ABSTRACT
This unique case reports the nonsurgical management of a late (2 years) methicillin-resistant Staphylococcus aureus neck infection around a Dacron-patched carotid endarterectomy. Because the patient was elderly with multiple serious risk factors and no drainable material, IV and oral antibiotics were selected as initial management. Follow-up computed tomography of the neck, however, documented complete resolution of the phlegmon. While the authors remain uncertain of the long-term outcome the patient is free of local infection 2 years after diagnosis and nonoperative treatment.
Subject(s)
Biocompatible Materials/adverse effects , Endarterectomy, Carotid/adverse effects , Polyethylene Terephthalates/adverse effects , Prosthesis-Related Infections/diagnostic imaging , Staphylococcal Infections/complications , Aged , Anti-Bacterial Agents/therapeutic use , Blood Vessel Prosthesis/adverse effects , Blood Vessel Prosthesis Implantation/adverse effects , Endarterectomy, Carotid/methods , Humans , Male , Methicillin Resistance , Prosthesis-Related Infections/drug therapy , Prosthesis-Related Infections/microbiology , Staphylococcus aureus , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
We report a very rare case of endometrial carcinoma causing extrahepatic bile duct obstruction. Management of this case and probable mechanism of spread are presented.
Subject(s)
Adenocarcinoma/complications , Cholestasis, Extrahepatic/etiology , Endometrial Neoplasms/complications , Adenocarcinoma/secondary , Aged , Cholestasis, Extrahepatic/surgery , Duodenal Neoplasms/secondary , Endometrial Neoplasms/pathology , Female , Humans , Lymphatic Metastasis , Retroperitoneal Neoplasms/secondaryABSTRACT
A unique case of fibromuscular dysplasia of the femoral artery with aneurysm and occlusion of the superficial femoral artery component is presented. This aneurysm was treated by dacron wrap. External dacron grafts have been previously reported and used with success in a variety of arterial aneurysms. The authors present their rationale and indication for its use in this unusual arterial problem.
Subject(s)
Aneurysm/complications , Aneurysm/surgery , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/surgery , Femoral Artery , Fibromuscular Dysplasia/complications , Fibromuscular Dysplasia/surgery , Adult , Aneurysm/diagnostic imaging , Angiography , Arterial Occlusive Diseases/diagnostic imaging , Blood Vessel Prosthesis , Female , Fibromuscular Dysplasia/diagnostic imaging , Humans , Polyethylene TerephthalatesABSTRACT
Reversed Autogenous Saphenous Vein (RASV) remains the material of choice in infrainguinal arterial bypass. A characteristic of RASV not seen in other grafts is its reverse tapered (RT) configuration. The purpose of this study was to investigate this geometric configuration. Straight 6 mm PTFE (gore-tex) grafts (SG) and 4-7 mm reverse tapered PTFE (gore-tex) grafts (RTG) were both implanted in the aorto-iliac position in 16 mongrel dogs. Specimens of surviving dogs were examined by the usual methods. In terms of absolute patency, 9 of 14 RTG (64%) and 5 of 14 SG (36%) P = 0.05, anastomotic thrombus formation 6 of 14 (43%) RTG vs. 10 of 14 (71%) SG P = 0.05 and in midgraft thrombus deposition P = 0.025 the RTG performed significantly better than the SG. In light of these results and other considerations, the reverse tapered configuration merits clinical investigation with other materials and in other species.
Subject(s)
Blood Vessel Prosthesis , Graft Occlusion, Vascular/prevention & control , Polytetrafluoroethylene , Animals , Aorta, Abdominal/surgery , Dogs , Iliac Artery/surgery , Prosthesis Design , Vascular PatencyABSTRACT
This is a brief case report of a patient who developed chylothorax subsequent to abdominal radiation for neuroblastoma, treated by aspirations and local chemotherapy, and mediastinal irradiation.
