1/198. median nerve damage from brachial artery puncture: a case report.This report describes a case in which puncture of the brachial artery to obtain a sample for blood-gas analysis resulted in damage to the median nerve with a persisting neuropathy and apparent loss of function. Errors in judgment and contributions to possible negligence included (1) inappropriate choice of sampling site; (2) lack of knowledge of precautions and possible complications; (3) incomplete/inadequate description of optimal procedure in departmental procedure manual; (4) arbitrary selection of the dominant hand.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
2/198. Subcutaneous, orbital, and mediastinal emphysema secondary to the use of an air-abrasive device.subcutaneous emphysema can occur whenever compressed air is employed intraorally. A case is presented of subcutaneous, orbital, and mediastinal emphysema subsequent to the use of an air-abrasive device. The case is believed to be the first reported case of an air-abrasive-related emphysema and is presented as a cautionary report.- - - - - - - - - - ranking = 76.460542897481keywords = air (Clic here for more details about this article) |
3/198. Ultrasound guided percutaneous thrombin injection for the treatment of iatrogenic pseudoaneurysms.Iatrogenic aneurysms are usually postcatheterisation pseudoaneurysms of the femoral artery. Until recently, the treatment of choice was ultrasound guided compression repair. A case of pseudoaneurysm of the axillary artery, arising as a complication of pacemaker insertion in an 83 year old man is reported. Compression repair was not possible in this case, and so the aneurysm was occluded by percutaneous ultrasound guided thrombin injection directly into the aneurysm sac. Percutaneous ultrasound guided thrombin injection is a promising new minimally invasive technique for the treatment of iatrogenic pseudoaneurysms.- - - - - - - - - - ranking = 21.84586939928keywords = air (Clic here for more details about this article) |
4/198. Successful completion of endoluminal repair of an abdominal aortic aneurysm after intraoperative iatrogenic rupture of the aneurysm.PURPOSE: A method of achieving successful completion of endoluminal repair of an abdominal aortic aneurysm (AAA) in the presence of intraoperative iatrogenic rupture of the aneurysm is reported. methods: An 83-year-old woman with an AAA that was 7 cm in diameter was treated electively by means of endoluminal repair with a Vanguard bifurcated prosthesis (boston Scientific, Natick, Mass). No difficulty was experienced with the introduction of the delivery catheter, despite extreme angulation in the aneurysm. An acute episode of hypotension prompted an aortogram to be performed. Extravasation of contrast outside the aneurysm sac was demonstrated. The balloon on the delivery catheter was immediately advanced to the suprarenal aorta and inflated. hypotension was reversed, and hemodynamic stability was restored, thus enabling deployment of the prosthesis to proceed and the repair to be completed by means of the endoluminal method. RESULTS: The patient's blood pressure remained stable after deflation of the balloon, allowing a postprocedure aortogram to be performed. Exclusion of the aneurysm sac was demonstrated. Exclusion of the aneurysm sac from the circulation and a large retroperitoneal hematoma were confirmed by means of a postoperative contrast computed tomography scan. convalescence was complicated by acute renal failure, pneumonia, and prolonged ileus. The patient remained well and active at the follow-up examination 6 months after operation. CONCLUSION: Iatrogenic perforation of an AAA during endoluminal repair may be treated by endovascular means and does not necessarily require conversion to open repair, although this may be the safest option.- - - - - - - - - - ranking = 98.306412296762keywords = air (Clic here for more details about this article) |
5/198. pneumocephalus secondary to colonic perforation by ventriculoperitoneal shunt catheter.We present a case of colonic perforation as a complication arising from ventriculoperitoneal shunt catheter. A 58-year-old woman with a ventriculoperitoneal shunt catheter inserted for obstructive hydrocephalus was admitted to hospital with signs and symptoms of meningitis. CT showed an air-fluid level within both lateral ventricles, raising the possibility of colonic perforation since no other aetiology for the pneumocephalus could be found. The CT demonstration of the colonic perforation played a crucial role in patient management.- - - - - - - - - - ranking = 10.92293469964keywords = air (Clic here for more details about this article) |
6/198. Repairing iatrogenic root perforations.BACKGROUND: Post preparation is an integral part of restoring endodontically treated teeth in indicated cases. Iatrogenic perforation of the root can result from preparing post space and can severely compromise the prognosis of the tooth. CASE DESCRIPTION: Two years after a patient's maxillary lateral incisor was restored with a post-retained composite resin, he went to a dental school emergency clinic with a chief complaint of soft-tissue swelling adjacent to the tooth. The authors took a periapical radiograph that revealed evidence of a circumscribed radiolucent lesion associated with the distal midroot area and a periapical radiolucency. Based on the radiograph, the authors suspected that the canal preparation for the post and the post placement had perforated the root at the base of the post. CLINICAL IMPLICATIONS: The authors used a combined surgical and orthograde approach with a biocompatible restorative material and a clear, plastic light-transmitting post to repair the iatrogenic perforation.- - - - - - - - - - ranking = 54.614673498201keywords = air (Clic here for more details about this article) |
