1
|
Abstract
Gangrenous cholecystitis is a kind of acute cholecystitis, whose course of disease progresses rapidly, early diagnosis is difficult and mortality is high, and clinicians are prone to misdiagnosis and missed diagnosis in clinical work.However, gangrenous cholecystitis has been ignored in various guidelines.This paper systematically summarized the pathogenesis, pathological manifestations, epidemiology, clinical diagnosis and treatment of gangrenous cholecystitis, hoping to provide a complete and clear diagnosis and treatment process for clinicians.
Collapse
Affiliation(s)
- Z Li
- Department of General Surgery,Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100072, China
| | - S Y Jia
- Department of General Surgery,Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100072, China
| | - F Z Liu
- Department of General Surgery,Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100072, China
| | - L J Ya
- Department of General Surgery,Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing 100072, China
| |
Collapse
|
2
|
Freire de Carvalho J, Shoenfeld Y. Gangrene and Livedo Reticularis in Antiphospholipid Syndrome. Isr Med Assoc J 2021; 23:601-602. [PMID: 34472238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Jozélio Freire de Carvalho
- Department of Internal Medicine and Diagnostic Support, Medical School, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel
- Ariel University, Ariel, Israel
- Laboratory of the Mosaics of Autoimmunity, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Chaudhary H, Mohan M, Jain A, Kumar V, Takia L, Sudhakar M, Angurana SK, Jindal AK. Acral Gangrene: Ugly Cousin of "COVID Toes" in Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2? Pediatr Infect Dis J 2021; 40:e312-e313. [PMID: 33941741 DOI: 10.1097/inf.0000000000003181] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A spectrum of dermatologic manifestations has been reported in multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection. We report 2 patients with multisystem inflammatory syndrome in children and severe cardiovascular dysfunction who developed acral gangrene. Both responded well to therapy and recovered in the follow-up.
Collapse
Affiliation(s)
- Himanshi Chaudhary
- From the Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mithun Mohan
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhinay Jain
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vijay Kumar
- Pediatric Intensive Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Lalit Takia
- Pediatric Intensive Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Murugan Sudhakar
- From the Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suresh Kumar Angurana
- Pediatric Intensive Care Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Kumar Jindal
- From the Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
4
|
Danset M, Lesort C, Jullien D, Kanitakis J. Cutaneous calciphylaxis of the glans penis presenting as a gangrenous ulceration. Dermatol Online J 2021; 27:13030/qt4qq316vx. [PMID: 33865284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023] Open
Abstract
Report _Case Presentation X Photo Vignette _Letter Authors declare that the contents of this article are their own original unpublished findings. Title: Cutaneous calciphylaxis of the glans penis presenting as a gangrenous ulceration Authors: Marie Danset, Cécile Lesort, Denis Jullien, Jean Kanitakis Affiliations: Dermatology Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon, France Corresponding Author: Jean Kanitakis, Department of Dermatology, Edouard Herriot Hospital Group, 69437 Lyon Cedex 03, France, Tel: 33-472110301, Email: jean.kanitakis@univ-lyon1.fr Abstract: Calciphylaxis is a rare microvascular disorder causing necrotic skin ulcers. It is characterized by deposits of calcium within vascular walls but its precise pathogenesis remains poorly understood. A major risk factor is end-stage renal disease on dialysis. We report a 67-year-old man with calciphylaxis revealed by an unusual necrotic ulcer of the glans penis. The patient also presented with bilateral panniculitis of the thighs and a calf ulcer. All those lesions were painful, highlighting the value of pain as a diagnostic clue. Penile involvement of calciphylaxis is rare and biopsy is often avoided in this area. However, rapid diagnosis of calciphylaxis is important because early treatment has a better chance of being successful. Our patient's condition deteriorated rapidly with development of bilateral retinal artery occlusion and he died shortly thereafter. This case further highlights the fact that calciphylaxis is a systemic vascular disease with an ominous prognosis.
Collapse
Affiliation(s)
- Marie Danset
- Dermatology Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Claude Bernard Lyon I University, Lyon
| | | | | | | |
Collapse
|
5
|
Ramachandran R, Vasudevan Pillai A, Raja S, Sailesh S. Axillary artery thrombosis resulting in upper limb amputation as a COVID-19 sequela. BMJ Case Rep 2021; 14:e240981. [PMID: 33500313 PMCID: PMC7839882 DOI: 10.1136/bcr-2020-240981] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 02/06/2023] Open
Abstract
Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles' heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Despite a successful embolectomy at the local hospital, there was re-occlusion of the axillary artery and the limb became ischaemic. He was referred to our institution by which time the limb became gangrenous above the elbow and had to be amputated. Extensive sloughing of the nerves was also seen in the local area. Hypercoagulability presenting with various manifestations is common in COVID-19 and needs early anticoagulation. We present this asymptomatic patient who lost a limb to this COVID-19 sequelae.
