ABSTRACT
Abstract Background: Villi morphology and function affect the absorption capacity of the small intestine. Most tissues are fragile and their morphology may change with excessive manipulation and inadequate sampling techniques. Intestinal sampling includes methodologies such as cutting longitudinally or transversely, keeping the intestinal content in it and preserving all in a 10% formalin solution; washing the intestinal sample in saline solution while emptying it by pressing downwards with two fingers, conserving the sample in a 10% formalin solution and knotting both ends of the sample, introducing 10% formalin into it and preserving it in the same solution. Objective: To compare height, area and desquamation caused by washing, pressing, and knotting used in sampling and conservation techniques of small intestine villi of pigs. Methods: Samples (n = 270) from duodenum, jejunum and ileum of 30 Landrace × Yorkshire crossed pigs, aged 7 to 8 months were randomly subjected to washing, soft pressing or knotting procedures, fixed in 10% formalin solution, embedded in paraffin, and stained with eosin and hematoxylin. Intestinal villi in each slide were observed to determine height, surface area and cellular desquamation of each villus. Results: Villi height from duodenum and ileum knotted samples was higher (p<0.05) compared with samples from the other procedures in the same anatomical portion, which were similar to each other (p>0.05). Villi from knotted jejunum samples were the shortest (p<0.05) compared to the other two procedures, which were similar to each other (p>0.05). Knotted samples from ileum had larger villi area compared with the rest of the procedures and intestinal portions (p<0.05). Villi desquamation was similar among procedures and portions of the intestine (p>0.05). Conclusion: Knotting is the recommended procedure for intestinal cell morphometry evaluation, as values of villi height and area are higher. Desquamation in the three procedures may be related to epithelial restoration processes.
Resumen Antecedentes: La morfología y función de las vellosidades afectan la capacidad de absorción del intestino delgado. La mayoría de los tejidos son frágiles y su morfología puede cambiar con una manipulación excesiva y técnicas de muestreo inadecuadas. El muestreo intestinal incluye metodologías tales como el corte longitudinal o transversal, conservando el contenido intestinal y conservando todo en una solución de formol al 10%; lavado de la muestra de intestino en solución salina mientras se vacía, presionándola hacia abajo con dos dedos, conservando la muestra en solución de formol al 10% y anudando ambos extremos de la muestra, introduciendo en ella formol al 10% y preservándola en la misma solución. Objetivo: Comparar la altura, área y descamación causada por el lavado, presión y anudamiento utilizados en la toma de muestras y técnicas de conservación utilizadas en vellosidades intestinales en cerdos. Métodos: Se obtuvieron 270 muestras de duodeno, yeyuno e íleon de 30 cerdos cruzados Landrace × Yorkshire de 7 a 8 meses de edad, y se sometieron aleatoriamente a procedimientos de lavado, prensado suave o anudado y fueron fijados en solución de formol al 10%, procesados por inclusión en parafina y teñidos con eosina y hematoxilina. Se observaron las vellosidades intestinales de cada muestra para determinar su altura, la superficie de cada vellosidad y la descamación celular. Resultados: La altura de las vellosidades de las muestras anudadas de duodeno e íleon fue mayor (p<0,05) que las muestras de los otros procedimientos en la misma porción anatómica, las cuales fueron similares entre sí (p>0,05). Las vellosidades procedentes de muestras de nudos de yeyuno fueron las más cortas (p<0,05) en comparación con los otros dos procedimientos, que fueron similares entre sí (p>0,05). Las muestras anudadas del íleon presentaron mayor área de vellosidades que el resto de los procedimientos y porciones intestinales (p<0,05). La descamación de las vellosidades fue similar en todos los procedimientos y porciones del intestino (p>0,05). Conclusión: El procedimiento de anudamiento es el recomendado para la evaluación morfométrica de células intestinales, considerando que los valores de altura y área de las vellosidades son mayores. La observación de la descamación en los tres procedimientos puede estar relacionada con un proceso de restauración epitelial.
