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1.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431448

RESUMO

Embolised needles causing injury to the right heart and cardiac tamponade has been reported before in intravenous drug users, but to our knowledge, this is the first reported case of a needle migrating via the pulmonary arterial system to cause perforation of the left ventricle. Appropriate utilisation of imaging modalities such as plain X-ray and point-of-care focused cardiac ultrasound can be vital and life-saving in the emergency setting, and the value of gated multidetector CT as a powerful tool for imaging moving structures is highlighted.


Assuntos
Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Ventrículos do Coração/lesões , Agulhas/efeitos adversos , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Ponte Cardiopulmonar , Ecocardiografia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/etiologia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Pericardiocentese , Artéria Pulmonar/diagnóstico por imagem , Cirurgia Torácica Vídeoassistida , Resultado do Tratamento
2.
Cardiovasc Pathol ; 50: 107287, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32937188

RESUMO

Ischemia is a common complication of various endovascular procedures including endovascular aortic aneurysm repair. Multiple mechanisms can contribute to the pathogenesis of ischemia: thrombosis, arterial dissection, graft malpositioning, cholesterol embolization, and polymer graft embolization which is an underrecognized complication. To the best of our knowledge, only 38 cases of polymer graft embolization have been reported in the literature. The phenomenon has been reported in different organs including brain, heart, lungs, kidneys, bowel, liver, and skin. We report a unique case of fatal simultaneous cholesterol and polymer graft embolization with subsequent ischemic infarction of multiple organs (liver, kidneys, spleen, pancreas, duodenum, and stomach) in a 76-year-old woman following endovascular repair for an enlarging thoracic aortic aneurysm.


Assuntos
Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Embolia de Colesterol/etiologia , Procedimentos Endovasculares/instrumentação , Migração de Corpo Estranho/etiologia , Infarto/etiologia , Insuficiência de Múltiplos Órgãos/etiologia , Idoso , Aneurisma da Aorta Torácica/diagnóstico por imagem , Autopsia , Implante de Prótese Vascular/efeitos adversos , Embolia de Colesterol/diagnóstico , Procedimentos Endovasculares/efeitos adversos , Evolução Fatal , Feminino , Migração de Corpo Estranho/diagnóstico , Humanos , Infarto/diagnóstico , Insuficiência de Múltiplos Órgãos/diagnóstico , Resultado do Tratamento
3.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370975

RESUMO

A 52-year-old man presented with lower urinary tract symptoms and intermittent haematuria for the last 6 months. He had undergone totally extraperitoneal right inguinal hernia repair a decade ago. The ultrasonography and an X-ray of the pelvis suggested a large radio-opaque shadow in the bladder. However, CT revealed an encrusted intravesical extension of the migrated mesh along the right anterolateral wall. The entire intravesical part of the migrated mesh with encrustations was successfully retrieved by endourological approach using holmium laser. The patient symptomatically improved and at follow-up, cystoscopy showed a complete re-epithelisation of the bladder mucosa. The intravesical extension of migrated mesh is a rare but challenging complication following mesh hernioplasty and can be successfully managed with a complete endoscopic approach.


Assuntos
Remoção de Dispositivo/métodos , Migração de Corpo Estranho/cirurgia , Herniorrafia/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Falha de Prótese , Telas Cirúrgicas/efeitos adversos , Cistoscopia , Remoção de Dispositivo/instrumentação , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/diagnóstico , Hematúria/diagnóstico , Hematúria/etiologia , Hematúria/cirurgia , Hérnia Inguinal/cirurgia , Herniorrafia/instrumentação , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Ultrassonografia , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/cirurgia
4.
Tokai J Exp Clin Med ; 45(3): 108-112, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901896

RESUMO

A 33G, 12-mm needle broke and entered the soft tissue in a 60-year old man. Panoramic X-ray imaging and cone-beam computed tomography (CT), which we performed a few hours after the breakage, revealed the needle in the soft tissue of the lower right mandibular molar. We immediately made an incision in the buccal gingiva of the lower right mandibular molar under local anesthesia and attempted to remove the needle but could not locate it. Thereafter, we adopted a watch-and-wait approach, as the patient had no subjective symptoms. Nine months later, we confirmed via CT that the needle had migrated subcutaneously to the right side of the neck. Two months later, we identified its location using C-arm fluoroscopy and removed it under general anesthesia. This report is a rare case and we are the first to document the subcutaneous migration of a fractured needle.