Collapse
Affiliation(s)
- Riju Ramachandran
- General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India
| | | | - Suyambu Raja
- General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India
| | - Sailakshmi Sailesh
- General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India
| |
Collapse
|
6
|
Bruni A, Garofalo E, Zuccalà V, Currò G, Torti C, Navarra G, De Sarro G, Navalesi P, Longhini F, Ammendola M. Histopathological findings in a COVID-19 patient affected by ischemic gangrenous cholecystitis. World J Emerg Surg 2020; 15:43. [PMID: 32615987 PMCID: PMC7330255 DOI: 10.1186/s13017-020-00320-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/14/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Since its first documentation, a novel coronavirus (SARS-CoV-2) infection has emerged worldwide, with the consequent declaration of a pandemic disease (COVID-19). Severe forms of acute respiratory failure can develop. In addition, SARS-CoV-2 may affect organs other than the lung, such as the liver, with frequent onset of late cholestasis. We here report the histological findings of a COVID-19 patient, affected by a tardive complication of acute ischemic and gangrenous cholecystitis with a perforated and relaxed gallbladder needing urgent surgery. CASE PRESENTATION A 59-year-old Caucasian male, affected by acute respiratory failure secondary to SARS-CoV-2 infection was admitted to our intensive care unit (ICU). Due to the severity of the disease, invasive mechanical ventilation was instituted and SARS-CoV-2 treatment (azithromycin 250 mg once-daily and hydroxychloroquine 200 mg trice-daily) started. Enoxaparin 8000 IU twice-daily was also administered subcutaneously. At day 8 of ICU admission, the clinical condition improved and patient was extubated. At day 32, patient revealed abdominal pain without signs of peritonism at examination, with increased inflammatory and cholestasis indexes at blood tests. At a first abdominal CT scan, perihepatic effusion and a relaxed gallbladder with dense content were detected. The surgeon decided to wait and see the evolution of clinical conditions. The day after, conditions further worsened and a laparotomic cholecystectomy was performed. A relaxed and perforated ischemic gangrenous gallbladder, with a local tissue inflammation and perihepatic fluid, was intraoperatively met. The gallbladder and a sample of omentum, adherent to the gallbladder, were also sent for histological examination. Hematoxylin-eosin-stained slides display inflammatory infiltration and endoluminal obliteration of vessels, with wall breakthrough, hemorrhagic infarction, and nerve hypertrophy of the gallbladder. The mucosa of the gallbladder appears also atrophic. Omentum vessels also appear largely thrombosed. Immunohistochemistry demonstrates an endothelial overexpression of medium-size vessels (anti-CD31), while not in micro-vessels, with a remarkable activity of macrophages (anti-CD68) and T helper lymphocytes (anti-CD4) against gallbladder vessels. All these findings define a histological diagnosis of vasculitis of the gallbladder. CONCLUSIONS Ischemic gangrenous cholecystitis can be a tardive complication of COVID-19, and it is characterized by a dysregulated host inflammatory response and thrombosis of medium-size vessels.
