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Niimi R, Hasegawa M, Sudo A, Uchida A. A large metallic cyst caused by wear particles after total knee arthroplasty. Arch Orthop Trauma Surg 2007; 127:51-4. [PMID: 16927094 DOI: 10.1007/s00402-006-0214-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2006] [Indexed: 02/09/2023]
Abstract
INTRODUCTION A symptomatic cyst is an uncommon complication after total knee arthroplasty (TKA). We present a case of a 77-year-old woman with a large cyst in the right knee caused by metal wear debris from the failure of a Miller-Galante I TKA performed 13 years earlier. CASE PRESENTATION The patient was treated with a two-stage operation including revision of the TKA followed by excision of the cyst, because there was a direct communication between the joint cavity and the cyst, and because the patient reported pain corresponding to the cystic area after revision. The patient was pain-free and had a satisfactory result 17 months after the second operation, without recurrence of cyst formation. CONCLUSION We recommend two-stage surgery in which the first-stage is correction of the intra-articular pathology with revision TKA and the second-stage is excision of the cyst.
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Enön S, Kayi Cangir A, Okten I. Swallowing of a dynamic tracheal stent: an unusual complication. Tuberk Toraks 2007; 55:92-4. [PMID: 17401801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
Cicatricial tracheal stenoses are mainly related to iatrogenic injury as postintubation, posttracheotomy or postoperative. Advances in airway prosthetics have provided a variety of silicone stents and expandable metal stents as a therapeutic option for tracheal stenoses. Nowadays, dynamic tracheal stents are performed prevalently for the treatment of tracheal stenosis. Four major problems are currently associated with airway stents: Mucostasis, formation of granulation tissue, infection and migration. In this report, we present a case of swallowing a tracheal dynamic stent as an unusual complication of tracheal stents.
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Brogdon BG, Cottrell WC, Nimityongskul P, Takhtani D. A bullet-sired bone cyst. Skeletal Radiol 2006; 35:959-63. [PMID: 16847647 DOI: 10.1007/s00256-006-0138-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Revised: 03/22/2006] [Accepted: 03/31/2006] [Indexed: 02/02/2023]
Abstract
Random gunfire deposited a bullet in the proximal tibial metaphysis of a 9-year-old girl. The wound was not incapacitating and was treated conservatively. Within 17 months, soreness developed in the proximal leg, and radiography revealed a large unicameral cyst within which the bullet freely tumbled. Eventually, fear of impending fracture prompted further radiography, computed tomography, surgical intervention and pathological examination of the cyst wall. We believe this is only the second description in the English-language literature of this rare sequence of events.
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Matcuk GR, Learch TJ, Keesara SR. Chronic circumferential periostitis of proximal phalanges related to tight fitting rings. Emerg Radiol 2006; 13:89-93. [PMID: 16957929 DOI: 10.1007/s10140-006-0511-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Accepted: 06/09/2006] [Indexed: 11/26/2022]
Abstract
We present three cases of chronic erosion injuries to the phalanges seen at our institution. We review the literature regarding this uncommon injury and discuss the clinical scenarios in which these injuries may occur, the radiographic findings, treatment options, and outcomes.
