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1.
China Journal of Orthopaedics and Traumatology ; (12): 1058-1064, 2023.
Article in Chinese | WPRIM | ID: wpr-1009185

ABSTRACT

OBJECTIVE@#To evaluate the feasibility of S2 alar iliac screw insertion in Chinese children using computerized three-dimension reconstruction and simulated screw placement technique, and to optimize the measurement of screw parameters.@*METHODS@#A total of 83 pelvic CT data of children who underwent pelvic CT scan December 2018 to December 2020 were retrospectively analyzed, excluding fractures, deformities, and tumors. There were 44 boys and 39 girls, with an average age of (10.66±3.52) years, and were divided into 4 groups based on age (group A:5 to 7 years old;group B:8 to 10 years old;group C:11-13 years old;group D:14 to 16 years old). The original CT data obtained were imported into Mimics software, and the bony structure of the pelvis was reconstructed, and the maximum and minimum cranial angles of the screws were simulated in the three-dimensional view with the placement of 6.5 mm diameter S2 alar iliac screws. Subsequently, the coronal angle, sagittal angle, transverse angle, total length of the screw, length of the screw in the sacrum, width of the iliac, and distance of the entry point from the skin were measured in 3-Matic software at the maximum and minimum head tilt angles, respectively. The differences among the screw parameters of S2 alar iliac screws in children of different ages and the differences between gender and side were compared and analyzed.@*RESULTS@#In all 83 children, 6.5 mm diameter S2 iliac screws could be placed. There was no significant difference between the side of each screw placement parameter. The 5 to 7 years old children had a significantly smaller screw coronal angle than other age groups, but in the screw sagittal angle, the difference was more mixed. The 5 to 7 years old children could obtain a larger angle at the maximum head tilt angle of the screw, but at the minimum cranial angle, the larger angle was obtained in the age group of 11 to 13 years old. There were no significant differences among the age groups. The coronal angle and sagittal angle under maximum cephalic angle and minimum cranial angle of 5 to 7 years old male were (40.91±2.91)° and (51.85±3.75)° respectively, which were significantly greater than in female. The coronal angle under minimum cranial angle was significantly greater in girls aged 8-10 years old than in boys. For the remaining screw placement angle parameters, there were no significant differences between gender. The differences in the minimum iliac width, the screw length, and the length of the sacral screws showed an increasing trend with age in all age groups. The distance from the screw entry point to the skin in boys were significantly smaller than that of girls. The minimum width of the iliac in boys at 14 to 16 years of age were significantly wider than that in girls at the same stage. In contrast, in girls aged 5 to 7 years and 11 to 13 years, the screw length was significantly longer than that of boys at the same stage.@*CONCLUSION@#The pelvis of children aged 5 to 16 years can safely accommodate the placement of 6.5 mm diameter S2 alar iliac screws, but the bony structures of the pelvis are developing and growing in children, precise assessment is needed to plan a reasonable screw trajectory and select the appropriate screw length.


Subject(s)
Humans , Male , Female , Child , Adolescent , Child, Preschool , Ilium/surgery , Retrospective Studies , Feasibility Studies , Bone Screws , Pelvis , Sacrum/surgery , Spinal Fusion/methods
2.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 1418-1422, 2023.
Article in Chinese | WPRIM | ID: wpr-1009077