Assuntos
Corpos Estranhos , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/cirurgia , Gengiva , Mandíbula , Pescoço , Agulhas/efeitos adversos , Anestesia Dentária , Anestesia Local , Tomografia Computadorizada de Feixe Cônico , Fluoroscopia , Humanos , Masculino , Pessoa de Meia-Idade
6.
Am J Emerg Med ; 38(8): 1697.e5-1697.e7, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32482484

RESUMO

Foreign body(FB) in soft tissue is a common injury in trauma, but it is rare for FB to enter the blood vessel. Typical causes of intravascular FB include iatrogenic and non-iatrogenic factors.A 65-year-old Chinese worker's left hand was hit by two colliding metal blocks while operating a machine tool. Then, he referred to our hospital's emergency department of orthopedics. The X-rays showed that metal FB could be seen in trapezium bone regions of the left hand. During the operation, the FB was found in the cephalic vein of his left hand, so the FB was removed by surgery. After six weeks of follow-up, he has returned to normal working conditions.The purpose of this article is to describe the diagnosis and treatment of a rare condition in the emergency department. In our emergency work, it is easy to miss the diagnosis of intravascular FB caused by trauma. To our knowledge, this is the third reported intravascular FB caused by trauma and the first reported intravascular FB was located in the vein of the hand. Detailed medical history and auxiliary examinations are the key to the diagnosis of FB in the blood vessels.


Assuntos
Corpos Estranhos/diagnóstico , Veias , Idoso , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/terapia , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/terapia , Traumatismos da Mão/complicações , Traumatismos da Mão/diagnóstico por imagem , Humanos , Masculino , Radiografia
7.
Ann Thorac Surg ; 110(3): e153-e155, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32142816

RESUMO

Inferior vena cava filters are used for patients with pulmonary embolism or those with risk of embolization. Here we present a case of a 38-year-old man who underwent placement of an inferior vena cava filter because of deep vein thrombosis. The operating arm fractured and embolized to the posteromedial papillary muscle of mitral valve and the posterior inferior wall of the left ventricle through right atrium and atrioventricular septum, leading to large symptomatic mitral and tricuspid insufficiency and pericardial tamponade. Here we report a rare case where the filter migrated to the left ventricle and destroyed the mitral valve.


Assuntos
Migração de Corpo Estranho/diagnóstico , Ventrículos do Coração , Insuficiência da Valva Mitral/etiologia , Valva Mitral/lesões , Insuficiência da Valva Tricúspide/etiologia , Filtros de Veia Cava/efeitos adversos , Adulto , Tamponamento Cardíaco/diagnóstico , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/cirurgia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/cirurgia , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/cirurgia , Embolia Pulmonar/etiologia , Embolia Pulmonar/prevenção & controle , Insuficiência da Valva Tricúspide/diagnóstico , Insuficiência da Valva Tricúspide/cirurgia , Veia Cava Inferior , Trombose Venosa/complicações
10.
J Cardiovasc Med (Hagerstown) ; 21(2): 156-157, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31567633

RESUMO

: Twiddler's syndrome is an uncommon cause of cardiac implantable electronic device malfunction, usually due to manipulation of the pulse generator. A few spontaneous cases have already been described. We present the unique case of a 77-year-old woman who experienced iatrogenic Twiddler's syndrome.


Assuntos
Acidentes por Quedas , Braquetes/efeitos adversos , Desfibriladores Implantáveis , Cardioversão Elétrica/instrumentação , Migração de Corpo Estranho/etiologia , Doença Iatrogênica , Traumatismos da Medula Espinal/terapia , Idoso , Feminino , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/cirurgia , Humanos , Desenho de Prótese , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/fisiopatologia
11.
Ann Thorac Surg ; 109(2): e107-e108, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31276648

RESUMO

Patients undergoing sternotomy routinely undergo sternal closure with stainless steel wires. Occasionally these wires can fracture, although normally this presents no concern as the broken wire remains fixed and is not problematic. We report a case of a segment of a broken sternal wire that migrated through the pericardium onto the right ventricular. It was removed with a minimally invasive approach with endoscopic assistance.