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Dudeck O, Okuducu AF, Jordan O, Tesmer K, Pech M, Weigang E, Rüfenacht DA, Doelker E, Felix R. Volume changes of experimental carotid sidewall aneurysms due to embolization with liquid embolic agents: a multidetector CT angiography study. Cardiovasc Intervent Radiol 2006; 29:1053-9. [PMID: 16897268 DOI: 10.1007/s00270-005-2361-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Iodine-containing polyvinyl alcohol polymer (I-PVAL) is a novel precipitating liquid embolic that allows for artifact-free evaluation of CT angiography (CTA). As accurate aneurysm volumetry can be performed with multidetector CTA, we determined volumes of experimental aneurysms before, immediately after, and 4 weeks after embolization of 14 porcine experimental carotid sidewall aneurysms with this liquid embolic. An automated three-dimensional software measurement tool was used for volumetric analysis of volume-rendering CTA data. Furthermore, intra-aneurysmal pressure changes during liquid embolization were measured in four silicone aneurysms and potential polymer volume changes within 4 weeks were assessed in vitro. Liquid embolic injection was performed during temporary balloon occlusion of the aneurysm neck, resulting in a mean occlusion rate of 98.3%. Aneurysms enlarged significantly during embolization by 61.1 +/- 28.9%, whereas a significant shrinkage of 5.6 +/- 2.7% was observed within the follow-up period. Histologic analysis revealed an inflammatory foreign body reaction with partial polymer degradation. In silicone aneurysm models, intra-aneurysmal pressure remained unchanged during liquid embolic injection, whereas balloon inflation resulted in a mean pressure increase of 31.2 +/- 0.7%. No polymer shrinkage was observed in vitro. The aneurysm enlargement noted was presumably due to pressure elevation after balloon inflation, which resulted in dilatation of the weak venous wall of the newly constructed aneurysm--another shortcoming of this experimental aneurysm model. The volume decrease after 4 weeks expressed partial polymer degradation.
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MESH Headings
- Angiography, Digital Subtraction
- Animals
- Artifacts
- Balloon Occlusion/adverse effects
- Carotid Artery, Common/diagnostic imaging
- Carotid Artery, Common/pathology
- Carotid Artery, Common/physiopathology
- Carotid Artery, Common/surgery
- Cerebrovascular Circulation
- Chemoembolization, Therapeutic/adverse effects
- Dilatation, Pathologic/diagnostic imaging
- Dilatation, Pathologic/etiology
- Disease Models, Animal
- Female
- Follow-Up Studies
- Foreign-Body Reaction/diagnostic imaging
- Foreign-Body Reaction/etiology
- Foreign-Body Reaction/pathology
- Foreign-Body Reaction/physiopathology
- Image Processing, Computer-Assisted
- Intracranial Aneurysm/diagnostic imaging
- Intracranial Aneurysm/physiopathology
- Intracranial Aneurysm/therapy
- Intracranial Pressure
- Polyvinyl Alcohol/administration & dosage
- Polyvinyl Alcohol/adverse effects
- Polyvinyl Alcohol/metabolism
- Swine
- Time Factors
- Tomography, Spiral Computed
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Macan D, Cabov T, Kobler P, Bumber Z. Inflammatory reaction to foreign body (amalgam) in the maxillary sinus misdiagnosed as an ethmoid tumor. Dentomaxillofac Radiol 2006; 35:303-6. [PMID: 16798931 DOI: 10.1259/dmfr/42499904] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A patient with chronic unilateral maxillary sinusitis caused by a foreign body (dental amalgam) and mistaken diagnosis of extensive ethmoid neoplasm is presented. The imitation of tumour symptoms was due to a long presence of foreign body in the maxillary sinus and chronic inflammation of maxillary, ethmoid and sphenoid sinuses.
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Scaranelo AM, de Fátima Ribeiro Maia M. Sonographic and mammographic findings of breast liquid silicone injection. JOURNAL OF CLINICAL ULTRASOUND : JCU 2006; 34:273-7. [PMID: 16788958 DOI: 10.1002/jcu.20235] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE To describe the sonographic and mammographic features of patients whose breasts have been injected with silicone. METHODS Between July 1997 and August 1999, 14 patients with a history of breast injection of liquid silicone underwent physical, mammographic, and sonographic examination. Mammographic findings were classified as macronodular, micronodular, or mixed striated patterns. Sonographic appearances were classified as macronodular, micronodular, mixed, or snowstorm patterns. RESULTS Eighty-six percent of the patients had abnormal physical examination. Well-defined nodules were palpable in 4 patients, 6 patients had diffusely heterogeneous breasts on palpation, and 2 patients had a combination of heterogeneous texture with dominant nodules. Sonographic examination revealed the presence of marked echogenicity (i.e., snowstorm pattern) in all 14 patients; in 11 patients it was associated with macronodules and/or micronodules, whereas in 3 patients only snowstorm appearance was noted. Mammographic patterns were macronodular in 7 patients and mixed macronodular and micronodular in 6 patients. CONCLUSIONS Both mammography and sonography can help identify free silicone injected directly into the breast.