ABSTRACT

OBJECTIVE@#To conduct anatomical study on the iliac crest chimeric tissue flap and summarize its effectiveness of clinical application in repairing limb wounds.@*METHODS@#Latex perfusion and anatomical study were performed on 6 fresh adult cadaver specimens with 12 sides, to observe the initial location, distribution, quantity, and direction of the common circumflexa iliac artery, the deep circumflexa iliac artery, and the superficial circumflexa iliac artery, and to measure their initial external diameter. Between December 2020 and September 2022, the iliac crest chimeric tissue flap repair was performed on 5 patients with soft tissue of limbs and bone defects. There were 3 males and 2 females, with an average age of 46 years (range, 23-60 years). Among them, there were 3 cases of radii and skin soft tissue defects and 2 cases of tibia and skin soft tissue defects. The length of bone defects was 4-8 cm and the area of skin soft tissue defects ranged from 9 cm×5 cm to 15 cm×6 cm. The length of the iliac flap was 4-8 cm and the area of skin flap ranged from 12.0 cm×5.5 cm to 16.0 cm×8.0 cm. The donor sites were directly sutured.@*RESULTS@#Anatomical studies showed that there were 10 common circumflex iliac arteries in 5 specimens, which originated from the lateral or posterolateral side of the transition between the external iliac artery and the femoral artery, with a length of 1.2-1.6 cm and an initial external diameter of 0.8-1.4 mm. In 1 specimen without common circumflexa iliac artery, the superficial and deep circumflex iliac arteries originated from the external iliac artery and the femoral artery, respectively, while the rest originated from the common circumflex iliac artery. The length of superficial circumflex iliac artery was 4.6-6.7 cm, and the initial external diameter was 0.4-0.8 mm. There were 3-6 perforator vessels along the way. The length of deep circumflex iliac artery was 7.8-9.2 cm, and the initial external diameter was 0.5-0.7 mm. There were 3-5 muscular branches, 4-6 periosteal branches, and 2-3 musculocutaneous branches along the way. Based on the anatomical observation results, all iliac crest chimeric tissue flaps were successfully resected and survived after operation. The wounds at recipient and donor sites healed by first intention. All patients were followed up 8-24 months, with an average of 12 months. The tissue flap has good appearance and soft texture. X-ray film reexamination showed that all the osteotomy healed, and no obvious bone resorption was observed during follow-up.@*CONCLUSION@#The common circumflex iliac artery, deep circumflex iliac artery, and superficial circumflex iliac artery were anatomically constant, and it was safe and reliable to use iliac crest chimeric tissue flap in repairing the soft tissue and bone defects of limbs.


Subject(s)
Adult , Male , Female , Humans , Middle Aged , Plastic Surgery Procedures , Ilium/surgery , Perforator Flap/blood supply , Skin Transplantation/methods , Lower Extremity/surgery , Soft Tissue Injuries/surgery , Treatment Outcome
3.
Int. j. med. surg. sci. (Print) ; 8(3): 1-7, sept. 2021. ilus
Article in English | LILACS | ID: biblio-1292580

ABSTRACT

Hip femoral head fractures are extremely uncommon, but likely associated with traumatic hip dislocations. Both lesions require emergent treatment to avoid further complications.19-year-old male patient was received after a high-energy motor vehicle accident with severe brain and thoraco-abdominal trauma and a displaced femoral head fracture with posterior hip dislocation with no acetabular fracture. An emergent open reduction and internal fixation with 2 headless screws was performed, as well as posterior capsule repair. After 1 month as an inpatient in Intensive Care Unit, he sustained a new episode of posterior hip dislocation. Consequently, a second successful surgical reduction was obtained, and hip stability was achieved by posterior reconstruction with iliac crest autograft fixed with cannulated screw and posterior structure repair. Two years later, he was able to walk independently and he does not present any signs of degenerative joint disease nor avascular necrosis.


Las fracturas de la cabeza femoral son extremadamente raras y están asociadas comúnmente con una luxación de cadera traumática. Ambas lesiones requieren tratamiento urgente con el objetivo de evitar complicaciones posteriores. Un paciente varón de 19 años fue trasladado tras un accidente de tráfico de alta energía en el que sufrió un traumatismo craneoencefálico y toracoabdominal grave, además de una fractura de cabeza femoral desplazada junto a una luxación posterior de cadera sin afectación acetabular. De manera urgente, fue intervenido mediante una reducción abierta y fijación interna de la fractura con dos tornillos canulados sin cabeza y reparación de la cápsula articular posterior. Tras un mes de ingreso en la unidad de cuidados intensivos, sufrió un nuevo episodio de luxación posterior de cadera. Debido a ello, se realiza una segunda intervención quirúrgica con reducción abierta y en la que se obtiene una adecuada estabilidad de la cadera mediante reconstrucción posterior con la adición de autoinjerto tricortical de cresta ilíaca y reparación capsular posterior. Después de dos años de seguimiento, el paciente deambula de manera independiente, sin dolor y sin signos degenerativos ni de necrosis avascular en las pruebas de imagen.


