia/efeitos adversos , Ureter/diagnóstico por imagem , Ureter/cirurgia , Tomografia Computadorizada por Raios X , Hidronefrose/diagnóstico por imagem , Hidronefrose/etiologia
4.
Sci Rep ; 14(1): 3929, 2024 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365842

RESUMO

In this study, according to the Location, Diameter, Risk factor (LDRf) classification principle, the influence and effect of esophageal varices diameter on the degree of complete ligation of multicyclic ligator were investigated. Methods. The esophageal veins of healthy piglets were filled with methylene blue solution, and the in vitro pig esophageal varices model was made, which were divided into three groups according to the diameter of esophageal varices: D1, 0.4-1.0 cm; D2, 1.1-1.5 cm; and D3, 1.6-2.0 cm. Finally, the ligation effect of each group was analyzed statistically. A total of 407 ligations were performed on the simulated esophageal variceal model. There were 103 ligations in the D1 group and 98 were complete (95.15%, 98/103); 151 ligations in the D2 group and 47 were complete (31.13%, 47/151); and 153 ligations in the D3 group but none were complete (0%, 0/153). There was significant difference in the degree of complete ligation between the two groups (χ2 = 38.0014, P ≤ 0.001). In the varicose ligation model, the complete ligation effect was the most complete and robust when the varicose diameter was 0.4-1.0 cm. This study showed that the varicose vein diameter in LDRf classification was reasonable and feasible to guide endoscopic varicose vein ligation.


Assuntos
Varizes Esofágicas e Gástricas , Varizes , Animais , Suínos , Varizes Esofágicas e Gástricas/cirurgia , Varizes Esofágicas e Gástricas/complicações , Endoscopia/efeitos adversos , Ligadura/métodos , Varizes/complicações , Hemorragia Gastrointestinal/etiologia
5.
Gastrointest Endosc Clin N Am ; 34(2): 249-261, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38395482

RESUMO

Acute variceal bleeding is a serious complication of portal hypertension. This most often manifests as bleeding from esophageal varices. Although less likely to occur, bleeding from gastric varices is usually more severe. The best endoscopic management for acute esophageal variceal bleeding is band ligation and this often proves to be definitive therapy for these patients. For gastric variceal bleeding, the best endoscopic therapy is endoscopic cyanoacrylate injection but this can be cumbersome to perform and is not a readily available resource at most centers in the United States.


Assuntos
Varizes Esofágicas e Gástricas , Hipertensão Portal , Humanos , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/cirurgia , Endoscopia/efeitos adversos , Hipertensão Portal/complicações , Ligadura , Escleroterapia/efeitos adversos
7.
BMJ Case Rep ; 17(1)2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38216165

RESUMO

Upper gastrointestinal perforation is a feared complication of diagnostic and therapeutic endoscopy, with an incidence of perforation between 0.3% and 5%. Even though is rare, the mortality rate can be as high as 40%. Currently, there is no consensus on the best therapeutic strategy and it usually depends on patient stability, the extent of perforation, time to diagnosis, surgeon experience and available resourcesWe present a case of a patient who presented to our institution to undergo an ambulatory oesophageal dilation. After dilation, the patient developed two full-thickness gastric perforations and a full-thickness oesophageal perforation without haemodynamic instability. All perforations were diagnosed and treated with a combination of intraoperative endoscopy and robotic surgery with excellent outcomes.We demonstrate that a robotic approach combined with intraoperative diagnostic endoscopy is a safe and feasible treatment option for esophageal and gastric perforations in a stable patient without large extraluminal contamination.


Assuntos
Traumatismos Abdominais , Perfuração Esofágica , Procedimentos Cirúrgicos Robóticos , Gastropatias , Traumatismos Torácicos , Humanos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Dilatação/efeitos adversos , Endoscopia/efeitos adversos , Perfuração Esofágica/etiologia , Perfuração Esofágica/cirurgia , Gastropatias/complicações , Traumatismos Abdominais/complicações , Traumatismos Torácicos/complicações
8.
BMC Musculoskelet Disord ; 25(1): 12, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38166911