7/198. Anterior segment ischemia and retinal detachment after vertical rectus muscle surgery.PURPOSE: The authors describe the clinical course of a woman who developed two complications following vertical strabismus repair: anterior segment ischemia (ASI) and retinal detachment. methods: A 62 year-old woman is described. She presented with new onset proptosis and left hypertropia with significant diplopia in all fields of gaze. This presentation, her 15 year history of thyroid disease, and preoperative computed tomography (CT) of the orbits were consistent with Graves' ophthalmopathy. Vertical strabismus repair was carried out by recessing the left superior rectus muscle and resecting the left inferior rectus muscle. RESULTS: The diplopia was eliminated. The patient developed significant postoperative ASI and iatrogenic rhegmatogenous retinal detachment in the left eye due to unsuspected globe perforation. She was treated with systemic corticosteroids and radial scleral buckling. CONCLUSIONS: Severe ASI following strabismus surgery is a well recognized complication, with age, thyroid ophthalmopathy, and manipulation of the vertical rectus muscles as risk factors. The retinal detachment soon after strabismus surgery was difficult to detect, possibly due to diminished visualization of the posterior segment as a result of ASI.- - - - - - - - - - ranking = 21.84586939928keywords = air (Clic here for more details about this article) |
8/198. Emergency portacaval shunt for control of hemorrhage from a parenchymal fracture after adult-to-adult living donor liver transplantation.As more adults undergo transplantation with partial liver grafts, the unique features of these segments and their clinical significance will become apparent. A patient presented with life-threatening hemorrhage from an iatrogenic laceration to a right lobe graft 11 days after transplantation. The creation of a portacaval shunt effectively controlled the bleeding, allowing more elective replacement of the organ with another right lobe graft. The regeneration process combined with increased portal blood flow and relative outflow limitation may have set the stage for this complication. Any disruption of the liver parenchyma during transplantation should be securely repaired and followed cautiously. Portacaval shunting is an option for controlling hemorrhage from the liver in transplant recipients. The timely availability of a second organ was likely the ultimate determinant of survival for this patient.- - - - - - - - - - ranking = 10.92293469964keywords = air (Clic here for more details about this article) |
9/198. Laparoscopic repair of a chronic diaphragmatic hernia.Diaphragmatic injuries that remain undetected after an acute traumatic event may lead to the formation of a diaphragmatic hernia. Symptoms of a chronic diaphragmatic hernia are related to the incarceration of abdominal contents in the defect or to impingement of the lung, heart, or thoracic esophagus by abdominal viscera. A 49-year-old woman with a symptomatic chronic diaphragmatic hernia from an unrecognized iatrogenic injury to the left hemidiaphragm sought treatment. The diaphragmatic injury occurred 2 years earlier when a low, left-sided chest tube was placed for a persistent pleural effusion 2 weeks after a lower lobectomy for an aspergilloma. The patient's diaphragmatic hernia was diagnosed after an upper gastrointestinal series and an esophagogastroduodenoscopy. Approximately 75% of her stomach was incarcerated in the diaphragmatic defect. The diaphragmatic hernia was repaired laparoscopically using a 9 cm x 10-cm polytetrafluoroethylene patch sewn with nonabsorbable, interrupted, horizontal mattress sutures. Improvement of video technology, laparoscopic instruments, and surgical skills has allowed surgeons to expand the boundaries of advanced therapeutic laparoscopy. These factors facilitated the authors' standard tension-free prosthetic repair of a chronic diaphragmatic hernia using minimally invasive techniques.- - - - - - - - - - ranking = 67.537608197841keywords = air, gas (Clic here for more details about this article) |
10/198. Detection of iatrogenic cardiac tamponade by transesophageal echocardiography during vena cava filter procedure.PURPOSE: To present a patient who developed cardiac tamponade during insertion of an inferior vena cava (IVC) filter. Intraoperative transesophageal echocardiography (TEE) was used as a means to diagnose the cardiac tamponade and to facilitate guiding of pericardiocentesis. CLINICAL FEATURES: A 45-yr-old man with protein s deficiency complicated by repeated attacks of deep vein thrombosis and pulmonary thromboembolism was scheduled for insertion of an IVC filter. He had history of chronic renal insufficiency, heart failure, and cerebral infarction with mild left hemiparesis. Current medication included diltiazem (30 mg, I tab tid ), prednisolone (5 mg, 2 tabs qd ), and warfarin (2.5 mg daily). Preoperative transthoracic echocardiography demonstrated bilateral pleural effusions, moderate mitral regurgitation and tricuspid regurgitation, left atrial appendage thrombus and severe generalized hypokinesia of left ventricle. Nuclear medicine examination by (99)Tc showed ejection fractions of left ventricle and right ventricle as 20% and 22%, respectively. Under the impression of protein s deficiency with multiple attacks of thromboembolism and failure of anticoagulant therapy, he was arranged for the procedure of vena caval filter insertion. Unfortunately, iatrogenic cardiac tamponade occurred during the course of the procedure with rapid hemodynamic deterioration. Because of the expedient of routine monitoring of cardiac condition with TEE, a prompt diagnosis was made. We successfully improved the patient's hemodynamic status after transthoracic echo-guided pericardiocentesis. CONCLUSION: Intraoperative TEE is recommended to be used routinely in patients undergoing vena cava filter procedures. The availability of echocardiographic monitoring in the operation room allows the confirmation of the diagnosis and facilitation pericardiocentesis.- - - - - - - - - - ranking = 191.56624563289keywords = embolism (Clic here for more details about this article) |
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