Subject(s)
Humans , Male , Young Adult , Transplantation, Autologous/methods , Femoral Fractures/surgery , Femur Head/injuries , Joint Dislocations/complications , Ilium/surgery
4.
Prensa méd. argent ; 105(2): 62-67, apr 2019. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1025660

ABSTRACT

Appendicitis is the inflammation of the vermiform appendix. Acute appendictis is the most common surgical emergency, and the most frequent cause of abdominal pain. It is considered that between 7 to 12% of the world population will develop the disease in some ciurcumstances of their lifes, being more frequent during the second and third decades. The aim of this study was to evaluate the comlications derivated from the delay in the anagement of the patients with this complaint. Usually, the signs and symptoms are frequently typical and the diagnosis quickly made. However, the classic syndrome may not be evident and the correct diagnosis may be obscure, in whom a delay in diagnosis can result in a lifebreatening situation. Inflammation of the appendix usually results from the obstruction of the appendiceal lumen. The diagnosis of appendicitis depends primarily on the history and physical findings, but confirmation of the diagnosis usually requires appropriate laboratory, radiographic or endoscopic studies. Pain is usually the first simptom. vomiting usually develops. Acute appendicitis should always be included in the differential diagnosis of abdominal pain. Low-grade fewer is usual. The most characteristic sign is point tenderness at Mc-Burney's pint, which is located one third of the distance from the anterior-superior iliac spine to the umbilicus.We present a retrospective analysis, descriptive and observational. In our study the Alvarado score was empliye. The complications observed are detailed, and the results obtained are commented


Subject(s)
Humans , Appendicitis/complications , Appendicitis/diagnosis , Epidemiology, Descriptive , Retrospective Studies , Delayed Diagnosis/adverse effects , Ilium/surgery
5.
Rev. cuba. ortop. traumatol ; 32(2): 0-0, jul.-dic. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1093703

ABSTRACT

El pinzamiento femoroacetabular provoca dolor agudo en la ingle anterior y limita la movilidad de la cadera. Es un síndrome clínico propiciado por una alteración en la anatomía ósea. Los osteocondromas son los principales tipos de tumores benignos, alteran la anatomía ósea y, según su localización, pueden generar dolor y pinzamiento. Este reporte de caso tuvo como objetivo el describir el tratamiento dado y la evolución clínica de un paciente con pinzamiento secundario a un osteocondroma ilíaco solitario. Se presenta un paciente masculino de 20 años con agudización de un dolor punzante y disminución en los arcos de movilidad en la articulación de la cadera derecha, sin mejoría con tratamiento sintomático. Mediante estudios de imagen se identificó una masa tumoral en la región afectada. Se realizó resección quirúrgica total mediante un abordaje lateral directo extendido de Hardinge. Dada la naturaleza benigna del tumor y su total resección, el paciente evolucionó satisfactoriamente y se pudo incorporar a sus actividades cotidianas. Se concluye que los osteocondromas no son exclusivos de las metáfisis o epífisis de huesos largos. Deben sospecharse las presentaciones atípicas cuando el cuadro clínico es sugestivo, aun después de la adolescencia(AU)


Femoroacetabular impingement generates acute pain in the anterior groin and limitation of hip mobility. It is a clinical syndrome caused by an alteration in bone anatomy. Osteochondromas are the main types of benign tumors, they alter the bone anatomy and depending on their location, they can generate pain and impingement. This case report aims to serve as a reference for specialized care in communicating the diagnostic challenges and approach in a patient with secondary clamping to osteochondroma of atypical presentation. The present case report aims to describe the given treatment and clinical evolution of a patients presenting femoroacetabular impingement secondary to a solitary osteochondroma. We report a 20-year-old male patient with exacerbation of a shooting pain and decrease in the mobility arches in his right hip joint, with no improvement with symptomatic treatment. Through imaging studies, a tumor mass was identified in the affected region. Total surgical resection was performed through an extended direct lateral approach of Hardinge. Given the benign nature of the tumor and its total resection, the patient evolved satisfactorily. The prognosis is favorable. He was able to return to his daily activities. We concluded that osteochondromas are not exclusive to the metaphysis or epiphyses of long bones. Atypical presentations should be suspected when clinical manifestations suggest so, even after adolescence(AU)