Collapse
Affiliation(s)
- Andrea Bruni
- Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Eugenio Garofalo
- Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Valeria Zuccalà
- Pathology Unit, "Pugliese-Ciaccio" Hospital, Viale Pio X°, 88100, Catanzaro, Italy
| | - Giuseppe Currò
- Digestive Surgery Unit, Department of Science of Health, "Magna Graecia" University, Catanzaro, Italy
- Surgical Oncology Division, Department of Human Pathology of Adult and Evolutive Age, University Hospital of Messina, Messina, Italy
| | - Carlo Torti
- Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy
| | - Giuseppe Navarra
- Surgical Oncology Division, Department of Human Pathology of Adult and Evolutive Age, University Hospital of Messina, Messina, Italy
| | - Giovambattista De Sarro
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Science of Health, "Magna Graecia" University, Catanzaro, Italy
| | - Paolo Navalesi
- Institute of Anesthesia and Intensive Care, Department of Medicine, University of Padua, Padua, Italy
| | - Federico Longhini
- Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
| | - Michele Ammendola
- Digestive Surgery Unit, Department of Science of Health, "Magna Graecia" University, Catanzaro, Italy
| |
Collapse
|
7
|
Nettleton J, Crawford-Smith H, Adimonye A, McMeekin F. Scrotal necrosis and no Fournier's in sight: a rare case of juvenile gangrenous vasculitis. BMJ Case Rep 2019; 12:e226530. [PMID: 30796076 PMCID: PMC6388882 DOI: 10.1136/bcr-2018-226530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2019] [Indexed: 01/06/2023] Open
Abstract
Juvenile gangrenous vasculitis of the scrotum is a rare entity, of which to our knowledge we describe the first documented case in the UK. It follows a typical disease course, demonstrated by an 18-year-old male who presented with three necrotic scrotal lesions; proceeded by 3 days of fever, pharyngitis and lethargy. Previous cases have been managed successfully with systemic steroids. On this occasion, surgical debridement was made of the necrotic areas under antibiotic cover and complete resolution was achieved with excellent wound healing and no evidence of recurrence. This case report discusses the importance of disease recognition and the merits of surgical management. We also add to the debate as to whether this disease is a variation of pyoderma gangrenosum or a distinct entity itself within the pantheon of scrotal gangrene.
Collapse
Affiliation(s)
- Jeremy Nettleton
- Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Hugh Crawford-Smith
- Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Anthony Adimonye
- Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Faith McMeekin
- Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| |
Collapse
|
8
|
Huang PH, Liao HT, Tsai CY. Severe Raynaud's phenomenon and Sjögren's syndrome with ferocious gangrene change and auto-amputation. Clin Med (Lond) 2019; 19:85. [PMID: 30651255 PMCID: PMC6399625 DOI: 10.7861/clinmedicine.19-1-85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Pin-Hsiang Huang
- Division of Allergy, Immunology and Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsien-Tzung Liao
- Division of Allergy, Immunology and Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Allergy, Immunology and Rheumatology, Taipei Medical University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chang-Youh Tsai
- Division of Allergy, Immunology and Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwain; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
9
|
Shah T, Shubrook JH. Dry Digital Gangrene. J Osteopath Med 2018; 118:765. [PMID: 30398575 DOI: 10.7556/jaoa.2018.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Millichap JJ, Strowd RE. Resident & Fellow Rounds. Neurology 2018; 90:805-807. [PMID: 29686125 DOI: 10.1212/wnl.0000000000005400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
11
|
Urade T, Sawa H, Murata K, Mii Y, Iwatani Y, Futai R, Abe S, Sanuki T, Morinaga Y, Kuroda D. Omental abscess due to a spilled gallstone after laparoscopic cholecystectomy. Clin J Gastroenterol 2018; 11:433-436. [PMID: 29564813 DOI: 10.1007/s12328-018-0853-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/15/2018] [Indexed: 01/27/2023]
Affiliation(s)
- Takeshi Urade
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan.
| | - Hidehiro Sawa
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Koichi Murata
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Yasuhiko Mii
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Yoshiteru Iwatani
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| | - Ryoko Futai
- Department of Gastroenterology, Kita-Harima Medical Center, Ono, Japan
| | - Shohei Abe
- Department of Gastroenterology, Kita-Harima Medical Center, Ono, Japan
| | - Tsuyoshi Sanuki
- Department of Gastroenterology, Kita-Harima Medical Center, Ono, Japan
| | - Yukiko Morinaga
- Department of Diagnostic Pathology, Kita-Harima Medical Center, Ono, Japan
| | - Daisuke Kuroda
- Department of Surgery and Digestive Surgery, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, 675-1392, Japan
| |
Collapse
|
12
|
Karatieieva S, Muzyka N, Semenenko S, Bakun O, Kozlovskaya I. ULTRASTRUCTURAL CHANGES OF WOUND MACROPHAGES UNDER THE INFLUENCE OF INTRAVENOUS OZONE THERAPY IN PATIENTS WITH DIABETES AND INFLAMMATORY PROCESSES OF SOFT TISSUES. Georgian Med News 2018:98-101. [PMID: 29697390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Investigation of ultrastructural peculiarities of morpho-functional changes of macrophages have been studied with the purpose of determining the dynamics and thrust of destructive-necrotic processes in these cells when the ischemic-gangrenous form of diabetic foot syndrome develops show what under the influence of intravenous ozone therapy stimulant effect on functional activity and beneficial effect on elimination, mainly due to genetically programmed cell death (apoptosis), playing a significant role in the regulatory mechanisms of the inflammatory process. The stimulation of macrophages functional activity under the influence of ozone, as well as the presence of destructive changes in such cells without necrotizing lesions, is explained by the inclusion of the mechanism of apoptosis as a positive factor in the regulation of local homeostasis at the completion of the inflammatory (exudative) stage of the wound process.