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Marcy PY, Hericord O, Novellas S, Ettore F. Lymph Node-Like Lesion of the Neck After Pharyngolaryngectomy. AJR Am J Roentgenol 2006; 187:W135-6. [PMID: 16794132 DOI: 10.2214/ajr.187.1.w135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ferraz LCB, Schellini SA, Wludarski SL, Padovani CR. Implantes de polietileno gel e poroso em cavidade anoftálmica de coelhos. Arq Bras Oftalmol 2006; 69:305-8. [PMID: 16936949 DOI: 10.1590/s0004-27492006000300004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Accepted: 07/11/2005] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate porous polyethylene implants as compared to solid and gel spheres in anophthalmic cavities. METHODS Thirty-six white rabbits underwent a right eye enucleation with placement of 12 mm of porous (18 animals) or gel (18 animals) polyethylene spheres. The animals were submitted to weekly clinical evaluation. Ultrasound examinations were done 30, 60 and 90 days after surgery and the animals were sacrificed on the day 90th. Then, the orbit content was removed and submitted to light microscopy. RESULTS Five animals (27.2%) which received porous polyethylene spheres presented sphere extrusion. With the gel polyethylene spheres, the extrusions happened in 94.4% of the animals and it was observed that the expelled gel spheres had higher diameter then the implanted ones. Ultrasound evaluation showed that the porous polyethylene implant becomes vascularized but the gel not, as confirmed by histological examination. CONCLUSION Spheres of material in the gel state hydrate and increase in volume making it necessary to know the final size before the implantation. Ultrasound examination allows the evaluation of the implant-tissue integration.
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60
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Bevernage C, Geusens E, Nijs S. Case report: a gossypiboma in the shoulder. Emerg Radiol 2006; 12:231-3. [PMID: 16673090 DOI: 10.1007/s10140-006-0480-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2005] [Accepted: 01/25/2006] [Indexed: 11/26/2022]
Abstract
We present the case of a 15-year-old boy who underwent shoulder surgery for repair of a Bankart lesion after dislocation of his right shoulder. A compress was left in the surgical wound. This case is presented to highlight an important pitfall in the diagnosis of gossypiboma (foreign body reaction): when the wires of a compress are visualized on X-ray, beware of the fact that it is possibly located inside the body. The diagnosis of an abscess was made by ultrasound. The compress wires were visualized on radiographs.
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Delank KS, Schmidt M, Michael JWP, Dietlein M, Schicha H, Eysel P. The implications of 18F-FDG PET for the diagnosis of endoprosthetic loosening and infection in hip and knee arthroplasty: results from a prospective, blinded study. BMC Musculoskelet Disord 2006; 7:20. [PMID: 16512924 PMCID: PMC1409773 DOI: 10.1186/1471-2474-7-20] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Accepted: 03/03/2006] [Indexed: 12/27/2022] Open
Abstract
Background The most frequent complications of joint arthroplasty are septic or aseptic loosening of endoprostheses. Preoperative differentiation is essential, since very different treatment methods result from the diagnoses. The aim of the current study was to evaluate the clinical value of 18F-Fluoro-deoxyglucose positron emission tomography (18F-FDG PET) as a diagnostic modality for inflammation and loosening in hip and knee joint prostheses. Methods 18F-FDG-PET examinations and multiphase bone scan were performed on hip and knee endoprostheses in 27 patients prior to revision surgical procedures planned for prosthetic loosening. Intact prostheses were found at the opposite site in some patients so that additional 9 joints could be examined with the field of view of 18F-FDG PET. Verification and valuation of the PET and scintigraphic image findings were conducted by comparing them with information combined from intraoperative findings, histopathology, and microbiological investigations. Results Evidence of loosening was correctly determined in 76.4% of cases using 18F-FDG-PET, and in 75% of cases using bone scan. The detection of periprosthetic inflammation using 18F-FDG-PET had a sensitivity of 100% for septic cases and of 45.5% in cases of increased abrasion and aseptic foreign-body reactions. However, reliable differentiation between abrasion-induced and bacterial-caused inflammation was not possible using 18F-FDG-PET. Conclusion 18F-Fluoro-deoxyglucose positron emission tomography (18F-FDG-PET) allows reliable prediction of peri-prosthetic septical inflammatory tissue reactions. Because of the high sensitivity of this method, a negative PET result in the setting of a diagnostically unclear situation eliminates the need for revision surgery. In contrast, a positive PET result gives no clear differentiation regarding the cause of inflammation.