Le pincement fémoro-acétabulaire provoque une douleur aigue au niveau du bassin antérieur et empêche la mobilité de la hanche. Il s'agit d'un syndrome clinique poussé par une altération de l'anatomie osseuse. Les ostéochondromes sont des tumeurs bénignes, altérant l'anatomie osseuse et, selon leur localisation, pouvant même déclencher la douleur et le pincement. Ce rapport de cas a le but de décrire le traitement proposé et l'évolution clinique d'un patient atteint de pincement secondaire à un ostéochondrome iliaque solitaire. Un patient âgé de 20 ans souffrant la recrudescence d'une douleur aigue et la diminution des arcs de mobilité de l'articulation de la hanche droite, sans soulagement, même sous traitement symptomatique, est présenté. Une masse tumorale a été identifiée par imagerie dans la région affectée. On a effectué une résection chirurgicale totale par la voie d'abord latérale directe et étendue de Hardinge. Étant données la nature bénigne de la tumeur et sa totale résection, le patient a eu une évolution satisfaisante, et a pu s'incorporer aux activités de la vie quotidienne. On peut conclure que les ostéochondromes ne sont pas exclusifs de la métaphyse ou de l'épiphyse des os longs. On doit suspecter des présentations atypiques lorsque le tableau clinique est suggestif, même après l'adolescence(AU)


Subject(s)
Humans , Male , Adult , Bone Neoplasms/surgery , Bone Neoplasms/diagnostic imaging , Osteochondroma/surgery , Osteochondroma/diagnostic imaging , Femoracetabular Impingement/etiology , Ilium/surgery
6.
Rev. bras. cir. plást ; 29(3): 337-345, jul.-sep. 2014. ilus, graf, tab
Article in English, Portuguese | LILACS, BBO | ID: biblio-717

ABSTRACT

INTRODUÇÃO: Enxerto ósseo autógeno é o padrão no tratamento da falha óssea alveolar. Como a morbidade na área doadora após a obtenção de enxerto ósseo continua sendo um problema relevante em pacientes fissurados, este estudo avaliou a dor na área doadora de pacientes fissurados submetidos ao tratamento de falhas ósseas alveolares com a transferência de enxerto ósseo obtido da crista ilíaca, por meio de um estudo prospectivo randomizado, comparando dois extratores ósseos. MÉTODO: Trinta e seis pacientes com fissura labiopalatina, submetidos ao reparo da falha óssea alveolar com enxerto obtido da crista ilíaca com auxílio do extrator ósseo SOBRAPAR (grupo A) ou extrator ósseo UCLA (grupo B), foram incluídos. A dor na área doadora foi avaliada no período pós-operatório com auxílio da escala numérica unidimensional de dor (0- "sem dor"; 10- "pior dor que se pode imaginar"). RESULTADOS: As médias das mensurações da dor na área doadora não revelaram diferenças significativas (p>0,05 para todas as comparações) nas comparações realizadas entre os grupos A e B, em nenhum dos momentos pós-operatórios avaliados. Houve um maior número (p<0,05) de pacientes do grupo B que não reportaram dor na área doadora, quando comparado ao grupo A. CONCLUSÕES: Este estudo apresentou um maior número de pacientes do grupo B "sem dor", quando comparado aos pacientes do grupo A, não existindo diferenças entre aqueles que reportaram quaisquer notas diferentes de zero.


INTRODUCTION: Autogenous bone grafting is the standard treatment for alveolar bone defects. However, morbidity in the donor area after the bone graft has been obtained continues to be a significant problem in cleft patients. This prospective randomized study compared donor area pain associated with the use of 2 bone extractors in patients with cleft lip and palate, who underwent treatment of alveolar bone defects using a bone graft obtained from the iliac crest. METHOD: Thirty-six patients with cleft lip and palate underwent alveolar bone defect repair using a graft from the iliac crest, harvested with either a SOBRAPAR bone extractor (group A) or UCLA bone extractor (group B). Donor area pain was evaluated in the postoperative period with the aid of a unidimensional numerical pain scale (0, "no pain"; 10, "worst pain imaginable"). RESULTS: Comparison of the mean donor area pain score did not reveal any significant differences (p >0.05 for all comparisons) between the groups A and B, at any of the postoperative times evaluated. A significantly higher number of patients in group B reported no pain in the donor area, compared with group A (p <0.05). CONCLUSIONS: This study showed that a significantly greater number of patients in group B reported "no pain", compared with patients in group A; with regard to patients who reported any level of pain greater than zero, there were no between-group differences.