Collapse
Affiliation(s)
- S Karatieieva
- Higher State Educational Institution of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - N Muzyka
- Higher State Educational Institution of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - S Semenenko
- Higher State Educational Institution of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - O Bakun
- Higher State Educational Institution of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| | - I Kozlovskaya
- Higher State Educational Institution of Ukraine "Bukovinian State Medical University", Chernivtsi, Ukraine
| |
Collapse
|
13
|
Coman IS, Radu EV, Șandru V, Bârsan IC, Badiu CD, Constantinescu G, Grigorean VT. Retained Common Bile Duct Lithiasis at a Pacient with Periampullary Duodenal Diverticulum. Chirurgia (Bucur) 2017; 111:517-521. [PMID: 28044956 DOI: 10.21614/chirurgia.111.6.517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 11/23/2022]
Abstract
Periampullary duodenal diverticula are associated with the presence of common bile duct stones, being encountered more frequently with the increase of age. We present the case of a 76 years old female patient, who underwents emergency surgery for a perforated lithiasic gangrenous acute cholecystitis and for whom we perform a cholecystectomy and an external biliary drainage using a transcystic tube. Both preoperative and postoperative imaging and endoscopic examinations certify the presence of a periampullary duodenal diverticulum. Postoperative cholangiography performed on the transcystic tube raises the suspicion of retained common bile duct lithiasis. An endoscopic retrograde cholangiopancreatography is performed, initially failing to cannulate the common bile duct. A precut sphincterotomy fistula technnique is performed, using as reference a guide inserted on the transcystic tube, with the extraction of biliay sludge from the common bile duct, and with subsequently favorable development. Association between common bile duct lithiasis and a periampullary duodenal diverticulum may represent a therapeutic challenge because of the increased risk of failure of the endoscopic treatment.
Collapse
|
14
|
Zheliba MD, Godlevsky AI, Goncharenko OV, Formanchuk TV, Formanchuk AM. [COMPLEX TREATMENT OF PURULENT-NECROTIC COMPLICATIONS IN THE PATIENTS, SUFFERING DIABETIC FOOT SYNDROME, USING NEGATIVE TRESSURE AND CAPICOR PREPARATION]. Klin Khir 2017:19-21. [PMID: 30272933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The comparative analysis data were presented, concerning the results of complex treatment of 28 patients, suffering ischemic-gangrenous form of the diabetic foot syndrome, developing on background of chronic ischemia of the lower extremities stage IV. In 14 patients (main group) a routine complex of the treatment measures was added by application of an active pressure (negative pressure wound therapy - NPWT) and a capicor preparation; 14 patients (the comparison group) were treated in accordance to routine scheme. In accordance to the comparative analysis data, in patients of the main group the wound surface sarea have kept reducing in twice more rapid, than in a comparison group, the wounds healing was achieved in 94% patients, duration of the patients’ stationary stay have reduced by (5.2 ± 1.4) days.
Collapse
|
15
|
Тrybushnyi OV, Shapoval SD, Savon IL, Novak VV. [АNALYSIS OF LETHALITY IN COMPLICATED DIABETIC FOOT SYNDROME AND SEPSIS]. Klin Khir 2017:58-60. [PMID: 30272920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There were examined in dynamics 724 patients, in whom complicated diabetic foot syndrome (DFS) was diagnosed, and in 71 (9.8%) of them the disease was complicated by sepsis. The state severity in a DFS patients have depended upon duration of purulent-necrotic process on the foot, in septic patients such dependence was not revealed. All the DFS patients without sepsis were operated on. In total 36 died (lethality 5.5%), in presence of sepsis - 42 (lethality 59.1%). The cause of sepsis in the patients, suffering complicated DFS, was predominantly a wet gangrene of the lower extremities. Among those, who were not operated on, 13 (30.9%) septic patients died, of them 5 – who refused operative intervention performance - died in first hours after admittance to hospital due to irreversible injury of organs and systems.
