ABSTRACT
We report the case of a 76-year-old woman with previous bariatric surgery and a large renal calculus following a prolonged lithotripsy session. The patient presented with peritonitis due to dehiscence of the gastrojejunal stapled anastomosis.
Subject(s)
Gastric Bypass/adverse effects , Jejunum/surgery , Kidney Calculi/therapy , Lithotripsy/adverse effects , Stomach/surgery , Surgical Wound Dehiscence/etiology , Aged , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Female , Follow-Up Studies , Gastric Bypass/methods , Humans , Kidney Calculi/complications , Kidney Calculi/diagnosis , Laparotomy/methods , Lithotripsy/methods , Obesity, Morbid/complications , Obesity, Morbid/surgery , Peritonitis/etiology , Reoperation , Suture Techniques/instrumentationABSTRACT
A case study of a patient who presented with abdominal pain and a palpable mesogastric mass is discussed. Ultrasound and computed tomography (CT) demonstrated that the palpable mass was jejunojejunal intussusception of the small intestine. The lead point of the intussusception was a lipoma that appeared in the CT scan as a small intramural mass with an attenuation coefficient of fat.
Subject(s)
Intussusception/diagnostic imaging , Jejunal Diseases/diagnostic imaging , Jejunal Neoplasms/complications , Lipoma/complications , Aged , Female , Humans , Intussusception/etiology , Jejunal Diseases/etiology , Tomography, X-Ray Computed , UltrasonographyABSTRACT
One hundred and one surgical procedures performed in children for construction and maintenance of vascular accesses for haemodialysis were retrospectively analyzed. There were 86 operations performed to create a new fistula in patients without vascular access or with nonrecoverable failed angio-access. Fifteen surgical procedures were performed to treat fistula complications. The new fistulas were radiocephalic n = 60 (70%), ulnar-basilic n = 5 (5.8%), antecubital n = 9 (10.3%), and PTFE grafts n = 12 (14%). Microsurgical techniques were used in all cases, including PTFE graft fistulas. A microscope was used in 56 cases (55.4%) and magnifying loupes (x 2.5 magnification) in the rest of the operations. Early-failure rate for radiocephalic fistulas was 10%. Cumulative patency rates in radiocephalic fistulas were 79%, 75%, and 70% at 1, 2, and 5 years, respectively. No statistical differences were found from the cumulative patency curve of 730 radial-cephalic fistulas performed in adults during the same period of time. Radiocephalic fistulas can be constructed in most paediatric cases using microsurgical technique. Elbow fistulas can be the second-choice vascular access, and PTFE grafts can be reserved for children with exhaustion of autologous veins. Brachial-jugular PTFE grafts can be used in cases of subclavian vein stenosis.
Subject(s)
Arteriovenous Shunt, Surgical/methods , Microsurgery/methods , Renal Dialysis , Adolescent , Blood Vessel Prosthesis , Child , Child, Preschool , Female , Follow-Up Studies , Graft Occlusion, Vascular/surgery , Humans , Infant , Male , Reoperation , Vascular Patency/physiologyABSTRACT
The Tc-99m HIDA scan is a valuable study after liver transplantation, associated with other image techniques. We have used this technique as a reliable and objective diagnostic method for biliary fistula after removal of the T-tube in 5 liver transplantation patients with pain after T-tube removal. All five patients who developed fistula not only were diagnosed immediately but, furthermore, the surgical technique was indicated by the gammagraphic study. After this experience, we propose to remove the T-tube during the Tc-99 HIDA scan.
