Cases reported "Prolapse"

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1/29. Conjunctival prolapse: a simple and effective treatment.

    OBJECTIVE: To describe a simple and noninvasive technique to manage conjunctival prolapse and to report its efficacy. DESIGN: Noncomparative, retrospective case series. PARTICIPANTS: Ten consecutive patients encountered over a span of 13 years developed postoperative conjunctival prolapse as a complication from various ocular and orbital procedures. INTERVENTION: The prolapsed tissue is tucked back to its proper position with the aid of jeweler's forceps and a strip of gauze saturated with petroleum jelly and antibiotic ointment; thereafter, a double patch is applied to the closed eyelids. MAIN OUTCOME MEASURES: Successful resolution is usually attained within 48 hours. RESULTS: The technique is easy, efficient, and effective. All ten patients experienced no further complications after resolution. CONCLUSION: Clinicians should consider adopting this noninvasive technique.
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ranking = 1
keywords = operative
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2/29. Incarcerated paraesophageal hernia associated with perforation of the fundus of the stomach: report of a case.

    We report herein a case of incarcerated paraesophageal hernia associated with perforation of the fundus of the stomach. A 71-year-old woman was transferred to our hospital after a diagnosis of gastrointestinal tract perforation had been made at a local hospital. Her history included an esophageal hiatal hernia. A laparotomy was performed which revealed that the antrum of stomach and the duodenal bulb had prolapsed into the esophageal hiatus and become incarcerated. This prolapse had caused stenosis in the corpus of the stomach, resulting in distension of the oral side of the stomach and thinning of the wall. A perforation, 15 mm long, was recognized in the major curvature of the fundus. The patient suffered respiratory failure postoperatively, necessitating respiratory support for 1 week. She was discharged on postoperative day 40. This case report serves to demonstrate that because of the very serious complications that may result from an untreated paraesophageal hernia, elective repair should be performed wherever possible even in asymptomatic patients.
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ranking = 2
keywords = operative
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3/29. iris prolapse in small incision cataract surgery.

    iris prolapse is a rare complication after small incision cataract surgery. We looked at the possible operative and perioperative factors that might have contributed to this complication in 2 of our patients and in another 10 patients identified through a national questionnaire survey. The details of 12 cases of iris prolapse following small incision cataract surgery are presented. Since iris prolapse may occur in small incision cataract surgery, notably in the presence of certain predisposing factors, extra diligence is required in wound construction and closure in high-risk patients.
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ranking = 2
keywords = operative
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4/29. Timing of fornix reconstruction for postoperative conjunctival prolapse.

    BACKGROUND AND OBJECTIVE: To describe fornix reconstruction for conjunctival prolapse occurring after ocular surgery. MATERIALS AND methods: Two patients with persistent conjunctival prolapse of variable duration following ocular surgery underwent fornix reconstruction using the method described by Barrett. The two patients underwent different surgical methods. In the second patient, no attempt was made to include the malar periosteum. RESULTS: Case 1 with longer duration of prolapse needed further surgery to excise residual prolapsing conjunctiva that had hyperplastic squamous epithelium. Case 2 in which fornix reconstruction was done 2 months after prolapse showed a good result after only one surgical operation. CONCLUSION: Forniceal reconstruction is recommended for persistent postoperative conjunctival prolapse. Early surgery appears to have better results.
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ranking = 5
keywords = operative
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5/29. Lens-induced astigmatism after perforating scleral injury.

    Within 6 weeks of a penetrating scleral injury that included vitreous prolapse, a 6-year-old boy developed lenticular astigmatism with a regular component of 5.5 diopters (D). Visible indentational folds in the posterior lens capsule, caused by anterior vitreous fibers and anterior hyaloid, were presumed to be the origin of the astigmatism. Because of decreased visual acuity and the suspicion of early amblyopia, a pars plana vitrectomy with removal of the anterior hyaloid and the critical anterior vitreous fibers was performed. Dense fibrotic tissue between the lens equator and the site of the original scleral perforation limited reduction of the preoperative astigmatism to 4.0 D. However, the striae-like lenticular deformation disappeared completely, and full visual acuity was restored. During the 12-month follow-up, the lens remained clear
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ranking = 1
keywords = operative
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6/29. Epithelial ingrowth in a phakic corneal transplant patient after traumatic wound dehiscence.