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Bessell-Browne R, Beer T, Wylie E. Tungsten particles mimicking the microcalcifications seen in ductal carcinoma in situ. AUSTRALASIAN RADIOLOGY 2006; 50:87-90. [PMID: 16499738 DOI: 10.1111/j.1440-1673.2005.01536.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mammographic detection and characterization of breast microcalcifications is important in the early diagnosis of ductal carcinoma in situ. A case is presented where tungsten microparticles simulated microcalcifications and prompted a full diagnostic assessment. The likely origin of the particles is discussed and the published work on metallic particles in the breast is reviewed. Awareness of possible alternative causes for apparent microcalcifications at mammography is important for the breast radiologist and pathologist.
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Abstract
Retained surgical sponge or gossypiboma in the abdominal cavity is an infrequent but serious surgical complication that may lead to medicolegal problem. The incidence of a surgical sponge retained at operation is difficult to estimate, but it has been reported as 1 in 100 to 3000 for all surgical interventions and 1 in 1000 to 1500 for intraabdominal operations. The natural evolution of a retained sponge, if aseptic, is to cause a foreign body reaction, followed by organization to form a foreign body granuloma, which may mimic a soft tissue neoplasm. Although features of CT and MR imaging of gossypibomas have been documented in the literature, they have often been misinterpreted preoperatively owing to the rarity of gossypibomas in daily clinical practice and to the low index of clinical suspicion. We report the FDG PET CT findings of a 42-year-old woman who had undergone cesarean sections twice previously, with an intraabdominal gossypiboma found incidentally in a routine health examination. We hope the PET CT findings in this case offer us useful adjunctive information to conventional imaging studies in the diagnosis of gossypiboma.
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Abstract
OBJECTIVE To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. STUDY DESIGN Retrospective study. ANIMALS Alpacas (7) and 1 llama. METHODS Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. RESULTS Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. CONCLUSIONS Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. CLINICAL RELEVANCE Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.
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Marcy PY, Hericord O, Novellas S, Ettore F. Lymph Node-Like Lesion of the Neck After Pharyngolaryngectomy. AJR Am J Roentgenol 2005; 185:1379-80. [PMID: 16247176 DOI: 10.2214/ajr.05.1154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Heimdal JH, Nygaard SJT, Olofsson J. [A four-year-old boy with swollen cheek after a fall]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2005; 125:2368-9. [PMID: 16163811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
A four-year-old boy had fallen from a tree in nursery school and had minor symptoms immediately after the trauma. He was admitted to the local casualty clinic the same night, but no signs of local injury were detected. The next morning he was admitted to the department of oto-rhino-laryngology at the local hospital due to increasing local swelling and pain in the cheek. A computed tomography examination demonstrated an extensive preauricular soft tissue swelling and a long central hypodensity from the left ear to the oropharynx. The presence of a penetrating foreign body was suspected and the boy was admitted to our hospital. An examination in general anaesthesia revealed a small skin lesion medial to the tragus in the left external auditory meatus and a wooden stick was seen crossing the oropharynx. The eight and a half centimetre long wooden stick had penetrated from the cartilaginous part of the left external auditory meatus to the right palatal tonsil. It was removed through a pre-auricular incision. No complications were observed and the boy could leave the hospital after four days of observation with antibiotic therapy and tetanus prophylaxis.
