1/141. Atrial tamponade causing acute ischemic hepatic injury after cardiac surgery.A patient developed late cardiac tamponade after aortic valve replacement and coronary artery bypass grafting. nausea and dramatic elevations of serum aminotransferases were the initial clinical manifestations of cardiac tamponade. Severe acute ischemic hepatic injury secondary to isolated compression of both atrial cavities by two loculated thrombi was diagnosed.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/141. Acute ischemia of the lower limb. An unusual complication of Paget's disease of bone.Paget's disease of bone (osteitis deformans) is one of the most common skeletal diseases, characterised by bone distortion and the loss of interior structure. Asymptomatic evolution is usual, so diagnosis is likely to be made only when complications of the disease appear. This paper describes such a diagnosis made in a patient with acute lower limb ischemia caused by the compression of the superficial femoral artery between the adductor muscles and an exostosis of the femur.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
3/141. Traumatic induced total myelomalacia of the cervical spinal cord associated with a space-occupying subdural hematoma.We report the case of a 20-year-old male driver who suffered from a trauma to the cervical vertebral column in a head-on collision with a tree. The injuries included subluxation of the 2nd and 3rd cervical vertebrae and fracture of the odontoid process of the axis with ventrally directed displacement of the proximal fragment and dorsally directed displacement of the distal fragment. Already at admission to hospital a space-occupying spinal subdural hematoma was diagnosed. Clinically, paraplegia was diagnosed with progressive loss of consciousness. pneumonia led to death 40 days after the accident. autopsy disclosed a total myelomalacia of the cervical spinal cord obviously resulting from an ischemia caused by a traumatic lesion of the dorsal truncus arteriosus spinalis as well as a compression by the spinal subdural hematoma.- - - - - - - - - - ranking = 1.127886094786keywords = compression, fracture (Clic here for more details about this article) |
4/141. The use of gastric tonometry in the assessment of celiac artery compression syndrome.This report describes the use of gastric tonometry to measure gastric mucosal ischemia/intestinal mucosa pH (pHi) in a patient treated for celiac artery compression syndrome. Significant gastric mucosal ischemia was demonstrated prior to celiac artery decompression as indicated by a pHi of 7.29. The ischemia was relieved by celiac artery decompression, with an increase in the pHi to 7.48. The patient experienced complete relief of his symptoms after surgical decompression and remains asymptomatic 14 months after surgery. Gastric tonometry provides an objective measurement of intestinal perfusion and ischemia in the treatment of celiac artery compression syndrome.- - - - - - - - - - ranking = 9keywords = compression (Clic here for more details about this article) |
5/141. Intraoperative SSEP detection of ulnar nerve compression or ischemia in an obese patient: a unique complication associated with a specialized spinal retraction system.OBJECTIVE: To report a case of peripheral nerve compression caused by a specialized spinal retraction system, the Thompson-Farley retractor system, that most likely would not have been detected without intraoperative monitoring of the ulnar nerve. DESIGN: Bilateral median and peroneal nerve somatosensory evoked potentials (SSEPs) were monitored continuously during a C5 corpectomy, as was core body temperature. RESULTS: Within minutes after cervical soft-tissue retraction, the left ulnar nerve SSEP began to decline in amplitude. peroneal nerve SSEPs were normal throughout the surgery; core body temperature remained at 36 degrees /- 0.2 degrees C. After much effort to reposition the patient, the SSEPs returned to baseline and the Thompson-Farley system was replaced by a self-retracting system. CONCLUSIONS: To our knowledge, this is the first report of peripheral nerve compression caused by the Thompson-Farley retractor system. Even with careful positioning on the operating table, obese patients may be particularly at risk for upper arm compression. Continuous monitoring of SSEPs is suggested to prevent postoperative morbidity.- - - - - - - - - - ranking = 7keywords = compression (Clic here for more details about this article) |
6/141. Hepatic ischemia as a complication after correction of post-traumatic gibbus at the thoracolumbar junction.STUDY DESIGN: This is a case report of hepatic ischemia secondary to celiac trunk stenosis as a complication after correction of a preoperative 30 degrees gibbus at the thoracolumbar junction. OBJECTIVES: A high index of suspicion is needed to make a timely diagnosis of hepatic ischemia in any setting. After spinal reconstruction involving lengthening, symptoms suggestive of an acute abdomen accompanied by markedly elevated liver enzymes should be evaluated with an angiogram to check for celiac trunk stenosis. SUMMARY OF BACKGROUND DATA: review of the literature showed no reported cases of hepatic ischemia or descriptions of the status of celiac trunk stenosis after spinal surgery. Even in more commonly associated settings, diagnosis of both phenomena is often delayed, with possible morbid consequences. methods: A case is presented of a patient who underwent gibbus correction