Collapse
|
16
|
Aounallah A, Ghariani Fetoui N, Ghariani N, Korbi M, Mokni S, Boussofara L, Saidi W, Ksiaa M, Ben Jazia I, Guerfala M, Sriha B, Belajouza C, Denguezli M, Nouira R. [Thrombotic skin gangrene: A rare extra-intestinal manifestation of ulcerative colitis]. Ann Dermatol Venereol 2016; 144:109-112. [PMID: 27769565 DOI: 10.1016/j.annder.2016.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/23/2016] [Accepted: 09/14/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Thrombotic cutaneous gangrene is a rare extra-intestinal manifestation of ulcerative colitis with a severe prognosis. CASE REPORT A 35-year-old woman with a 7-year history of ulcerative colitis presented with extensive ecchymotic lesions that began a few hours earlier. On examination, she was febrile with multiple necrotic lesions. Skin biopsy showed multiple microthrombi in the dermal vessels. A diagnosis of thrombotic cutaneous gangrene was established. The patient was treated with heparin and systemic corticosteroids. The majority of cutaneous lesions showed improvement after 1 month. Thrombophlebitis of the left lower limb occurred subsequently. CONCLUSION Thrombotic cutaneous gangrene is attributed to microvascular thrombosis, which arises from the hypercoagulability observed in ulcerative colitis. Complete blood and coagulation tests must be performed and early anticoagulation with heparin must be considered in order to prevent the progression of cutaneous infarction.
Collapse
Affiliation(s)
- A Aounallah
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie.
| | - N Ghariani Fetoui
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - N Ghariani
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Korbi
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - S Mokni
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - L Boussofara
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - W Saidi
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Ksiaa
- Service de gastro-entérologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - I Ben Jazia
- Service de médecine interne et gastroentérologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Guerfala
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - B Sriha
- Laboratoire d'anatomie et de cytologie pathologiques, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - C Belajouza
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - M Denguezli
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| | - R Nouira
- Service de dermatologie, CHU Farhat Hached, avenue Ibn El Jazzar, 4000 Sousse, Tunisie
| |
Collapse
|
17
|
Abstract
Calciphylaxis, now better known as Calcific uraemic arteriolopathy (CUA), is an uncommon condition characterised by small vessel calcification and occlusion with resultant painful violaceous skin lesions that typically ulcerate to form non-healing gangrenous ulcers. The syndrome is usually found in patients with renal failure. In this report we describe a 61 year old lady who developed lower limb ulceration secondary to calciphylaxis and discuss the current treatment options for this serious condition.
Collapse
Affiliation(s)
- N Lang
- Department of Medicine, Queen Margaret Hospital, Whitefield Road, Dunfermline, Scotland.
| | | | | | | | | |
Collapse
|
18
|
Rimar D, Rozenbaum M, Slobodin G, Boulman N, KaLy L, Rosner I. [THROMBOANGIITIS OBLITERANS OVERLAPPING WITH ATHEROSCLEROTIC OCCLUSIVE ARTERIAL DISEASE: SMALL MESENTERIC ARTERY INVOLVEMENT BY THROMBOANGIITIS OBLITERANS]. Harefuah 2016; 155:41-66. [PMID: 27012074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Thromboangiitis obliterans is an inflammatory occlusive vascular disease of young smokers that commonly involves the small and medium sized arteries and veins of the extremities. An important differential diagnosis of thromboangiitis obliterans is atherosclerotic arterial disease. An atypical presentation of thromboangiitis obliterans by involvement of mesenteric arteries has been described sporadically. CASE PRESENTATION We report the case of a patient presenting with Raynaud's phenomenon, ischemia of the upper and lower extremities, as well as mesenteric ischemia. The dramatic course of the disease advanced to gangrene of the calves and intestinal infarction. In this patient, angiographic and histologic features were consistent with thromboangiitis obliterans associated with atherosclerotic arteriopathy. DISCUSSION A review of the literature revealed 31 reported cases of mesenteric artery involvement by thromboangiitis obliterans. The overlap between thromboangiitis obliterans and atherosclerotic arteriopathy is rare but has recently focused attention in the literature. CONCLUSION In the differential diagnosis of mesenteric ischemia, thromboangiitis obliterans is a rare but important diagnosis that should be considered. In view of shared features of thromboangiitis obliterans and peripheral artery disease, awareness of their possible coexistence is needed in order to make the right diagnosis and offer proper treatment.
Collapse
|
19
|
|
20
|
Abstract
As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.