Assuntos
Fios Ortopédicos/efeitos adversos , Remoção de Dispositivo/métodos , Endoscopia/métodos , Migração de Corpo Estranho/cirurgia , Traumatismos Cardíacos/cirurgia , Ventrículos do Coração/lesões , Pericárdio/lesões , Idoso , Falha de Equipamento , Feminino , Fluoroscopia , Migração de Corpo Estranho/diagnóstico , Traumatismos Cardíacos/diagnóstico , Traumatismos Cardíacos/etiologia , Ventrículos do Coração/diagnóstico por imagem , Humanos , Pericárdio/diagnóstico por imagem , Radiografia Torácica , Esternotomia/efeitos adversos
13.
J Vasc Access ; 21(2): 259-264, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31364466

RESUMO

INTRODUCTION: Peripherally inserted central catheter tip migration is an infrequent event that occurs in neonatal, pediatric, and adult patients. We discuss a novel technique of utilizing intracavitary electrocardiogram to help confirm proper peripherally inserted central catheter tip repositioning, thereby reducing the need for serial radiographs. CASE PRESENTATION: A case series of four patients will be discussed. The first three patients had peripherally inserted central catheter tips that were initially appropriately positioned but had later peripherally inserted central catheter tip migration. The use of intracavitary electrocardiogram was able to confirm the appropriate repositioning of the peripherally inserted central catheters without the need for serial radiographs. The fourth patient had several central lines in place, which led to difficulty in identifying the peripherally inserted central catheter tip location. The use of intracavitary electrocardiogram confirmed proper positioning of his peripherally inserted central catheter tip when standard radiographs could not provide clarity. DISCUSSION: Several techniques have been published on methods to reposition a migrated peripherally inserted central catheter tip back to the superior vena cava/right atrial junction. These repositioning techniques often require fluoroscopic guidance or a confirmatory radiograph to assess the appropriate peripherally inserted central catheter tip location. At times, several radiographs may be required before the tip is successfully repositioned. This novel application of intracavitary electrocardiogram can help to minimize radiographs when peripherally inserted central catheter tip repositioning is required.


Assuntos
Cateterismo Venoso Central/instrumentação , Cateterismo Periférico/instrumentação , Cateteres de Demora , Cateteres Venosos Centrais , Eletrocardiografia , Migração de Corpo Estranho/diagnóstico , Adolescente , Cateterismo Venoso Central/efeitos adversos , Cateterismo Periférico/efeitos adversos , Pré-Escolar , Feminino , Migração de Corpo Estranho/etiologia , Migração de Corpo Estranho/terapia , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Radiografia Intervencionista
14.
Medicine (Baltimore) ; 98(48): e18153, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770257

RESUMO

RATIONALE: Migration of endoclips and stitches into the duodenum after laparoscopic hepatectomy is incredibly rare with a poorly understood mechanism. PATIENT CONCERNS: A 56-year-old woman who underwent laparoscopic left hepatectomy and cholecystectomy in August 2016 was admitted to our hospital with nausea and vomiting in December 2017. DIAGNOSES: Abdominal computed tomography (CT) scan showed high density shades in duodenal ampulla. Esophagogastroduodenoscopy showed deformation of the duodenal ampulla into two lumens; hem-o-lock clips and stitches were detected in the upper lumen. Contrast enhanced CT scan revealed gastric cancer with liver metastasis (GCLM). INTERVENTIONS: The hem-o-lock clips and stitches were present in the wall of the duodenum; therefore, no attempt was made to remove them. High quality liquid diet, partial parenteral nutrition, and chemotherapy were administered to the patient. OUTCOMES: In September 2018, the patient died of hepatic failure caused by GCLM. LESSONS: This rare complication of the migration of endoclips and stitches into the duodenum after laparoscopic hepatectomy can cause epigastric pain and duodenal obstruction. The complication could be potentially avoided using absorbable endoclips and stitches or by performing of ultrasonic dissection by a skilled operator.


Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Obstrução Duodenal , Migração de Corpo Estranho , Hepatectomia/efeitos adversos , Complicações Pós-Operatórias , Instrumentos Cirúrgicos/efeitos adversos , Colecistectomia Laparoscópica/métodos , Tratamento Conservador/métodos , Obstrução Duodenal/diagnóstico por imagem , Obstrução Duodenal/etiologia , Obstrução Duodenal/fisiopatologia , Obstrução Duodenal/terapia , Endoscopia do Sistema Digestório/métodos , Feminino , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/fisiopatologia , Hepatectomia/métodos , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Administração dos Cuidados ao Paciente/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Neoplasias Gástricas/complicações , Neoplasias Gástricas/patologia , Neoplasias Gástricas/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
15.
Pan Afr Med J ; 33: 259, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692836

RESUMO

Central venous catheter placement especially the femoral venous catheter is a common practice in critically ill patients. Awareness of potential complications of the guidewire such as guidewire migration is of utmost importance. Though potentially retrievable by a vascular surgeon or interventional radiologist if it occurs, close supervision by a senior person during passage by a junior or inexperienced person, the use of ultrasound before and after placement of catheter, and use of a checklist may help to identify and prevent its occurrence. We present a very rare complication of central venous cannulation of a guidewire migration in our institution. A 12-year-old girl presented to the Paediatric Emergency Unit (PEU) with status epilepticus and aspiration pneumonia and subsequently transferred to the Paediatric Intensive Care Unit (PICU) for ventilatory support. She had accidental guidewire migration to the left internal jugular vein following a right transfemoral central venous catheterization. She underwent successful guidewire retrieval via a right groin incision.


