1/1031. Venous gas embolism during endoscopy.Venous gas embolism is a rare but serious complication of laparoscopic and endoscopic procedures. We describe the case of a 33-year-old woman with a strictured hepaticojejunostomy anastomosis who was treated with transabdominal endoscopic balloon dilation. During the procedure, she suffered a venous gas embolus with immediate cardiovascular collapse. After treatment with pressors, electrical cardioversion, and multiple aspirations of the right ventricle, the patient recovered fully. We reviewed all reported cases of venous gas embolism during endoscopy over the past 30 years and identified multiple risk factors. We suggest precautions to minimize future complications in patients at increased risk.- - - - - - - - - - ranking = 1keywords = stricture (Clic here for more details about this article) |
2/1031. Pathogenic role of glomerulo-tubular junction stenosis in glomerulocystic disease.Glomerulocystic disease is an uncommon cystic renal condition characterized by cystic dilatation forming a glomerular cyst. The pathogenesis of this familial disease is unknown. We performed a serial section study using a biopsy specimen of a 16-year old female patient with glomerular cystic disease who had a family history of end stage renal failure. A total of 14 different glomeruli were analyzed, four of which exhibited a cystic appearance. Five glomerulotubular junctions were observed by serial sections, two of which had a stenotic appearance where glomerular cystic changes and periglomerular fibrosis were observed concomitantly. There were no such cystic glomerular changes in the other three glomeruli with non-stenotic glomerulo-tubular junctions. These findings suggest that the glomerular cystic lesion develops as a consequence of glomerulo-tubular junctional stenosis probably caused by periglomerular fibrosis.- - - - - - - - - - ranking = 2.7421957565904keywords = stenosis (Clic here for more details about this article) |
3/1031. coronary angiography with 5 French diagnostic catheters may miss an ostial left main stenosis.Critical ostial left main disease may lead rapidly to sudden death and is, therefore, of paramount importance to diagnose. While the number of cardiac catheterizations is increasing, government and third party reimbursement sources are imposing pressure to perform more studies in an outpatient setting, as the economic resources for medical procedures are shrinking. Outpatient cardiac catheterization requires the patient to ambulate within several hours after the procedure. In order to allow patients to safely ambulate early after their procedures, 5 French catheters are often used (whether the femoral or brachial approach is used) rather than the standard 7 French catheters. We describe a patient with an ostial left main stenosis that was not visualized when coronary arteriography was performed using a diagnostic 5 French catheter. Selective intubation of the left main coronary artery was easily achieved without damping of the pressure tracing. Selective coronary angiography did not demonstrate the ostial stenosis, and there appeared to be a normal amount of contrast refluxing into the aortic root. When the patient returned for an angioplasty and a guiding angiogram was performed with an 8 French catheter, an ostial stenosis was evident with coronary angiography.- - - - - - - - - - ranking = 3.8390740592266keywords = stenosis (Clic here for more details about this article) |
4/1031. Stenosis of the nasal vestibule and its treatment.From our own experience and a review of the literature, we present a few techniques which, in our eyes, give the surgeon the possibility to treat most encountered cases of stenosis of the nasal vestibule. During 1991 to 1998 the author in Stuttgart (W.G.) performed simple z-plasty combined with local flaps in 6 patients and composite grafts only in 12 cases, to correct nasal vestibule stenosis. The author in Lausanne (R.M.), who first described the paranasal myocutaneous flap to correct not only nasal vestibule stenosis but also alar base malposition has treated over 50 patients with this technique and with composite grafts during the last 20 years.- - - - - - - - - - ranking = 1.6453174539542keywords = stenosis (Clic here for more details about this article) |
5/1031. Hysteroscopic cervical canal shaving: a new therapy for cervical stenosis before embryo transfer in patients undergoing in vitro fertilization.OBJECTIVE: To report a case of cervical stenosis repaired by hysteroscopic cervical shaving that created a smooth passage for ET in a patient undergoing IVF. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A woman with a history of multiple failed IVF attempts in whom ET was extremely difficult. INTERVENTION(S): Operative hysteroscopy with creation of a cervical tract. MAIN OUTCOME MEASURE(S): Ease of postoperative ET and outcome of IVF treatment after the hysteroscopic procedure. RESULT(S): Easy performance of ET and a resulting triplet pregnancy. CONCLUSION(S): This novel hysteroscopic repair of cervical stenosis resulted in a markedly easier ET and a viable pregnancy.- - - - - - - - - - ranking = 3.2906349079085keywords = stenosis (Clic here for more details about this article) |