Collapse
Affiliation(s)
- Akın Önder
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Murat Kapan
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Burak Veli Ülger
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Abdullah Oğuz
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ahmet Türkoğlu
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Ömer Uslukaya
- Department of General Surgery, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| |
Collapse
|
21
|
Denjalić A, Bečulić H, Jusić A, Bečulić L. Evaluation of the surgical treatment of diabetic foot. Med Glas (Zenica) 2014; 11:307-312. [PMID: 25082245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 06/14/2014] [Indexed: 06/03/2023]
Abstract
AIM To examine two modalities of surgical treatment of diabetic foot based on two different approaches, classical and multidisciplinary. METHODS A retrospective-prospective study including 120 consecutive patients with diabetic foot treated in the Department of Surgery, General Hospital Tešanj in the period 1999-2006. Since 2003 a new multidisciplinary approach to the treatment of diabetic foot based on a more conservative approach has been introduced. Two groups of patients were analyzed according to two treatment approaches: the first group included patients treated with classical method (in the period 1999-2002), and the second group included patients treated with multidisciplinary approach (in period 2003- 2006). An age distribution, gender, local changes in the extremities, results of microbiological analysis of wound swabs, and modalities of surgical treatment of diabetic foot were analyzed. RESULTS Duration of the disease (p=0.24), the level of blood glucose (p=0.52) and glycosylated hemoglobin (p=0.10) had no statistically significant effect to the outcome of the treatment of diabetic foot, while the level of hematocrit (p less than 0.006), fibrinogen (p less than 0.003), cholesterol (p less than 0.000001), and the absence of a pulse in the peripheral arteries (p less than 0.000002), and the outcome of surgical treatment of diabetic foot had the influence to the outcome of the treatment of diabetic foot with statistical significance. CONCLUSION Aggressive and appropriate medical and surgical treatment according to a grade of disease could improve the outcome and reduce the morbidity and mortality of diabetic foot. The results of this study showed the importance of proper diabetes treatment, prevention of complications and a multidisciplinary approach to the treatment of diabetic foot.
Collapse
Affiliation(s)
- Amir Denjalić
- 1Department of Surgery, General Hospital Tešanj, Tešanj, 2Department of Neurosurgery, 3Department of Oncology, Hematology and Radiotherapy; Cantonal Hospital Zenica, Zenica; Bosnia and Herzegovina
| | | | | | | |
Collapse
|
22
|
Haider I, Siddiqui M, Naji W, Sheikh M, Waqar A. Calciphylaxis leading to penile necrosis. J PAK MED ASSOC 2014; 64:711-713. [PMID: 25252499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Penile gangrene is a rare disease. It represents a poor prognostic sign in end stage renal disease (ESRD) patients and an indicator of metastatic vascular calcification. Pathogenesis of this life threatening condition is not clearly understood and treatment is also controversial. We describe the case of a 61-year-old man known to have diabetes mellitus, chronic renal failure on haemodialysis, who was complaining of worsening groin pain for 4 weeks. On examination dry gangrene of glans penis was noted. Cultures from the penis showed multiple organisms. Computed tomography (CT) showed diffuse calcification of external and internal iliac arteries. Later, he developed caciphylaxis of right anterior thigh. His overall condition did not improve in spite of adequate antibiotics and he was shifted to intensive care unit (ICU) where he required high doses of vasopressors. Clinically he kept deteriorating and passed away due to septic shock.
Collapse
|
23
|
Sasaki Y, Oda S, Fujikata S, Tanimoto S, Kan M. [Gangrene of the penis due to strangulation by a rubber band: a case report]. Hinyokika Kiyo 2014; 60:155-157. [PMID: 24759505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a case of strangulation of the penis by a rubber band. A 79-year-old man placed a rubber band tightly around the corona of his glans penis in order to prevent urinary incontinence. After five days, he was taken to our hospital in an ambulance for high temperature and general malaise. We found the rubber band and removed it immediately. Gangrene of the penis continued and he did not recover from sepsis, so we performed partial penectomy. After the operation, he completely recovered. Penile strangulation using a soft constricting object such as a rubber band might result in severe complications and we should be careful.