RESUMO

BACKGROUND: There are insufficient in-depth studies on whether percutaneous lumbar nucleoplasty (PLN) is effective and safe for the treatment of uncontained lumbar disc herniation (ULDH). This study aimed to investigate the clinical efficacy of PLN on radiating leg pain caused by ULDH. METHODS: Patients who underwent PLN for ULDH and met the inclusion criteria between June 2018 and July 2022 were included. Clinical outcomes were evaluated using the numeric rating scale (NRS) for radiating pain preoperatively; at 1 day, 1 week, and 1 month postoperatively; and at the last follow-up. Patient satisfaction was assessed using MacNab criteria. RESULTS: Forty-one patients were enrolled. The mean age was 50.2 years (range 24-73 years). The mean and standard deviation of the preoperative NRS in 39 patients with radiating pain was 9.0 ± 1.2. The NRS scores at 1 day, 1 week, and 1 month postoperatively and at the last follow-up were 4.6 ± 3.2, 3.6 ± 3.3, 2.9 ± 3.2, and 1.4 ± 2.0, respectively, showing significant improvement (all, p < 0.001). The number of patients (percentage) with excellent or good satisfaction according to the MacNab criteria was 29 (70.7%). Major complications were not observed. Three patients underwent additional surgery after PLN because of persistent radiating pain. CONCLUSIONS: PLN is a safe and feasible treatment option for ULDH. Treatment outcomes were favorable on average; however, the lack of consistency was a drawback.


Assuntos
Discotomia Percutânea , Deslocamento do Disco Intervertebral , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/complicações , Estudos Retrospectivos , Resultado do Tratamento , Dor/etiologia , Satisfação do Paciente , Discotomia Percutânea/efeitos adversos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Endoscopia/efeitos adversos
9.
Curr Gastroenterol Rep ; 26(2): 53-56, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38194110

RESUMO

PURPOSE OF REVIEW: The purpose of this article is to review available literature on management of persistent ostomy following PEG tube removal. We will discuss the incidence of persistent gastrocutaneous fistula (GCF) following PEG tube removal, risk factors for their development, and management strategies that have been proposed and their efficacy. RECENT FINDINGS: The use of over the scope clips (OTSC) have evolved recently in the management of gastrointestinal bleeding, perforation, and fistula closures. OTSC has become more readily available and proven to be effective and safe. Suturing devices have shown promising results. Persistent gastrocutaneous fistula following PEG removal is a rare yet serious complication that can lead to continuous skin irritation and leakage of gastric contents and acid. There are several postulated risk factors but the most important of these is duration of placement. Management can include medical therapy which has recently been shown to be somewhat effective, endoscopic therapy and surgery as a last resort. Overall, the data on GCFs is limited and further study with larger sample size is needed.


Assuntos
Fístula Cutânea , Fístula Gástrica , Humanos , Gastrostomia/efeitos adversos , Gastrostomia/métodos , Fístula Cutânea/complicações , Fístula Cutânea/cirurgia , Fístula Gástrica/etiologia , Fístula Gástrica/cirurgia , Endoscopia/efeitos adversos , Nutrição Enteral
10.
Ann Otol Rhinol Laryngol ; 133(4): 462-464, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38183238

RESUMO

OBJECTIVE: We present a case of propofol infusion syndrome (PRIS) following jet ventilation. METHOD: Case report and review of literature. RESULTS: A 70-year-old man required CO2 laser endoscopic tracheoplasty for tracheal and subglottic stenosis due to A-frame deformity. Postoperatively, the patient was reintubated for respiratory distress and propofol was resumed. Over the next two days the patient developed acute kidney injury, leukocytosis, acute primary respiratory acidosis with high anion gap metabolic acidosis, multiple end organ damage, elevated cardiac markers, and worsening lactic acidosis. The patient was recognized as having propofol infusion syndrome and propofol was immediately discontinued and replaced with dexmedetomidine. Unfortunately the patient progressed to multi-organ failure complicated by rhabdomyolysis and distributive intravascular coagulopathy. CONCLUSIONS: Propofol is often used as an anesthetic for jet ventilation during otolaryngologic airway surgery. Propofol related infusion syndrome is an uncommon but life-threatening peri-operative complication that should be considered in any patient with an unusual post-operative recovery characterized by metabolic acidosis, ECG changes, end organ damage, and elevated lactate.