and re-establishment of lost anterior intervertebral distance at the thoracolumbar junction. After surgery, ischemic hepatitis, a perforated gallbladder, and splenic infarction developed secondary to celiac trunk stenosis-a result of cephalad displacement of the celiac trunk and compression of the artery by the diaphragmatic ligament. RESULTS: An emergent exploratory laparotomy with cholecystectomy was performed followed by an angiogram, which demonstrated stenosis of the celiac trunk. After release of the arcuate ligament, the patient's condition improved rapidly, and he made a complete recovery. CONCLUSIONS: The consequences of a delay in diagnosis of hepatic ischemia can be disastrous. An awareness of the possibility of this complication after spinal lengthening should facilitate a timely angiogram and operative intervention.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
7/141. Femorofemoral bypass, even in pregnancy--a case report.A 29-year-old pregnant woman sustained blunt, left lower abdominal trauma, with hip and pelvic fractures, and progressive dissection of an intimal flap in the left iliac artery, which manifested two days later as profound ischemia of the left leg. The patient underwent distal thromboembolectomy, fasciotomies and revascularization of the leg by femorofemoral polytetrafluoroethylene bypass. The patient recovered completely and gave normal birth three months later to a healthy child. Four years after the operation she gave uneventful birth to another child. Various considerations pertinent to this complex traumatic-vascular-gestational state are discussed.- - - - - - - - - - ranking = 0.12788609478604keywords = fracture (Clic here for more details about this article) |
8/141. femoral artery ischemia during spinal scoliosis surgery detected by posterior tibial nerve somatosensory-evoked potential monitoring.STUDY DESIGN: A case report of unilateral leg ischemia caused by femoral artery compression detected using posterior tibial nerve somatosensory-evoked potentials during spinal scoliosis instrumentation surgery. OBJECTIVES: To report a rare cause of intraoperative unilateral loss of all posterior tibial nerve somatosensory-evoked potential waveforms. SUMMARY OF BACKGROUND DATA: Failure to obtain adequate popliteal fossa, spinal, subcortical, and cortical potentials during posterior tibial nerve somatosensory-evoked potential spinal cord monitoring usually results from technical factors or chronic conditions affecting the peripheral nerve. methods: A 16-year-old boy with thoracic scoliosis had normal posterior tibial nerve somatosensory-evoked potentials both before surgery and in the operating room immediately after anesthesia induction and prone positioning on a four-post spinal frame. RESULTS: One hour after the start of surgery, a minimal amplitude reduction of the right popliteal fossa potentials appeared. Fifteen minutes later, the amplitudes of the popliteal fossa, subcortical, and cortical potentials evoked by right posterior tibial nerve stimulation became substantially reduced. Subsequently, all waveforms were lost. Malfunction of the right posterior tibial nerve stimulator was initially suspected, but when proper function was verified, a search for other causes of this loss led to discovery of leg ischemia. The patient was repositioned on the spinal frame, and all posterior tibial nerve somatosensory-evoked potentials waveforms began to reappear 7 minutes later. There was no postoperative clinically detectable complication. CONCLUSIONS: Although technical malfunction should always be suspected when all intraoperative somatosensory-evoked potential waveforms are initially seen and subsequently lost, one should also consider the possibility that intraoperative ischemia due to limb positioning could be the etiology.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
9/141. Congenital Volkmann-Lesser ischemic contracture of the upper limb.Neonatal vascular compromise to limbs has been associated traditionally with perinatal injury of the brachial plexus, fracture of the clavicle or humerus, or iatrogenic causes. Congenital Volkmann's ischemic contracture is an exceptional etiology of ischemic limb in the newborn. Fewer than 10 cases had been described in the literature. The authors report a newborn presenting at birth with partial bluish discoloration of the right forearm. The clinical picture and laboratory studies lead to the diagnosis of congenital Volkmann-Lesser ischemic contracture.- - - - - - - - - - ranking = 0.12788609478604keywords = fracture (Clic here for more details about this article) |
10/141. Compartmental syndromes in which the skin is the limiting boundary.Following closed fasciotomy, skin may become the limiting boundary of extremity swelling. The resulting increase in pressure within the limb may threaten its survival. Realizing this potential complications, we reserve closed fasciotomy for those cases in which only moderate swelling is anticipated. Following this procedure the patient is observed closely for evidence that decompression dermotomy is indicated. patients in whom severe swelling is present or anticipated are treated with fasciotomy and primary dermotomy. Wounds are closed by either primary or delayed skin graft. This approach has proven useful in the management of traumatized or vascularly embarrassed limbs in which swelling may compromise extremity viability.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
| | Next -> |