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De Wulf M, Ceuppens H, Gheysens B, Inderadjaja N. Destroyed lung due to aspiration of phenolphthalein. Acta Chir Belg 2005; 105:545-7. [PMID: 16315846 DOI: 10.1080/00015458.2005.11681152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 76-year-old female, presented with a recurrent cough and haemoptysis after an aspiration of a 'grain de Valls'. Chest radiography and computed tomography demonstrated an atelectasis of the medial segment of the right middle pulmonary lobe. Bronchoscopy was negative for any malignancy but the onco-PET-scan showed a pathologic hypermetabolic lesion in the right middle lobe. A lobectomy was performed and pathology revealed a 'destroyed lung' with images of foreign body reactions and microabscesses without any sign of malignancy. Postoperatively, clinical improvement with complete resolution of the symptoms was observed. With this case report we demonstrate the irritative and clastogenic characteristics of phenolphtalein, the main active ingredient of the 'grain de Valls'. This case also illustrates an example of a false positive PET-scan.
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69
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Bekhof J, Norbruis OF, Scheenstra R, de Weerd W. [Active management of children after ingestion of a button battery]. NEDERLANDS TIJDSCHRIFT VOOR GENEESKUNDE 2005; 149:1429-33. [PMID: 16010950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Four children, three girls in the age range up to 14 months and a boy aged 10 years, were admitted because of button battery ingestion. In two patients, the course was uncomplicated, with spontaneous passage of the batteries. Two other patients, a girl aged 11 months and a girl aged 6 weeks, developed severe complications: stenosis of the oesophagus in one patient and a dramatic clinical course with a tracheo-oesophageal fistula and oesophageal damage in the other. Ingestion of foreign bodies in children is a common problem. With the increased use of miniature electronic devices, the incidence of button battery ingestion is rising. Ingestion of a battery is an indication for urgent referral and radiological examination. Electrochemical tissue damage and impaction may lead to serious complications within hours. If the battery is located in the oesophagus, endoscopic removal should be attempted as soon as possible. A conservative approach can be followed when the battery is located in the stomach or beyond, and complaints are absent.
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Pettigrew RW, Stefanaci JD, Loughin CA, Marino DJ. What is your diagnosis? Metal foreign body reaction complicated by a staphylococcal infection. J Am Vet Med Assoc 2005; 226:1485-6. [PMID: 15881997 DOI: 10.2460/javma.2005.226.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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71
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Lazaridis C, Papaziogas B, Patsas A, Galanis I, Paraskevas G, Argiriadou H, Papaziogas T. Detection of tract formation for prevention of bile peritonitis after T-tube removal. Case report. Acta Chir Belg 2005; 105:210-2. [PMID: 15906918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Bile leakage after removal of T-tube is a relatively rare complication caused by inadequate tract formation around the tube. We report a case of bile peritonitis after removal of a latex T-tube. The patient underwent reoperation and a new T-tube was introduced. The T-tube was removed six weeks later. Immediately after removal of the tube, the cutaneous ostium of the tube was catheterized with a thin Nelaton catheter. The administration of gastrographin showed the presence of an intact tract. The removal of the t-tube was uneventful. We would propose this method for detecting the tract after removal of the T-tube in order to prevent severe bile leakage after inadequate tract formation.