Subject(s)
Humans , Male , Female , Child , History, 21st Century , Postoperative Complications , Pain Measurement , Case Reports , Comparative Study , Dipyrone , Prospective Studies , Cleft Lip , Cleft Palate , Bone Transplantation , Evaluation Study , Alveolar Bone Grafting , Ilium , Mouth Abnormalities , Postoperative Complications/drug therapy , Pain Measurement/adverse effects , Pain Measurement/methods , Dipyrone/therapeutic use , Cleft Lip/surgery , Cleft Palate/surgery , Bone Transplantation/adverse effects , Bone Transplantation/methods , Alveolar Bone Grafting/adverse effects , Alveolar Bone Grafting/methods , Ilium/surgery , Mouth Abnormalities/surgery
7.
Clinics in Orthopedic Surgery ; : 225-229, 2013.
Article in English | WPRIM | ID: wpr-202397

ABSTRACT

Placing instrumentation into the ilium has been shown to increase the biomechanical stability and the fusion rates, but it has some disadvantages. The diagonal S2 screw technique is an attractive surgical procedure for degenerative lumbar deformity. Between 2008 and 2010, we carried out long fusion across the lumbosacral junction in 13 patients with a degenerative lumbar deformity using the diagonal S2 screws. In 12 of these 13 patients, the lumbosacral fusion was graded as solid fusion with obvious bridging bone (92%). One patient had a rod dislodge at one S2 screw and breakage of one S1 screw and underwent revision nine months postoperatively. So, we present alternative method of lumbopelvic fixation for long fusion in degenerative lumbar deformity using diagonal S2 screw instead of iliac screw.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bone Screws , Cohort Studies , Ilium/surgery , Lumbar Vertebrae/abnormalities , Sacrum/surgery , Spinal Fusion/adverse effects , Treatment Outcome
8.
Rev. bras. ortop ; 46(supl.1): 40-43, 2011.
Article in Portuguese | LILACS | ID: lil-596376

ABSTRACT

OBJETIVO: Avaliar a segurança do uso de fixação iliosacral com parafusos em pacientes com lesão do anel pélvico. MÉTODOS: Trata-se de um trabalho restrospectivo analisando por tomografia computadorizada a topografia de 60 parafusos inseridos em 46 pacientes portadores de lesões do anel pélvico e operados no INTO-RJ, no período de 2006 e 2010. RESULTADOS: Em 21,7 por cento dos casos o parafuso encontrava-se fora do corredor de segurança descrito em literatura. Destes, 77 por cento estavam associados a uma redução insatisfatória do anel pélvico. Não houve casos de lesão neurovascular em nossa série. CONCLUSÃO: O uso de parafusos ílio-sacrais é uma técnica segura, pois mesmo em casos onde o parafuso não respeitou uma topografia ideal, não houve complicações significativas associadas a este método. A má redução do anel pélvico é um fator muito importante associado ao mau posicionamento dos parafusos.


OBJECTIVE: To evaluate the safety of iliosacral screw fixation in pelvic injuries. METHODS: A retrospective study based on computer tomography evaluation of screw topography and its relationship with the so called pelvic safe corridor. RESULTS: We evaluated the topography of 60 screws inserted in 46 patients sustaining pelvic injuries which were operated in the INTO from 2006 to 2010. In 21.7 percent of cases the screw was located outside the safe corridor. 77 percent of these misplaced screws were associated with an unsatisfactory reduction of the pelvic injury. CONCLUSIONS: In our study, a significant rate of misplaced screws in relationship with the safe corridor has been pointed out and in most of these cases an insufficient reduction of the pelvis was also identified. We conclude that iliosacral fixation is a safe adjuvant method for pelvic fixation since in our series even with a relative high incidence of misplacements, no neurovascular injuries have been recorded in association with this technique.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Sacroiliac Joint/injuries , Bone Screws , Fracture Fixation, Internal , Ilium/surgery , Ilium/injuries , Pelvis/surgery , Pelvis/injuries
9.
West Indian med. j ; 57(5): 490-492, Nov. 2008. tab
Article in English | LILACS | ID: lil-672405

ABSTRACT

OBJECTIVES: To evaluate the complications of harvesting autogenous bone from the iliac crest. METHODS: A retrospective review of patients undergoing iliac crest bone grafting at the University Hospital of the West Indies, during the period 2000-2004, was performed. One hundred and three patients were identified. Thirty-two patients were successfully contacted and 30 completed the questionnaire. There were 18 males (60%) and 12 females (40%). Their ages ranged from 13 years to 80 years (average 45.6 years). RESULTS: Of the 30 patients, 22 (73.3%) had complications. Fourteen (46.6%) patients had temporary pain; five (16.6%) had chronic pain. Two (6.6%) changed position of clothing due to discomfort at the graft site; five (16.6%) experienced difficulty walking, one reported itching of the scar, one had altered sensation and one was unhappy with the scar. Fourteen patients (46.6%) had minor complications and eight patients (26.6%) had major complications. CONCLUSION: Autogenous iliac crest bone grafting is associated with significant complications.