Resumo Antecedentes: A morfologia e função das vilosidades afeta a capacidade de absorção no intestino delgado. A maioria dos tecidos são frágeis e podem mudar sua morfologia com um manuseio excessivo e técnicas de amostragem inadequada. A amostragem de intestino inclui metodologias tais como corte longitudinal ou transversal, conservando o conteúdo intestinal e mantendo tudo em uma solução de formalina a 10%. A amostra do intestino é lavada em solução salina enquanto se esvazia pressionando para baixo com dois dedos, após isso a amostra é submergida em uma solução de formalina a 10% e atam-se as duas extremidades do intestino, mais formalina 10% é introduzida no mesmo e é preservado na mesma solução. Objetivo: Comparar a altura, área e descamação nas vilosidades do intestino delgado em porcos, causada pela lavagem, pressão e colocação do nó y pelas técnicas de conservação. Métodos: Duzentos e setentaa mostras de duodeno, jejuno e íleo de 30 porcos de cruzamento de raças Landrace e Yorkshire de sete a oito meses de idade foram submetidos aleatoriamente a procedimentos de lavagem, prensagem suave ou colocação de nós e foram fixados em solução de formalina a 10%, processados para inclusão em parafina e corados com hematoxilina e eosina. Foram observadas as vilosidades de cada amostra para determinar a sua altura, a superfície de cada célula vilosidade e descamação celular. Resultados: A altura das vilosidades nas amostras de duodeno e íleo com nó foi maior (p<0,05) do que as amostras de outros procedimentos na mesma parte anatómica, as quais foram semelhantes entre si (p>0,05). Amostras de jejunos com nó apresentaram vilosidades menores (p<0,05) em comparação com os outros dois procedimentos, que foram semelhantes entre si (p>0,05). Amostras de íleo com nó apresentaram maior área nas vilosidades do que outros procedimentos e outras porções do intestino (p<0,05). A descamação das vilosidades foi semelhante em todos os procedimentos e porções do intestino (p>0,05). Conclusão: O procedimento de colocação do nó é o recomendado para a avaliação morfométrica das células intestinais, já que os valores de altura e área das vilosidades são mais elevados. A observação da descamação nos três procedimentos poderia estar relacionada com um processo de restauração epitelial.
ABSTRACT
The clinical application of delayed double knotting over the entire microvascular ananstomotic for free tissues transform has the advantages of direct vision and it easy approachs,is useful to avoid the opposite wall biting and other mistakes.It is especially feasible in the management of the cases with endangium denudation.
ABSTRACT
Naso-Gastric (NG) tube use is very common in patients’ care at all levels of healthcare service delivery Worldwide. However, it is not without its complications. Naso-Gastric tube self-knotting is an unusual complication associated with its insertion and removal. A review of literature shows that no such case has been documented in our environment. Therefore, we thought it necessary to report this first case of self-knotting of NG tube encountered in the management of a 60 year old male post laryngectomy patient in the University of Port-Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. We want colleagues and other healthcare providers to be conversant with this unusual complication.
ABSTRACT
Abstract: Urethral catheterisation is a common and safe procedure performed routinely. The small size of the urethra in a child necessitates the use of an infant feeding tube (Size 5 to 8 F) for catheterisation. Knotting within the bladder is a rare complication with significant morbidity often necessitating surgical or endoscopic removal. Insertion of an excessive length of tube contributes to coiling and knotting. We report an instance of knotting of an infant feeding tube in the proximal penile urethra of a 4 year-old male child requiring urethrotomy to remove it. Awareness of the risk and proper technique can reduce this complication
ABSTRACT
The use of pulmonary artery catheter can be helpful in managing patients after cardiac surgery. Nevertheless, there is a risk of serious complications, such as knotting. A 61 year old man underwent tricuspid valve replacement under cardiopulmonary bypass (CPB). After implantation of a stented tissue valve in the tricuspid valve, repositioning of the catheter was performed. After weaning from CPB, an abnormal pattern of pulmonary artery pressure was suddenly observed on the monitor. Resistance was met when removing the catheter with the balloon deflated, at a 20 cm distance from the tip of the catheter. Chest radiography showed a knot in the catheter within the right brachiocephalic vein. Superior vena cava opened and the distal part of the catheter with the knot was successfully removed.