Collapse
Affiliation(s)
- Yutaro Sasaki
- The Department of Urology, Ehime Prefecture Central Hospital
| | - Shinpei Oda
- The Department of Urology, Ehime Prefecture Central Hospital
| | - Shiro Fujikata
- The Department of Urology, Ehime Prefecture Central Hospital
| | - Shuji Tanimoto
- The Department of Urology, Ehime Prefecture Central Hospital
| | - Masaharu Kan
- The Department of Urology, Ehime Prefecture Central Hospital
| |
Collapse
|
24
|
Socea B, Carâp A, Rac-Albu M, Constantin V. The value of serum bilirubin level and of white blood cell count as severity markers for acute appendicitis. Chirurgia (Bucur) 2013; 108:829-834. [PMID: 24331322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2013] [Indexed: 06/03/2023]
Abstract
Discussions regarding the correlations between elevated white blood cell levels and clinical and pathological stages of acute appendicitis are well known. Recent studies show that a high level of serum bilirubin could emerge as a prognostic marker for gangrenous or perforated stages of acute appendicitis. We studied the correlations between anatomical and pathological stages of acute appendicitis and white blood cell count, serum total bilirubin, and indirect serum bilirubin on a large series of cases, in the course of one year, in our department. Although there being a correlation between severe forms of acute appendicitis (gangrenous, perforated), elevated white blood cell count, elevated serum bilirubin (mostly the indirect fraction), none of the indicators proved to have a definitive diagnostic value. Cases with perforation and localized generalized peritonitis are more frequently associated with elevated bilirubin levels.
Collapse
|
25
|
Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R. A rare case of Meleney's ulcer after partial chemical matricectomy. Rev Esp Quimioter 2013; 26:128-131. [PMID: 23817651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Meleney's ulcer is a rare, but potentially deadly infection that often occurs in post-surgical sites. This type of ulcer has not previously been reported in the toenail after phenol matricectomy. PATIENT CASE A female patient underwent partial phenolization of the medial nail matrix of the hallux, but after 2 months had a recurrent spicula that caused Meleney's ulcers. RESULTS The ulcers remained after treatment with antibiotics, and further surgery was required to fully clear the infection. CONCLUSION This case and review of Meleney's ulcer highlights the deceptively benign initial presentation of necrotizing fasciitis at the hallux after partial chemical matricectomy surgery using a phenol-based approach.
Collapse
|
26
|
Makni A, Mizouni H, Rebai W, Ayadi S, Daghfous A, Ben Safta Z. [Retroperitoneal gangrene in perforated appendicitis]. Tunis Med 2013; 91:427-429. [PMID: 23868052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
27
|
Sabbatani S. [The death of Goffredo Mameli in 1849]. Infez Med 2013; 21:76-84. [PMID: 23524905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
After the introduction of firearms, which became increasingly efficient over time, the number of seriously injured soldiers increased considerably during the nineteenth century. As a consequence, surgeons were called upon to broaden their activity, performing operations which had hitherto been considered too hazardous, since they were deemed to be too extensive, or were contraindicated by the risk of complications during surgery (haemorrhage, heart and circulatory failure). From 1846 onwards, the introduction of anaesthetic techniques carried out with ether had expanded surgical perspectives in anatomical districts like the abdomen, which were previously considered a sort of taboo, such that few surgeons ventured into the realm of this internal surgery. In the mid nineteenth century the possibility of suffering from severe infections, as an immediate complication after a firearm injury or after surgical intervention, was very high, ranging between 23% in London, up to 80% in Munich, according to the available records; in Zurich a 46% mortality is reported, and a similar 43% rate came from Edinburgh. The situation worsened during war time, since injured soldiers were recovered in extremely precarious conditions, ad hoc hospitals were located in dilapidated old buildings, and the physicians and health care providers were unaware of the minimum hygiene conditions required, and performed both operations and medications without taking sterility measures into consideration. The author reports and comments on the most significant parts on the documents written by Agostino Bertani, who described in full detail the clinical evolution of the wound suffered by Goffredo Mameli, the poet and patriot of the Italian Risorgimento who wrote the Italian national anthem. The clinical evolution of Mameli's disease was unfavourable: he underwent amputation of the left lower limb after the firearm injury suffered during the defence of the Roman Republic, since a gangrenous complication had become apparent. The poet died of septicaemia on July 6, 1849, 17 days after the surgical operation.
Collapse
Affiliation(s)
- Sergio Sabbatani
- Unita Operativa di Malattie Infettive Policlinico S. Orsola-Malpighi di Bologna, Bologna, Italy.
| |
Collapse
|
28
|
Wilson CR. Feline gangrenous mastitis. Can Vet J 2013; 54:292-294. [PMID: 23997269 PMCID: PMC3573639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 3.7-kg, 3-year-old intact female domestic shorthaired cat was presented with the chief complaint of anorexia and lethargy of 3 days duration with a noticeable decrease in body condition and a large open wound on her ventral caudal abdomen. A diagnosis of acute mastitis with gland abscessation was made. The patient was successfully treated with oral antibiotics and open wound management using surgical debridement and lavage followed by wound dressings using honey.