Assuntos
Cateterismo Venoso Central/efeitos adversos , Migração de Corpo Estranho/diagnóstico , Veias Jugulares , Criança , Feminino , Veia Femoral , Humanos , Unidades de Terapia Intensiva Pediátrica
17.
Orthop Traumatol Surg Res ; 105(5): 1013-1020, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31255502

RESUMO

BACKGROUND: The osseointegrated (OI) prosthesis is a treatment option for transfemoral amputees with a short residual femur and/or difficulties caused by using the prosthetic socket. Implant removal due to aseptic or septic loosening is not uncommon, but the association between implant migration patterns and the need for removal has not previously been studied. We conducted a prospective model-based radiostereometric analysis study to investigate: if the OI implant migration pattern 1) differs between later removed implants and non-removed implants, (2) predicts later implant removal, and (3) if the precision of the method is acceptable. HYPOTHESIS: Model-based radiostereometric analysis of the OI implant migration pattern can be used to predict later OI implant removal. MATERIAL AND METHODS: A prospective cohort of 17 consecutive transfemoral amputees suitable for surgery (11 males), mean age 50 (range 32-66) were treated with an OI implant (Integrum AB, Sweden). Postoperative stereoradiographs of the OI implant were obtained during 24-month follow-up. X, Y, and Z translations and total translations were evaluated using CAD-implant models. Implant survival was followed for up to 60 months. RESULTS: Six total implant removals (fixture and abutment) and four partial removals (abutment) were conducted (10/17 (59%)), and one patient did not use the OI implant. The removed implants group migrated a mean (±standard deviation) 0.55mm±0.75mm (p=0.009) and the non-removed implants group migrated 0.31mm±0.51mm (p=0.22) in total translations from 3 months to last follow-up. Odds ratio for implant removal was 22.5 (95% CI: 1.6 to 314 (p=0.021)) if the OI implants migrated distally. CONCLUSION: Later removed OI implants migrated from 3 months to last follow-up and more than the non-removed OI implants. Distal implant migration greatly increased the odds of implant removal. Ten out of 17 OI implants were removed within 5 years of follow-up. We advise to use OI implants with caution and close follow-up in consideration of the risk of complications. LEVEL OF EVIDENCE: IV, Prospective study.


Assuntos
Amputados , Prótese Ancorada no Osso/efeitos adversos , Remoção de Dispositivo/métodos , Fêmur/cirurgia , Migração de Corpo Estranho/cirurgia , Implantação de Prótese/efeitos adversos , Análise Radioestereométrica/métodos , Adulto , Idoso , Feminino , Seguimentos , Migração de Corpo Estranho/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Osseointegração , Estudos Prospectivos , Desenho de Prótese , Radiografia , Fatores de Tempo , Resultado do Tratamento
18.
Physiol Res ; 68(4): 667-673, 2019 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-31177789

RESUMO

Electrode migration is the most common complication of spinal cord stimulation (SCS). The problem of longitudinal migration has already been solved, but lateral migration remains the most common current complication. The present article describes new electrodes fixation opportunities for the reduction of lateral migration in SCS. The pig was chosen as an animal model to illustrate a new protocol of electrode fixation for the control of lateral and longitudinal migration. The displacement of the electrode was measured using two different optical methods: the digital image stereo-correlation and the digital image processing methods. Fixation with two anchors has always considerably reduced electrode displacement and when fixation is done with two anchors and a loop then lateral migration is reduced by 62.5 % and longitudinal migration is reduced by 94.1 %. It was shown that the results are significantly different at the alpha=0.001 significance level. Based on a statistical evaluation it is possible to state that the differences between experimental results obtained for three different protocols of lead fixation are statistically significant and we can recommend the new fixation method for common practice.


Assuntos
Eletrodos Implantados/normas , Migração de Corpo Estranho/diagnóstico , Migração de Corpo Estranho/prevenção & controle , Processamento de Imagem Assistida por Computador/métodos , Modelos Animais , Animais , Suínos
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