OBJETIVOS: Evaluar las complicaciones de la cosecha de hueso autógeno de la cresta iliaca. MÉTODOS: Se realizó una revisión retrospectiva de pacientes a los que se les practicó el injerto de hueso de cresta iliaca en el Hospital Universitario de West Indies durante el periodo 2000-2004. Se identificaron ciento tres pacientes. Se logró contactar a treinta y dos de ellos, y 30 respondieron el cuestionario. Hubo 18 varones (60%) y 12 hembras (40%). La edad abarcó de 13 años a 80 años (promedio 45.6 años) RESULTADOS: De los 30 pacientes, 22 (73.3%) tuvieron complicaciones. Catorce (46.6%) pacientes tuvieron dolor temporal; 5 (16.6%) tenían dolor crónico. Dos (6.6%) cambiaron la posición de la ropa porque sentían malestar en el sitio del injerto; 5 (16.6%) experimentaron dificultad al caminar; uno reportó sentir comezón en la cicatriz; otro sentía alteración en sus sensaciones, y un último no se sentía satisfecho debido a la cicatriz. Catorce pacientes (46.6%) tuvieron complicaciones menores y ocho pacientes (26.6%) tuvieron complicaciones mayores. CONCLUSIÓN: El injerto de hueso autógeno de la cresta iliaca está asociado con complicaciones significativas.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Bone Transplantation/adverse effects , Ilium/surgery , Pain, Postoperative/epidemiology , Postoperative Complications/epidemiology , Tissue Donors , Tissue and Organ Harvesting/methods , Incidence , Jamaica , Pain, Postoperative/etiology , Postoperative Complications/etiology , Surveys and Questionnaires , Retrospective Studies
10.
HU rev ; 34(2): 141-145, abr.-jun. 2008. ilus
Article in Portuguese | LILACS | ID: lil-530922

ABSTRACT

O Íleo biliar é complicação rara da colecistite decorrente de uma comunicação anormal entre a via biliar e o tubo digestivo a qual permite a migração de um cálculo biliar volumoso para a luz entérica. É responsável por 1% a 4% de todos os casos de obstrução intestinal mecânica e apresenta maior prevalência em pacientes com mais de 65 anos. Freqüentemente cursa com um quadro de obstrução intestinal que, se não tratada a tempo, pode apresentar elevados índices de morbidade e mortalidade. O conhecimento prévio dessa patologia é de grande importância, principalmente em atendimentos de urgência e emergência, pois o tratamento é eminentemente cirúrgico e a incidência de diagnóstico pré-operatório é relativamente baixa. O presente artigo apresenta o caso de uma paciente de 67 anos, com Íleo biliar, que foi cirurgicamente tratada com a realização de enterotomia e retirada do cálculo. Não foram realizados os procedimentos de colecistectomia e correção de fístula colecistoduodenal em um primeiro momento em função das condições clínicas da paciente.


Gallstone ileus is a rare complication of cholecystitis, occurring because an abnormal connection of the biliary tree to the gut allows for a large gallstone to reach the intestinal lumen. The condition accounts for 1 to 4% of all cases of mechanical intestinal obstruction, and is more prevalent over the age of 65 years. It frequently leads to intestinal obstruction with high morbidity and mortality rates if not relieved in time. Because treatment is surgical and preoperative diagnosis rates are low, knowledge of the condition is of the essence, especially for those working in emergency rooms. We report a 67-year-old female with gallstone ileus, treated with enterotomy and stone removal. Because of the patient's clinical status, no cholecystectomy or correction of the cholecystoduodenal fistula were performed.


Subject(s)
Female , Aged , Gallstones/complications , Intestinal Obstruction , Cholelithiasis/complications , Ilium/surgery
12.
Egyptian Journal of Urology. 1996; 3 (1): 7-12
in English | IMEMR | ID: emr-40732

ABSTRACT

This study was carried out on 100 rats with an average weight of 250 grams. They were divided Into 5 groups: 20 non-operated rats served as a control group, while 20 rats each underwent sham procedure, gastrocystoplasty, ileocystoplasty and sigmoidocystoplasty. All operations were performed with microsurgery by a technique which is described. The rats were sacrificed 12 months postoperatively. There were no differences in serum electrolytes or renal function between the single groups. All urine cultures taken pre- and postoperatively were sterile. Prominent histopathologic changes were observed in the transplanted gastric and intestinal tissues and in the adjacent bladder wall. Possible aetiologies are discussed, but the actual aetiology and the potential for malignant progression of these lesions are unknown. Thus further studies with longer follow-up are warranted


