1/6. Bilateral choroidal folds and optic neuropathy: a variant of the crowded disk syndrome?PURPOSE: To describe the clinical features of the syndrome that includes bilateral choroidal folds and optic neuropathy and to propose a novel etiology to explain this presentation. DESIGN: Observational small case series. PARTICIPANTS: Three patients. methods: Three patients received an extensive clinical work-up including complete ocular examination, A and B scan ultrasonography, Humphrey visual field analysis, and imaging of the brain and orbit. Neurological consultation was obtained in each patient two of whom underwent lumbar puncture. The findings of this detailed investigation are reported. RESULTS: Each patient demonstrated bilateral choroidal folds with optic disk congestion and leakage in one eye and optic atrophy in the fellow eye. Extensive ocular and extraocular investigation failed to uncover a specific etiology. pseudotumor cerebri, a well-documented cause of papilledema and choroidal folds, was ruled out in each case. Each patient did demonstrate variable degrees of hyperopia and shortened axial lengths. CONCLUSIONS: The syndrome of bilateral choroidal folds and optic neuropathy may have various etiologies. pseudotumor cerebri needs to be definitively ruled out. Normal neuro-ophthalmological investigation including lumbar puncture may indicate an alternative cause. Idiopathic acquired hyperopia in middle-aged patients who are hyperopic with shortened axial lengths may be associated with choroidal folds and a constricted scleral canal causing optic disk congestion and complicated by nonarteritic anterior ischemic optic neuropathy due to a crowded disk.- - - - - - - - - - ranking = 1keywords = puncture (Clic here for more details about this article) |
2/6. Examination of the excluded distal stomach after gastric bypass for obesity.We describe a method of examination of the excluded distal stomach after gastric bypass for obesity using Chiba needle puncture of the distal stomach and water soluble contrast injection.- - - - - - - - - - ranking = 0.5keywords = puncture (Clic here for more details about this article) |
3/6. Balloon therapy for obesity--when the balloon bursts.Intragastric balloon placement is a non-invasive treatment for morbid obesity. We report a patient who illustrates incomplete bowel obstruction and pancreatitis following dislodgement of such a balloon. Percutaneous transabdominal puncture of the balloon is an effective method of decompression.- - - - - - - - - - ranking = 0.5keywords = puncture (Clic here for more details about this article) |
4/6. Percutaneous decompression of an intraintestinal balloon--case report.A study was designed in order to determine whether waterfilled intragastric balloons are superior to airfilled balloons for facilitating weight reduction. In the first volunteer the small intestine was obstructed by the dislocated waterfilled balloon. This complication was successfully treated by transabdominal fine needle puncture of the balloon. In contrast to airfilled balloons waterfilled balloons offer two advantages: water does not escape through the very thin wall of the balloon; the intraabdominal location of a waterfilled balloon is easily checked by sonography.- - - - - - - - - - ranking = 0.5keywords = puncture (Clic here for more details about this article) |
5/6. Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles.BACKGROUND. A new method of subcuticular underming for the treatment of depressed cutaneous scars and wrinkles is introduced. OBJECTIVE. To define the newly coined term "Subcision" and to describe this minor surgical procedure for treating depressed scars and wrinkles. methods. A tri-beveled hypodermic needle is inserted through a puncture in the skin surface (hence, "incisionless" surgery), and its sharp edges are maneuvered under the defect to make subcuticular cuts or "-cisions." RESULTS. The depression is lifted by the releasing action of the procedure, as well as from connective tissue that forms in the course of normal wound healing. CONCLUSION. This technique is useful in treating a variety of cutaneous depressions, including scars and wrinkles.- - - - - - - - - - ranking = 0.5keywords = puncture (Clic here for more details about this article) |
6/6. A simple technique for anticipating and managing secondary puncture site hemorrhage during laparoscopic surgery. A report of two cases.BACKGROUND: Clinically significant hemorrhage from secondary port sites at laparoscopy is an uncommon but serious complication and can go unrecognized intraoperatively. CASES: A 28-year-old woman undergoing operative laparoscopy sustained abdominal wall vessel injury and required a blood transfusion. A second patient received the same injury but, when the author's technique was used, had minimal blood loss and a benign postoperative course. With this technique, a blunt instrument is placed through the sheath and into the peritoneal cavity before any secondary port is removed. The sheath is withdrawn, only the probe is kept in the abdomen, and then hemorrhage usually becomes evident. CONCLUSION: A new technique aids the diagnosis of occult abdominal vessel injury and allows rapid recanalization of the secondary trocar sheath paths.- - - - - - - - - - ranking = 2keywords = puncture (Clic here for more details about this article) |