RESUMO
This report discusses a premature complex newborn with persistent pulmonary difficulties following the clipping of the PDA. Bronchoscopy was critical in revealing a metallic clip obstructing the bronchus. Thoracothomy revealed that the clip had been placed across the bronchus. This case illustrates the importance of bronchoscopy in the face of persistent unexplained pulmonary symptoms as well as having clear intraoperative exposure of the anatomy in this region to assure accurate placement of PDA metallic clips.
Assuntos
Brônquios/lesões , Permeabilidade do Canal Arterial/cirurgia , Recém-Nascido Prematuro , Ligadura/efeitos adversos , Instrumentos Cirúrgicos/efeitos adversos , Paralisia das Pregas Vocais/etiologia , Adulto , Obstrução das Vias Respiratórias/diagnóstico por imagem , Obstrução das Vias Respiratórias/cirurgia , Angiografia/métodos , Broncoscopia/métodos , Cesárea , Permeabilidade do Canal Arterial/diagnóstico por imagem , Endoscopia/efeitos adversos , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Recém-Nascido , Ligadura/instrumentação , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/cirurgia , Gravidez , Gravidez Múltipla , Reoperação/métodos , Medição de Risco , Resultado do Tratamento , Trigêmeos , Paralisia das Pregas Vocais/diagnóstico por imagem , Paralisia das Pregas Vocais/terapiaRESUMO
Cardiovascular magnetic resonance imaging (CMR) plays an important role in the preoperative and postoperative evaluation of congenital heart disease with newer techniques enabling faster and more comprehensive evaluation of the pediatric patient. This article reviews the clinical applications of CMR before and after surgery in the most common congenital heart anomalies in pediatric patients.
Assuntos
Cardiopatias Congênitas/patologia , Imageamento por Ressonância Magnética/métodos , Cuidados Pós-Operatórios/métodos , Cuidados Pré-Operatórios/métodos , Adolescente , Criança , Feminino , Humanos , Masculino , Miocárdio/patologiaRESUMO
OBJECTIVES: To determine the prevalence of transient bacteraemia after CT colonography (CTC). METHODS: Blood cultures were obtained at 5, 10 and 15 min after CTC from 100 consecutive consenting patients. Blood samples were cultured in both aerobic and anaerobic media and positive blood culture samples were analysed by a microbiologist. RESULTS: Blood culture samples were positive for growth in sixteen patients. All positive blood culture samples were confirmed skin contaminants. There were no cases of significant bacteraemia. The estimated significant bacteraemia rate as a result of CTC is 0-3.7%, based on 95% confidence intervals around extreme results using Wilson's score method. CONCLUSIONS: American Heart Association and National Institute for Clinical Excellence guidelines advise that antibiotic prophylaxis before lower gastrointestinal endoscopy is not indicated in patients with at risk cardiac lesions (ARCL) as the risk of a transient bacteraemia leading to infective endocarditis is low. These data show that the prevalence of transient bacteraemia after CTC is also low. It follows that patients with ARCL do not require antibiotic prophylaxis before CTC.
Assuntos
Antibacterianos/uso terapêutico , Bacteriemia/epidemiologia , Bacteriemia/prevenção & controle , Colonografia Tomográfica Computadorizada/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Irlanda/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de RiscoRESUMO
INTRODUCTION: Insertion of a percutaneous nephrostomy (PCN) catheter decompresses the upper urinary tract, thereby removing the hydroureteronephrosis upon which magnetic resonance (MR) urography is dependent for diagnosing the precise level and cause of ureteric obstruction. METHOD: We present the case of a young woman who required PCN insertion during pregnancy. RESULT: Only when unenhanced T2-weighted MR urography was repeated after the creation of an artificial hydronephrosis by an injection of sterile saline via the PCN catheter was the diagnosis of stone in the mid-ureter later made possible. CONCLUSION: This case highlights an easy solution to a limitation with the use of MR urography during pregnancy, when a physiological hydroureteronephrosis has been relieved by the insertion of a PCN catheter.