Assuntos
Acidose , Síndrome da Infusão de Propofol , Propofol , Masculino , Humanos , Idoso , Propofol/efeitos adversos , Hipnóticos e Sedativos , Endoscopia/efeitos adversos , Anestésicos Intravenosos
11.
Int J Pediatr Otorhinolaryngol ; 177: 111856, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38185003

RESUMO

OBJECTIVE: Percutaneous tracheostomy is routinely performed in adult patients but is seldomly used in the pediatric population due to concerns regarding safety and limited available evidence. This study aims to consolidate the current literature on percutaneous tracheostomy in the pediatric population. METHODS: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, EMBASE, CINAHL, and Web of Science were searched for studies on pediatric percutaneous tracheostomy (age ≤18). The Joanna Briggs Institute and ROBINS-I tools were used for quality appraisal. RESULTS: Twenty-one articles were included resulting in 143 patients. Patient age ranged from 2 days to 17 years, with the largest subpopulation of patients (n = 57, 40 %) being adolescents (age between 12 and 17 years old). Main indications for percutaneous tracheostomy included prolonged ventilation (n = 6), respiratory insufficiency (n = 5), and upper airway obstruction (n = 5). One-third (n = 47) of percutaneous tracheostomies were completed at the bedside in an intensive care unit. Select studies reported on surgical time and time from intubation to tracheostomy with a mean of 13.8 (SD = 7.8) minutes (n = 27) and 8.9 (SD = 2.8) days (n = 35), respectively. Major postoperative complications included tracheoesophageal fistula (n = 4, 2.8 %) and pneumothorax (n = 3, 2.1 %). There were four conversions to open tracheostomy. CONCLUSION: Percutaneous tracheostomy had a similar risk of complications to open surgical tracheostomy in children and adolescents and can be performed at the bedside in a select group of patients if necessary. However, we feel that consideration must be given to the varying anatomical considerations in children and adolescents compared with adults, and therefore suggest that this procedure be reserved for adolescent patients with a thin body habitus and clearly demarcated and palpable anatomical landmarks who require a tracheostomy. When performed, we strongly support using endoscopic guidance and a surgeon who has the ability to convert to an open tracheostomy if required.


Assuntos
Complicações Pós-Operatórias , Traqueostomia , Adulto , Adolescente , Humanos , Criança , Recém-Nascido , Traqueostomia/efeitos adversos , Traqueostomia/métodos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Endoscopia/efeitos adversos , Unidades de Terapia Intensiva , Duração da Cirurgia
12.
Mymensingh Med J ; 33(1): 192-197, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38163792

RESUMO

Endoscopic transnasal repair of CSF rhinorrhoea is gaining popularity around the world because of its tremendous success rate but it depends on defect site, size, technique of repair, experiences of surgeon and also patient's profile. Aim of this study was to analysis of surgical outcome of endoscopic transnasal repair of CSF rhinorrhoea. A retrospective study carried out in the department of ENT and Head neck surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) from January 2018 to December 2019. Of the total of 24 patients 16(66.0%) were female and 8(33.0%) males. The commonest site of the leak was in the cribriform plate in 18(75.3%) followed by 5(20.8%) in the fovea ethmoidalis, and 1(4.0%) in the sphenoid sinus, the overall success rate of this series with first surgical procedure was 95.83% and 100.0% with a second procedure. Meticulous pre-operative evaluation, proper identification of leakage site, choice of graft materials and surgical technique are keys to attaining excellent results.


Assuntos
Rinorreia de Líquido Cefalorraquidiano , Masculino , Humanos , Feminino , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Rinorreia de Líquido Cefalorraquidiano/etiologia , Estudos Retrospectivos , Universidades , Endoscopia/efeitos adversos , Endoscopia/métodos , Seio Esfenoidal
13.
J Equine Vet Sci ; 132: 104986, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38135197

RESUMO

Effects of general anesthesia with controlled ventilation on the respiratory system have had limited evaluation in horses. A prospective observational study was performed with eleven client-owned horses undergoing elective surgery. Physical examination, auscultation with a rebreathing bag, complete blood cell count, lung ultrasound imaging, tracheal endoscopy imaging and transendoscopic tracheal wash were conducted before and 24 hours after anesthesia. Lung ultrasound imaging was also repeated just after recovery. A significant increase in blood neutrophil count between pre- and post-anesthesia (P=0.004) was observed. There was an increase in ultrasonographic score of the lungs at recovery (left P=0.007, right P=0.017). The score of the dependent lung was higher than the independent lung at recovery time (P=0.026) but no difference was observed 24 hours after anesthesia. The tracheal mucus score was higher after anesthesia (P=0.001); severe local inflammation was present in several horses at the site of endotracheal tube cuff. Neutrophil count was significantly higher on tracheal wash fluid cytology after anesthesia (P=0.016), without any significant changes on bacterial load. Increased tracheal mucus score and neutrophil count in tracheal wash samples were observed after general anesthesia in healthy horses without clinical evidence of pneumonia (fever, cough). Tracheal inflammation secondary to endotracheal intubation and cuff inflation was, therefore, suspected. Elective surgery without complications can induce inflammation of the trachea and changes in ultrasound images of the lungs in healthy horses and should be considered when evaluating respiratory system after a general anesthesia.