Subject(s)
Humans , Brachiocephalic Veins , Cardiopulmonary Bypass , Catheters , Organothiophosphorus Compounds , Pulmonary Artery , Stents , Thoracic Surgery , Thorax , Tricuspid Valve , Vena Cava, Superior , WeaningABSTRACT
Placement of a pulmonary artery catheter is associated with various complications, including catheter knotting. Fluoroscopy can be used to visualize and confirm catheter knotting. Transesophageal echocardiography is readily available to detect knot formation in the operating room or intensive care unit. We present a case in which pulmonary artery catheter knotting was detected by transesophageal echocardiography. This method may be useful in the operating room or in the intensive care unit to identify the presence and location of catheter knotting.
Subject(s)
Catheters , Echocardiography, Transesophageal , Fluoroscopy , Intensive Care Units , Operating Rooms , Pulmonary ArteryABSTRACT
Central venous catheterization has been frequently used in pediatric patients in wide variety of conditions. Several authors have described about various complication of central venous catheterization in pediatric patients and reported complication rates of 3% to 6%. Knotting of guidewire as a complication of central venous catheterization has been reported in adult patients, but knotting of guidewire has not been reported in infants. Therefore we report an infant who experienced a knotting of guidewire during internal jugular vein catheterization which was successfully removed without any adverse events. We suggest that knot formation is possible in infants and there should be a high suspicion if resistance is felt at the time of catheter advancement.
Subject(s)
Adult , Humans , Infant , Catheterization , Catheterization, Central Venous , Catheters , Central Venous Catheters , Jugular VeinsABSTRACT
The purposes of central venous catheterization (CVC) are as followings, central venous pressure monitoring, pulmonary artery catheterization and monitoring, transvenous cardiac pacing, temporary hemodialysis, drug administration, rapid infusion of fluids, aspiration of air embolism. Various complications may occur during CVC, such as hematoma, pneumothorax, hemothorax, hydrothorax, chylothorax, nerve and artery injury, air embolism, thromboembolism, arrhythmia, heart block, cardiac tamponade, and tracheal puncture. In Korea, several complications have been reported after CVC, such as pneumothorax, hemothorax, hemomediastinum, cardiac tamponade and tracheal puncture. However, there has been no report about the knotting of J-guide wire during the CVC. We report a case of J-guide wire knotting during central venous catheterization.
Subject(s)
Arrhythmias, Cardiac , Arteries , Cardiac Tamponade , Catheterization, Central Venous , Catheterization, Swan-Ganz , Central Venous Catheters , Central Venous Pressure , Chylothorax , Embolism, Air , Heart Block , Hematoma , Hemothorax , Hydrothorax , Korea , Pneumothorax , Punctures , Renal Dialysis , ThromboembolismABSTRACT
A pulmonary artery catheter (PAC) is a useful monitoring device for measuring pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac output, but its insertion brings about many complications including pulmonary artery rupture, infarction, thrombosis and infection. This case concerns the knotting of a PAC in a 27 year-old female patient who had undergone cardiac transplantation due to dilated cardiomyopathy. The PAC was inserted via the right subclavian vein to the pulmonary artery and withdrawn to the superior vena cava before heart was removed. After the weaning of the cardiopulmonary bypass (CPB), we tried to reinsert the PAC, which was neither advanced nor withdrawn. Postoperative chest x-ray revealed that the PAC appeared to be knotted in the subclavian vein. Two days later, we loosened the knot of the PAC and removed it via femoral and bracheal cineangiography techniques guided by fluoroscopy without any complications. In this case, we thought the knotting of the PAC occurred at insertion due to severe tricuspid regurgitation, and its size was reduced at withdrawal before the CPB and wedging to the subclavian vein. Knotting of PAC is very rare and unpredictable, but once it or other complications of the PAC is suspected, we recommend that the manipulation of the PAC should be stopped and x-ray should be checked.