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Aide N, Deux JF, Peretti I, Mabille L, Mandet J, Callard P, Talbot JN. Persistent Foreign Body Reaction Around Inguinal Mesh Prostheses: A Potential Pitfall of FDG PET. AJR Am J Roentgenol 2005; 184:1172-7. [PMID: 15788589 DOI: 10.2214/ajr.184.4.01841172] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE FDG PET has been recognized as an efficient imaging technique for the treatment of oncology patients. However, false-positive results can occur. The purpose of this study is to describe three oncology patients with persistent FDG up-take around inguinal mesh prostheses that occurred up to 10 years after the surgical repair of inguinal hernias and led to false-positive results. CONCLUSION Remote mesh prostheses can induce FDG uptake because of persistent foreign body reaction. Consequently, each time an unexpected pelvic focus is noticed on FDG PET, the medical history of patients should be carefully reviewed to avoid false-positive results.
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Shyung LR, Chang WH, Lin SC, Shih SC, Kao CR, Chou SY. Report of gossypiboma from the standpoint in medicine and law. World J Gastroenterol 2005; 11:1248-9. [PMID: 15754416 PMCID: PMC4250725 DOI: 10.3748/wjg.v11.i8.1248] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We report on a case of gossypiboma. A 78-year-old man was admitted to our hospital with acute abdomen. He had undergone an operation for colon cancer 4 mo previously. Abdominal ultrasonography revealed an echogenic lesion with a hypoechoic rim and strong posterior acoustic shadowing in the lower abdomen. Diagnosis of gossypiboma can be made by ultrasonography to avoid loss-of-chance of survival. We reviewed the English literature briefly of gossypiboma from the medical and juridical view. According to the theory of loss-of-chance, the damage of plaintiff is the loss of the chance of survival or recovery, rather than the final harm. The victim would allow recovery for the loss of the chance from the defendant. But the plaintiff would show by a preponderance that he was deprived of a betterchance of a cure. Under the proposed rule, the compensable value of the victim would be the plaintiff’s compensation for the loss of the victim’s chance of survival.
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Eylon S, Mosheiff R, Liebergall M, Wolf E, Brocke L, Peyser A. Delayed reaction to shrapnel retained in soft tissue. Injury 2005; 36:275-81. [PMID: 15664592 DOI: 10.1016/j.injury.2004.09.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2004] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treatment of penetrating injuries to soft tissues does not require surgical excision of shrapnel. Metals usually remain inert and do not cause damage and are therefore left in soft tissue. OBJECTIVE Characterization of delayed reaction to shrapnel retained for many years in soft tissue. PATIENTS Four patients sustained penetrating injuries to the limbs with embedded shrapnel. Many years later, they experienced delayed reaction to the metals that required surgery, with very unusual findings. CONCLUSIONS Although nonsurgical treatment of shrapnel in soft tissues is the treatment of choice in most cases, we need to be aware of the possibility of late complications requiring surgical treatment.
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Chen MY, Ng KK, Ma SY, Wu TI, Chang TC, Lai CH. False-positive fluorine-18 fluorodeoxy-D-glucose positron emission tomography imaging caused by retained gauze in a woman with recurrent ovarian cancer: a case report. EUR J GYNAECOL ONCOL 2005; 26:451-3. [PMID: 16122202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We report a case of a 47-year-old woman with a false-positive [18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) result caused by retained gauze during resection of liver metastasis for a Stage IV ovarian cancer at primary cytoreductive surgery. She achieved complete remission and remained free of progression for seven years. Owing to elevation of CA-125, computed tomography and PET studies were performed, and both showed two potentially resectable lesions. One was located ventral to the diaphragmatic surface of the left hepatic lobe and the other was around the gauze at the right hepatorenal fossa. During surgical intervention, the left supraheptic tumor was excised and the gauze with surrounding granulation was removed. However, the former proved to be recurrent ovarian cancer with the latter proven false-positive. This case demonstrates that PET results should be interpreted with caution in differentiating a benign inflammatory process from malignant abnormalities, especially in regions with a high probability of granulomatous lesions.
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