Subject(s)
Animals, Laboratory , Ilium/surgery , Colon, Sigmoid/surgery , Rats , Follow-Up Studies
13.
Minoufia Medical Journal. 1996; 8 (2): 419-428
in English | IMEMR | ID: emr-42542
14.
Rev. bras. ortop ; 30(11/12): 881-4, nov.-dez. 1995. ilus
Article in Portuguese | LILACS | ID: lil-162659

ABSTRACT

Os autores descrevem caso de tumor de células gigantes do ilíaco direito com invasao sacra. O caso foi negligenciado por vários meses antes de ser referido. Estadiamento e biópsia revelaram o diagnóstico. Realizou-se embolizaçao pré-operatória. A cirurgia constou de ressecçao marginal lateral e intralesional no sacro, devido à continuidade com as raízes sacras. O peso tumoral foi de 1,650kg. A paciente teve incontinência urinária e fecal transitória, com resoluçao espontânea. Após quatro meses, teve apoio progressivo com muletas. Houve giro pélvico para cima, com fulcro no púbis. Paciente sem dor ou sinais clínicos de recidiva com 25 meses de lesao, no momento do relato.


Subject(s)
Humans , Female , Adult , Bone Neoplasms , Giant Cell Tumors , Ilium , Angiography , Ilium/surgery , Ilium , Bone Neoplasms/surgery , Bone Neoplasms , Tomography, X-Ray Computed , Giant Cell Tumors/surgery , Giant Cell Tumors
15.
Rev. bras. ortop ; 30(1/2): 57-60, jan.-fev. 1995. ilus, graf
Article in Portuguese | LILACS | ID: lil-161235

ABSTRACT

Foi avaliada a influência da osteotomia de Salter no crescimento do osso ilíaco. Para isso, nove coelhos de quatro semanas de idade foram submetidos à osteotomia de Salter no ilíaco direito e cinco coelhos foram submetidos a operaçao simulada. A pelve de cada animal foi radiografada imediatamente após a cirurgia e depois de seis meses, quando ocorreu o sacrifício. Nas radiografias foram realizadas medidas segmentares do comprimento da pelve, com o objetivo de avaliar o crescimento ósseo longitudinal dos ilíacos direito e esquerdo. Além disso, a pelve foi dissecada e, livre das partes moles, foi avaliada e medida diretamente. Foi constatado que o ilíaco operado (D) cresceu significativamente menos em todos os animais submetidos à osteotomia, em comparaçao como o ilíaco contralateral. Em 50 por cento dos animais operados, houve alteraçao significativa do contorno interno do anel pélvico, assim como assimetria da asa do ilíaco em que ocorreu a intervençao. Nos animais submetidos à operaçao simulada, nao houve diferença entre os lados.


Subject(s)
Animals , Female , Rabbits , Ilium/growth & development , Osteotomy/adverse effects , Ilium/surgery , Ilium , Pelvis
16.
Rev. bras. ortop ; 28(11/12): 825-8, nov.-dez. 1993. ilus
Article in Portuguese | LILACS | ID: lil-199752

ABSTRACT

Os autores descrevem um caso de osteossarcoma localmente avançado do osso iliaco tratado com quimioterapia neoadjuvante, ressecçäo de todo osso ilíaco, cabeça e dolo do fêmur, em monobloco, com todas as partes moles que envolviam o tumor e quimioterapia neoadjuvante. A paciente está livre de doença três anos após o início do tratamento, deambulando sem nenhuma forma de apoio e com suas atividades normais. Concluindo, com os avanços da quimioterapia no tratamento do osteossarcoma, a hemipelvectomia interna total representa uma nova abordagem cirúrgica que precisa ser divulgada em nosso meio, proporcionando melhora importante na qualidade de vida dos pacientes, quando comparamos com os resultados funcionais da amputaçäo interlioabdominal


Subject(s)
Humans , Female , Adolescent , Hemipelvectomy , Ilium/surgery , Bone Neoplasms/surgery , Osteosarcoma/surgery
17.
GEN ; 43(4): 261-5, oct.-dic. 1989. tab
Article in Spanish | LILACS | ID: lil-105610