Assuntos
Endoscopia , Doenças dos Cavalos , Humanos , Cavalos , Animais , Endoscopia/efeitos adversos , Endoscopia/veterinária , Traqueia/diagnóstico por imagem , Traqueia/microbiologia , Inflamação/diagnóstico , Inflamação/veterinária , Neutrófilos , Anestesia por Inalação/veterinária , Doenças dos Cavalos/diagnóstico
14.
Am J Otolaryngol ; 45(1): 104107, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37948825

RESUMO

OBJECTIVES: Topic treatment can be useful to improve short and long-term nasal outcomes after nasal surgery, reducing discomfort and risk of synechia. This study aimed at evaluating the effect on clinical outcomes of nasal packaging using Fitostimoline® gauze in FESS and septoplasty. METHODS: A case-control study on hospitalized patients was performed in a tertiary referral center. The control group included 20 patients treated with the standard surgical protocol for septoplasty and standard nasal packaging; treatment group included 21 patients underwent same surgical procedure but in whom the nasal tampon was wrapped with a gauze containing Fitostimoline® before being placed into the nose. RESULTS: Patients in treatment group had better outcomes than control; nasal mucosa showed better healing - recovery of normal color- in those patients in whom we applied the Fitostimoline® gauze around tampons. Moreover, 100 % patients in the treatment group did not refer discomfort during at tampon removal versus 60 % subjects in the control group who referred pain, tension or tearing during the same action. CONCLUSION: Our results, although preliminary because of the small cohort of subjects included, suggest that the apposition of a gauze with Fitostimoline® after nasal surgery might improve the mucosal healing with consequent reduction of patients discomfort during the post-surgical period.


Assuntos
Obstrução Nasal , Rinoplastia , Humanos , Estudos de Casos e Controles , Septo Nasal/cirurgia , Rinoplastia/métodos , Endoscopia/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Resultado do Tratamento , Obstrução Nasal/cirurgia
15.
Surg Endosc ; 38(3): 1358-1366, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38114876

RESUMO

BACKGROUND: This study aimed to investigate the association between gastrectomy and endoscopic resection for gastric cancer and the subsequent tuberculosis incidence. METHODS: We conducted a nationwide matched cohort study using data from the Korea National Health Insurance Service from 2013 to 2019. We created two cohorts: patients who underwent gastrectomy and those who had endoscopic resection. Each patient was matched 1:1 with an unexposed individual based on index year, age, sex, income, and various comorbidities. The primary outcome was the incidence of tuberculosis during the follow-up period. RESULTS: Our study comprised 90,886 gastrectomy patients and 46,759 endoscopic resection patients. The tuberculosis incidence was significantly higher in the gastrectomy group compared to its matched non-gastrectomy group (IRR 1.69, 95% CI 1.43-1.99, p < .001). In contrast, there was no significant difference in tuberculosis incidence between the endoscopic resection group and its matched non-resection group (IRR 0.95, 95% CI 0.75-1.19, p = 0.627). The Kaplan-Meier cumulative incidence also did not differ between the two groups. However, tuberculosis incidence significantly increased in the first year after endoscopic resection. CONCLUSION: Gastrectomy for gastric cancer is associated with a higher incidence of subsequent tuberculosis, while no significant association was observed for endoscopic resection. However, tuberculosis incidence increases significantly during the first year after endoscopic resection.


Assuntos
Ressecção Endoscópica de Mucosa , Neoplasias Gástricas , Tuberculose , Humanos , Estudos de Coortes , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/complicações , Endoscopia/efeitos adversos , Gastrectomia/efeitos adversos , Tuberculose/epidemiologia , Tuberculose/etiologia , Tuberculose/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Ressecção Endoscópica de Mucosa/efeitos adversos
16.
Z Gerontol Geriatr ; 57(1): 59-70, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38108897

RESUMO

Gastrointestinal bleeding is a frequent symptom, with increasing age as a risk factor. Upper, middle and lower gastrointestinal bleeding are differentiated depending on the location, whereby only upper and lower gastrointestinal bleeding are elucidated in this article. The symptomatology varies depending on the localization of the bleeding. German and international clinical guidelines currently exist for the preclinical and clinical management of gastrointestinal bleeding. The main focus of the article is on pre-endoscopic management of upper gastrointestinal nonvariceal and variceal bleeding, including the risk stratification, transfusion and coagulation management as well as the initial pharmacological treatment. In addition, current developments in endoscopic and interventional treatment of gastrointestinal bleeding are highlighted.


