ABSTRACT
Duodenal loop obstruction is an unusual cause of acute pancreatitis. Increased intraluminal pressure hinders pancreatic flow, causing dilatation of the pancreatic duct and inducing acute pancreatitis. We experienced three cases of acute pancreatitis that resulted from duodenal loop obstruction after (1) an esophagectomy with gastric pull-up procedure for esophageal cancer, (2) a gastrectomy with Billroth I reconstruction for gastric cancer, and (3) a gastrojejunostomy for abdominal trauma. An abdominal CT scan revealed a distended duodenal loop, dilated pancreatic duct, and inflamed pancreas with fluid collection. Acute pancreatitis with duodenal loop obstruction was diagnosed by abdominal pain, elevated serum amylase/lipase, and abdominal CT findings. Immediate decompression with a nasogastric tube was performed, and all patients showed improvement within one week after admission. Each patient was followed up for more than two years without recurrence. Our findings suggest the usefulness of nasogastric tube decompression as the first line of treatment for acute pancreatitis related to duodenal loop obstruction.
Subject(s)
Humans , Abdominal Pain , Decompression , Dilatation , Duodenal Obstruction , Esophageal Neoplasms , Esophagectomy , Gastrectomy , Gastric Bypass , Gastroenterostomy , Pancreas , Pancreatic Ducts , Pancreatitis , Recurrence , Stomach Neoplasms , Tomography, X-Ray ComputedABSTRACT
Combination treatment of antiplatelet drugs containing aspirin and clopidogrel reduces systemic ischemic events after percutaneous coronary intervention (PCI) in high risk patients. However, this combination treatment of antiplatelet drugs is associated with increased risk of nonfatal and fatal bleeding. Diffuse alveolar hemorrhage after PCI is a rare complication that has been mostly reported in association with glycoprotein IIb/IIIa inhibitors. We report the case of a 62-year-old man who presented with ST elevation myocardial infarction and suffered a diffuse alveolar hemorrhage after clopidogrel use following primary PCI.
Subject(s)
Humans , Aspirin , Glycoproteins , Hemoptysis , Hemorrhage , Myocardial Infarction , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors , TiclopidineABSTRACT
Traumatic optic neuropathy is a complication resulting from facial trauma, with an incidence of 2% to 5%. The most widely accepted treatments include observation, high dose steroid, surgical decompression and combination therapy of steroid and surgical treatment. However, there has been no established mode of treatment and there are still debates about what the best treatment should be for the patients with optic canal fracture. We experienced two cases of traumatic optic neuropathies due to intracanalicular fracture of the optic canal after trauma. Surgical decompression was performed using an endoscope int-ranasally one day after injury as required for minimal invasive surgery. We report the results and progression of these two cases.
Subject(s)
Humans , Decompression , Decompression, Surgical , Endoscopes , Incidence , Optic Nerve , Optic Nerve InjuriesABSTRACT
Enophthalmos means displacement of the globe into the bony orbit backward, and usually downward. In post-traumatic enophthalmos, the mechanisms that determine the globe position can be the enlargement of the orbital cavity, the herniation of orbital fat into the maxillary sinus, fat atrophy, loss of ligament support, and scar contracture. It can be reconstructed through several approaches such as transconjunctival, canthotomy, lower eye lid, coronal approach, and by using bone, cartilage, and alloplastic materials. The authors report a case of postoperative enophthalmos reconstructed through subciliary and transnasal endoscopic approaches using porous polyethylene with embedded titanium.