1/134. Chronic traumatic aortic pseudoaneurysm: resolution with observation.Immediate operative repair is the most commonly recommended treatment for traumatic aortic ruptures, regardless of age or size of the lesion. We report a patient who presented with a large chronic aortic pseudoaneurysm and has been thus far managed nonoperatively with shrinkage of his lesion and no symptoms.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
2/134. Chronic aneurysm of the descending thoracic aorta presenting with right pleural effusion and left phrenic paralysis.A 62-year-old man was admitted to the emergency department with chronic dysphagia and lower back pain. Chest radiography revealed a wide mediastinal shadow and an elevated left diaphragm, which proved to be secondary to left phrenic paralysis. The patient was diagnosed with an aneurysm of the descending thoracic aorta and was admitted to the hospital. After the patient was admitted, the aneurysm ruptured into the right chest. The patient underwent an emergency operation to replace the ruptured segment with a synthetic graft. Postoperative recovery and follow-up were uneventful. This report describes an unusual presentation of a thoracic aortic aneurysm. Hemidiaphragmatic paralysis caused by compression of the phrenic nerve is an unusual complication that, to our knowledge, has not been previously reported.- - - - - - - - - - ranking = 2keywords = rupture (Clic here for more details about this article) |
3/134. Surgical approaches for pancreatic ascites: report of three cases.Pancreatic ascites can occur in association with the rupture of a pseudocyst or the disruption of a pancreatic duct during the natural course of chronic pancreatitis. We report herein the successful treatment of three patients with pancreatic ascites by performing a surgical procedure after 4-6 weeks of total parenteral nutrition (TPN) proved ineffective. The principles of our surgical procedure for pancreatic ascites are as follows: (1) minimum pancreatic tissue is resected; (2) surgical intervention to repair leaking sites is not necessary; (3) pancreatic duct drainage is facilitated by an intestinal Roux-en-Y loop; (4) An external drainage tube is inserted through the Roux-en-Y loop into the main pancreatic duct. All three patients who underwent our surgical procedure had a good outcome. Although the mean follow-up time is still only 18.3 months, their condition has improved, with no evidence of recurrent ascites. Thus, our surgical procedure should be considered as an appropriate treatment for pancreatic ascites because it can be applied for all types of leakage, including leakage from the posterior wall of pancreas; it preserves pancreatic function, especially endocrine function; and it enables preservation of the spleen.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
4/134. Massive subependymal hemorrhage caused by an occult vascular malformation--two case reports.Two patients presented with massive subependymal hemorrhage caused by vascular anomalies occult to angiography, computed tomography (CT) scanning, and magnetic resonance (MR) imaging. A 47-year-old male initially presented with a headache and became comatose 3 weeks later. CT and MR imaging demonstrated a massive hematoma in the right caudate head projecting into the lateral ventricle. A 60-year-old male sustained heaviness of his left extremities 8 days prior to admission and his condition gradually deteriorated. neuroimaging revealed a right thalamic hematoma adjacent to the lateral ventricle. cerebral angiography, CT, and MR imaging failed to detect any vascular anomaly. The hematomas increased in size gradually and were surgically explored. The histological diagnosis was arteriovenous malformation for the first case and cavernous angioma for the second case that had ruptured repeatedly. These cases were unique in the unusual location in the subependyma, and diagnostic neuroimaging modalities could not disclose the vascular anomalies, and the hematomas enlarged progressively to become critically symptomatic. Surgical intervention is mandatory for mass reduction and correct diagnosis of such lesions, with favorable outcome as long as the surgery is not delayed until too late.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
5/134. Chronic intrauterine meconium aspiration causes fetal lung infarcts, lung rupture, and meconium embolism.Three neonates with chronic intrauterine meconium aspiration are reported. All had distinctive subpleural plate-infarcts of the lungs caused by meconium-induced vasoconstriction of peripheral preacinar arteries. These vessels showed plexogenic arteriopathy with medionecrosis and obliterative hyaline sclerosis. Organized thrombi and systemic-pulmonary arterial anastomoses were numerous. The infarcts contained inspissated meconium with a granulomatous reaction.In one case, lung rupture occurred, causing meconiumthorax and meconium embolism to hilar lymphatics and lymph nodes; this suggests that particulate meconium may enter the circulation. This fetus had rubella and probable acute twin-twin transfusion following the intrauterine death of the co-twin. The cause of the hypoxia that led to intrauterine passage of meconium in the other cases is unknown. meconium-stained amniotic fluid was noted in only one case.- - - - - - - - - - ranking = 5keywords = rupture (Clic here for more details about this article) |
6/134. Asymptomatic rupture of an aortoiliac aneurysm.The rupture of an abdominal aortic aneurysm is one of the most feared complications confronted by cardiovascular surgeons. Such ruptures are usually catastrophic, but in some instances the rupture is posterior and remains sealed. These chronic ruptures may manifest with any of a variety of clinical presentations. This report describes an uncommon presentation of a chronic rupture of an aortoiliac aneurysm in a patient with generalized aneurysmal disease. The rupture presented as an asymptomatic giant pulsatile mass in the patient's abdomen. The mass had developed over a period of several years. The literature is also reviewed.- - - - - - - - - - ranking = 10keywords = rupture (Clic here for more details about this article) |
7/134. Autogenous fascia augmentation of a partially extirpated muscle with a subperiosteal medial orbitotomy approach.INTRODUCTION: Endoscopic sinus surgery can result in serious extraocular muscle dysfunction. The medial rectus muscle is more frequently affected than other extraocular muscles. methods: A transconjunctival subperiosteal medial orbitotomy was successful in retrieving a partially extirpated medial rectus muscle after endoscopic sinus surgery. RESULTS: A previous attempt to localize this muscle by conventional surgery with extensive exploration was unsuccessful. A Hummelsheim procedure was also abandoned after a rupture of the nasal aspect of the inferior rectus muscle occurred. CONCLUSION: The approach we describe allowed adequate visualization of the posterior orbital content, as well as adequate space for suture placement.- - - - - - - - - - ranking = 1keywords = rupture (Clic here for more details about this article) |
8/134. Peroneus brevis tendon rupture with tophaceous gout infiltration.The authors present a patient with a history of chronic lateral ankle instability and pain. Physical and diagnostic evaluation revealed anterior ankle instability and peroneus brevis weakness. An MRI showed an attenuated anterior-talofibular ligament and a longitudinal tear of the peroneus brevis tendon. Surgical exploration exhibited tophaceous gout within the tear of the peroneus brevis as well as within the attenuated anterior-talofibular ligament. Presented is an unusual case of a longitudinal tear of the peroneus brevis tendon with tophaceous gout infiltration.- - - - - - - - - - ranking = 4keywords = rupture (Clic here for more details about this article) |
9/134. Peroneus longus tendon rupture as a cause of chronic lateral ankle pain.rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is presented. The authors review their clinical, radiographic, and operative treatment of this patient and review the literature of this unusual injury.- - - - - - - - - - ranking = 5keywords = rupture (Clic here for more details about this article) |
10/134. Aneurysm rupture secondary to transcatheter embolization.False aneurysms of the pancreatic and peripancreatic arteries are a well recognized complication of chronic pancreatitis due to proteolytic enzymatic digestion of the arterial wall. These false aneurysms can be a source of life-threatening hemorrhage. Three cases are reported in which attempted embolizations of these bleeding aneurysms resulted in rupture into the gastrointestinal tract. Special precautions should be taken in such a procedure because of the inherent weakness of the aneurysmal wall.- - - - - - - - - - ranking = 5keywords = rupture (Clic here for more details about this article) |
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