Assuntos
Varizes Esofágicas e Gástricas , Hemorragia Gastrointestinal , Humanos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Varizes Esofágicas e Gástricas/complicações , Fatores de Risco , Endoscopia/efeitos adversos
17.
Artigo em Chinês | MEDLINE | ID: mdl-38114317

RESUMO

Congenital laryngomalacia is the most common disease causing laryngeal stridor in infants. The pathogenesis has not yet been clearly concluded. It may be related to abnormal development of laryngeal cartilage anatomical structure, neuromuscular dysfunction, gastroesophageal and laryngeal reflux disease, etc. The typical manifestations of the disease are inspiratory laryngeal stridor and feeding difficulties, which can be divided into mild, moderate and severe according to the severity of symptoms. The diagnosis is mainly based on clinical symptoms, signs and endoscopy, among which endoscopy is an important diagnostic basis. The treatment of laryngomalacia depends on the severity of symptoms. Mild and some moderate congenital laryngomalacia children can be relieved by conservative treatment, and severe and some moderate congenital laryngomalacia children should be treated by surgery. Supraglottic plasty is the main surgical method, which can effectively improve the symptoms of laryngeal stridor, dyspnea, feeding difficulties and growth retardation in most children, and the surgical effect is good.


Assuntos
Doenças da Laringe , Laringismo , Laringomalácia , Laringe , Lactente , Criança , Humanos , Laringomalácia/diagnóstico , Laringomalácia/terapia , Sons Respiratórios/diagnóstico , Sons Respiratórios/etiologia , Laringe/cirurgia , Doenças da Laringe/cirurgia , Endoscopia/efeitos adversos
18.
Medicine (Baltimore) ; 102(50): e36665, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-38115266

RESUMO

BACKGROUND: Unilateral biportal endoscopy (UBE) has been widely and skillfully used in the treatment of lumbar disc herniation and spinal canal stenosis. UBE surgery also brings some complications, such as dural tear, epidural hematoma, residual nucleus pulposus, etc. And we found a rare case of arachnoid cyst after UBE. CASE PRESENTATION: A 48 years old female who had a history of cholecystectomy, nephrolithiasis, hyperthyroidism, chronic atrophic gastritis, and colonic polyps with several years of low back pain and numbness in both lower limbs was found have arachnoid cyst 3 years after UBE operation. We hope that we can give a new aspect of complication after the UBE treatment in the future. CONCLUSION: We believe that the postoperative hypertension and the lack of postoperative back muscle strength training and some personal factors are the possible reasons for the arachnoid cyst in this case.


Assuntos
Cistos Aracnóideos , Hematoma Epidural Craniano , Hematoma Epidural Espinal , Feminino , Humanos , Pessoa de Meia-Idade , Endoscopia/efeitos adversos , Colecistectomia , Vértebras Lombares , Resultado do Tratamento , Estudos Retrospectivos
19.
BMJ Case Rep ; 16(12)2023 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-38129093

RESUMO

During this era of advanced and minimally invasive procedures for treating urolithiasis, percutaneous nephrolithotomy (PCNL) remains the primary choice for removing large renal calculi. While there are various known complications associated with PCNL, such as bleeding, sepsis and injury to neighboring organs, the occurrence of retained foreign bodies as a result of the procedure is rarely reported. In this case report, we present a unique instance of encrustation involving a retained guidewire sheath following PCNL, which was initially mistaken for a residual stone fragment in imaging studies. Fortunately, the foreign body was successfully removed using retrograde intrarenal surgery.


Assuntos
Corpos Estranhos , Cálculos Renais , Nefrolitotomia Percutânea , Nefrostomia Percutânea , Urolitíase , Humanos , Nefrolitotomia Percutânea/métodos , Endoscopia/efeitos adversos , Cálculos Renais/diagnóstico por imagem , Cálculos Renais/cirurgia , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Resultado do Tratamento , Nefrostomia Percutânea/efeitos adversos , Nefrostomia Percutânea/métodos
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