6/1031. Posterior decompression of the vertebral artery narrowed by cervical osteophyte: case report.BACKGROUND: Symptomatic vertebral artery compression caused by cervical spondylosis usually is caused by compression of the artery by osteophytes arising from the uncinate process. Compression from facet joint osteophytes is seldom reported. CASE DESCRIPTION: A 69-year-old male developed symptomatic vertebral artery stenosis secondary to an osteophyte arising from the superior facet of the sixth cervical vertebra posterior to the artery. A posterior decompression of the vertebral artery with removal of the offending facet joint complex relieved the patient's transient neurologic events. CONCLUSION: Symptomatic vertebral artery stenosis may be caused by osteophytes compressing the vertebral artery anteriorly from the uncinate process or posteriorly from the facet complex.- - - - - - - - - - ranking = 1.0968783026362keywords = stenosis (Clic here for more details about this article) |
7/1031. Laparoscopic ileocecal resection for Crohn's disease associated with intestinal stenosis and ileorectal fistula.Although a complete remission of Crohn's disease can be induced by conservative therapy, surgical treatment is often required for patients with intestinal stenosis or fistulas, for whom minimally invasive laparoscopic surgery appears to be most appropriate. We herein report on a 26-year-old patient with Crohn's disease, who presented with an ileorectal fistula and severe stenosis of the terminal ileum and thus underwent laparoscopic surgery. The ileorectal fistula was divided intracorporeally using an autostapling device. The return to full activity after laparoscopic surgery is earlier than after open surgery, and the former approach is often beneficial for some patients with Crohn's disease. This is the first report of laparoscopic surgery for Crohn's disease associated with ileorectal fistula.- - - - - - - - - - ranking = 3.2906349079085keywords = stenosis (Clic here for more details about this article) |
8/1031. Colonic stenosis after hemolytic-uremic syndrome.Colonic necrosis and intestinal perforation are the usual surgical complications of hemolytic syndrome. We present a case of right transverse colon stricture following hemolytic-uremic syndrome.- - - - - - - - - - ranking = 3.1937566052723keywords = stricture, stenosis (Clic here for more details about this article) |
9/1031. Rotational atherectomy for left anterior descending artery septal perforator stenosis.Stenosis in large septal perforators can result in significant clinical ischemia. The distribution of the septal arteries is as large as many more commonly treated branch vessels. The interventricular septal blood supply has been ignored as a target for revascularization due to its inaccessibility for surgical revascularization, and the elastic recoil associated with balloon angioplasty in this location. Rotational atherectomy is a new therapeutic option for revascularization in this previously difficult location. The septal perforator ostium is the most common site of lesions and is functionally a branch ostial stenosis. We describe four cases in which rotational atherectomy was performed in patients with reversible ischemia due to septal artery stenosis. The acute angiographic results were stable, without evidence for immediate recoil. By debulking, facilitated angioplasty can yield stable acute results in this location. The small size of most septal branches and their angulated origin make rotational atherectomy challenging, and cases must be selected carefully. This previously ignored lesion location can be considered for revascularization in patients with suitable lesion and vessel morphology.- - - - - - - - - - ranking = 3.2906349079085keywords = stenosis (Clic here for more details about this article) |
10/1031. Tubular stenosis of the aorta with aortic fibromuscular dysplasia.The autopsy findings in a 2-year-old girl with severe hypertension resulting from stenosis of the lower part of the thoracic and the abdominal aorta were reviewed. The lower portion of the thoracic aorta and the abdominal aorta showed uniform narrowing down to the level of the bifurcation of iliac arteries. Histologically, the aortic wall of the stenotic site showed irregular proliferation of smooth muscle cells and collagen fibers. The elastic fibers had disappeared from outside the media. No intimal thickening and inflammatory cell infiltration were observed. These histologic changes of the aortic media in this case are apparently similar to fibromuscular dysplasia (medial hyperplasia).- - - - - - - - - - ranking = 2.7421957565904keywords = stenosis (Clic here for more details about this article) |
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