ABSTRACT

Evaluamos el curso post-operatorio en niños anastomosis ileo-anal (Grupo 1, N-9), comparado con los resultados después de la anastomosis ileo-anal con reservorio (Grupo 2, N=7). Tres de nueve niños del Grupo 1 desarrollaron diarrea intratable, lo que hizo necesario una revisión de la anastomosis, para incluir una bolsa ileal. No hubo necesidad de revisión quirúrgica de la anastomosis para los pacientes del Grupo 2, aunque dos pacients tienen todavía la ileostomía, debido a la formación de absceso perianastomótico. Estos dos pacientes fueron excluídos del análisis subsiguiente. Dos meses después que la cirugía fue completada, niños en el Grupo 1 tuvieron 16 ñ 2 evacuaciones diarias en los cinco niños del Grupo 2, P < 0,05. Niños en el Grupo 1 tuvieron una evolución más pobre comparado con pacientes en el Grupo 2, determinado esto por: Incontinencia fecal (7/9 vs 0/5), dermatitis perianal (6/9 vs 1/5), tratamiento con agentes antidiarréicos (5/9 vs 0/5) ausentismo escolar (4/9 vs 0/5). Concluímos que para niños quienes requieren colectomía, quizás se obtengan mejores resultdos funcionales después de realizar una anastomosis ileo-anal con reservorio (creación de bolsa ileal) comparado con la anastomosis ileo-anal simple sin reservorio


Subject(s)
Anal Canal/surgery , Anastomosis, Surgical/methods , Ilium/surgery , Proctocolectomy, Restorative/methods , Adenomatous Polyposis Coli/surgery , Anastomosis, Surgical/adverse effects , Colitis, Ulcerative/surgery , Postoperative Complications
18.
GEN ; 43(4): 266-71, oct.-dic. 1989. tab
Article in Spanish | LILACS | ID: lil-105611

ABSTRACT

Se analizan los aspectos clínicos, el tratamiento quirúrgico y los resultados de 16 casos consecutivos de Megacolon tóxico como complicación de la rectocolitis ulcerosa, atendidos en la I Clínica Quirúrgica de la Universidad de Roma, en el período 1976-1987. La cirugía realizada fue la colectomía total con ileorecto-anastomosis en un solo tiempo, sin ileostomía de protección, en 14 pacientes y colectomía con ileostomía terminal e ileorectoanastomosis diferida, cinco meses más tarde, en 2 pacientes no tuvimos mortalidad operatoria, las complicaciones inmediatas fueron: dehiscencia parcial de la anastomosis en un caso, proctorragia en tres casos. Las tardías fueron: fistulización y perforación del "cul de sac" ileal, en 2 casos. En un paciente 10 meses más tarde fue necesaria la protectomía por intensa reaquidización de la enfermedad a nivel rectal, sobre la base de los resultados obtenidos, en casos seleccionados proponemos: La colectomía total con ileorectoanastomosis inmediata como tratamiento de esta grave complicación


Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Megacolon, Toxic/surgery , Anastomosis, Surgical/methods , Colectomy/methods , Colitis, Ulcerative/complications , Colitis, Ulcerative/surgery , Ileostomy/methods , Ilium/surgery , Megacolon, Toxic/diagnosis , Megacolon, Toxic/etiology , Postoperative Complications , Rectum/surgery , Retrospective Studies
19.
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo ; 40(6): 254-7, nov.-dez. 1985. ilus
Article in Portuguese | LILACS | ID: lil-28183

ABSTRACT

É notória a dificuldade de se estabilizar quadris portadores de luxaçäo patológica ou de displasia, principalmente nas seqüelas de pioartrite em crianças, nas quais geralmente se dá a destruiçäo da cabeça e colo femorais e grande ascensäo do segmento femoral; o mesmo ocorre nos casos de displasia do quadril de tipo congênito, embora a subida da cabeça femoral seja em menor grau. Nestes casos os métodos de estabilizaçäo do quadril através de enxertos ósseos usados como neoteto falham em funçäo de sua reabsorçäo e o quadro de instabilidade do quadril se reproduz. Nesta série de 11 casos, mostram-se os resultados preliminares obtidos com o emprego de enxerto ósseo pediculado usado como neoteto


Subject(s)
Adolescent , Adult , Humans , Bone and Bones/transplantation , Bone Lengthening , Hip Dislocation, Congenital/surgery , Hip Dislocation/surgery , Bone Resorption , Femur/surgery , Ilium/surgery
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