    PURPOSE: To report a case of epithelial ingrowth (downgrowth) occurring in a phakic corneal transplant patient after traumatic wound dehiscence with iris prolapse that was successfully eradicated with early surgical intervention. methods: Interventional case report of a 70-year-old monocular, phakic patient who developed epithelial ingrowth within 1 week of repair of a traumatic penetrating keratoplasty wound dehiscence, with reposition of the iris that had been prolapsed for 36 hours. A gradually expanding membrane developed from the surface of the reposited iris, across the anterior lens capsule. argon laser photocoagulation applied to the surface of the iris confirmed the diagnosis and outlined the extent of the epithelial tissue on the iris. RESULTS: Intraoperative peeling of the epithelial membrane from the surface of the lens and excision of the involved iris were performed combined with extracapsular cataract extraction and insertion of a posterior chamber intraocular lens via an open-sky technique through a repeat penetrating keratoplasty opening in the cornea. This resulted in complete resolution of the intraocular epithelialization. Histopathologic examination of the excised tissue confirmed the diagnosis of epithelial ingrowth. CONCLUSIONS: Reposition of traumatically prolapsed iris tissue can result in epithelial ingrowth. Early aggressive surgical intervention can successfully remove all the epithelial tissue from within the anterior segment.
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ranking = 1
keywords = operative
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7/29. iris prolapse at the surgical site: a late complication of nonpenetrating deep sclerectomy.

    To investigate the occurrence and management of late-onset iris prolapse through the surgical wound after nonpenetrating deep sclerectomy. Two cases of iris prolapse that presented 8 and 10 months, respectively, after surgery for glaucoma were reviewed. One of the cases was associated with mild trauma. The postoperative follow-up was 5 and 24 months, respectively. The iris tissue bulge did not progress and there were no other complications. The visual acuity was not affected and the intraocular pressure was controlled with medical therapy. These cases demonstrate that the eye is weaker than normal at the surgical site after nonpenetrating deep sclerectomy, allowing iris protrusion. iris prolapse should be added to the list of late postoperative complications of nonpenetrating deep sclerectomy.
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ranking = 2
keywords = operative
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8/29. Comeoscleral perforation after pterygium excision and intraoperative mitomycin C.

    A 28-year-old man underwent pterygium excision with a single intraoperative application of mitomycin C (0.02%) for 3 minutes. One week after the surgery, the patient developed a corneoscleral perforation with iris prolapse. To the best of our knowledge, corneoscleral melting in the first postoperative week after a single intraoperative application of mitomycin C has not been reported. Moreover, the perforation occurred despite using a minimum concentration of the drug, risk factors were absent, and the surgery was performed by an experienced surgeon. Although a single case, this report questions the safety of using an intraoperative application of mitomycin C for preventing a recurrence of pterygium.
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ranking = 8
keywords = operative
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9/29. Double trouble: prolapsing epiglottis and unexpected dual pathology in an infant.

    A 3-week-old full-term female neonate was admitted with a 4-day history of episodic stridor, desaturations and difficult feeding. Initial assessment using fluoroscopy suggested distal tracheomalacia. Inhalational induction for examination under anaesthesia of the upper airway at 4 weeks of age caused almost complete airway obstruction due to severe anterior, or epiglottic, laryngomalacia. This airway obstruction was unresponsive to continuous positive airway pressure, the use of an oropharyngeal airway and hand ventilation and required urgent tracheal intubation using suxamethonium. Epiglottopexy, a relatively unknown procedure, was performed uneventfully 2 days later, with complete relief of the respiratory compromise. However, the infant remained desaturated postoperatively. A ventilation perfusion scan subsequently revealed multiple pulmonary arteriovenous malformations, unsuitable for embolization and requiring nocturnal home oxygen therapy. review at 3 months of age found a thriving infant with no airway obstruction and good epiglottic positioning on examination under anaesthesia. Although the patient's oxygen requirements had diminished, the long-term outcome remains uncertain.
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ranking = 1
keywords = operative
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10/29. Gastroesophageal intussusception: a new cause of acute esophageal obstruction in children.

    Gastrointestinal intussusception with obstruction is common in the small bowel and colon; however, such a process is not known to cause esophageal obstruction. Recent experience with gastroesophageal intussusception permits discussion of diagnosis and consideration of treatment options. A 3-year-old child presented with acute esophageal obstruction. physical examination was significant for epigastric tenderness and excessive salivation. Chest x-ray showed a posterior mediastinal fullness. Esophagram documented a smooth crescent-filling defect, which caused obstruction of the esophagus at the level of the carina with proximal esophageal dilatation. Chest computed tomography of the thorax showed a soft tissue mass of the distal esophagus. esophagoscopy confirmed occlusion of the midesophagus with the mucosa intact. A right thoracotomy permitted visualization of dilated proximal esophagus and a palpation of an intraluminal mass in the distal esophagus. Mobilization of the distal esophagus and gentle manual pressure cleared the obstruction to a point below the diaphragm. After a normal intraoperative esophagram, final treatment consisted of a longitudinal esophagomyotomy. The child recovered without complication and continues without recurrence for 18 months. This is the first report of gastroesophageal intussusception in children. Management by thoracotomy, manual reduction, and esophageal myotomy reestablished intestinal continuity and appears to eliminate recurrence; fundoplication or gastropexy may be alternative options. Preoperative recognition of gastroesophageal intussusception may allow nonoperative reduction or treatment by minimally invasive surgery.
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ranking = 3
keywords = operative
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