Collapse
|
29
|
Fathi R, Shamma HN, Fathi A. Clopidogrel-associated vasculopathic cutaneous reaction. Dermatol Online J 2013; 19:7. [PMID: 23374949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
We present a case report of a man who experienced vascular thromboses, which subsequently resolved following discontinuation of clopidogrel.
Collapse
Affiliation(s)
- Ramin Fathi
- Rush Medical College of Rush University Medical Center, Chicago, IL, USA
| | | | | |
Collapse
|
30
|
Sabharwal S, Banerji JS, Kekre NS. Penile skin necrosis mimicking penile gangrene: an unusual case. Urol J 2013; 10:755. [PMID: 23504677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Sagar Sabharwal
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India.
| | | | | |
Collapse
|
31
|
Affiliation(s)
- Saurabh Dahiya
- Department of Internal Medicine, Baystate Medical Center/Tufts University School of Medicine, 759 Chestnut Street, Springfield, MA 01199, USA.
| | | | | |
Collapse
|
32
|
Affiliation(s)
- N Mumoli
- Department of Internal Medicine, Ospedale Civile Livorno, viale Alfieri 36, 57100 Livorno, Italy.
| |
Collapse
|
33
|
Kurnia E, Hardi F, Dewiasty E. Digital gangrene in systemic lupus erythematosus. Acta Med Indones 2012; 44:335-336. [PMID: 23314976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Enny Kurnia
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia-Cipto Mangunkusumo Hospital. Jl. Diponegoro no 71, Jakarta Pusat 10430, Indonesia.
| | | | | |
Collapse
|
34
|
Demidov SM, Kadyshev IG, Kopylovich AV, Osadchiĭ AV. [Observation of a gangrenously changed giant vermiform appendix]. Klin Khir 2012:63. [PMID: 23285657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
35
|
Affiliation(s)
- Jeffrey Forris Beecham Chick
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | | | | |
Collapse
|
36
|
Angelsky PO. Fourier phasometry of human effusion polycrystalline networks. Appl Opt 2012; 51:C70-C76. [PMID: 22505115 DOI: 10.1364/ao.51.000c70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 02/03/2012] [Indexed: 05/31/2023]
Abstract
A model of generalized optical anisotropy of polycrystalline networks of albumin and globulin of the effusion of appendicitis has been suggested. The method of Fourier phasometry of linear and circular birefringence with a spatial-frequency selection of the coordinate distributions for the differentiation of acute and gangrenous conditions have been analytically substantiated. A set of criteria of a polarization-phase differentiation of acute and gangrenous appendicitis states has been detected and substantiated.
Collapse
Affiliation(s)
- Pavlo O Angelsky
- Correlation Optics Department, Chernivtsi National University, Chernivtsi, Ukraine.
| |
Collapse
|
37
|
Nagy V. Unusual presentation of the urogenital myiasis caused by Luciliasericata (Diptera: Calliphoridae). Ann Agric Environ Med 2012; 19:802-804. [PMID: 23311811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION AND OBJECTIVE The case report describes the unusual presentation of the urogenital myiasis caused by Luciliasericata in two Slovakian men. MATERIAL AND METHODS The first patient, aged 66, who suffered from a locally advanced and inoperable urinary bladder dedifferentiated TCC with bilateral ureteral obstruction, chronic renal insufficiency and non-functioning left kidney. After surgical exploration the patient developed a malignant vesico-intestino-cutaneous fistula with stool leakage through the open wound. Because of very poor hygiene, and unsatisfactory attendance by staff, a fly deposited ova in the patient's necrotic wound. The patient died three months later of metastatic cancer disease. The second patient, a 43-year old homeless alcoholic male had gangrene of the scrotum and penis, urethro-cutaneous urinary fistula with numerous live and motile larvae on the surfaces. In both patients, some larvae were removed and sent to the lab for identification. The larvae were identified as maggots of the fly Luciliasericata. Antibiotic therapy, disinfection and debridement with sterile covering of the wound were used. RESULTS For both patients, complex treatment of myiasis was successful and patient recovered without parasitic consequences. CONCLUSIONS To our knowledge, this is the first report of the unusual presentation of the urogenital myiasis in Slovakian men with poor social habits and hygiene.
Collapse
Affiliation(s)
- Vincent Nagy
- Department of Urology, Medical Faculty and L Pasteur University Hospital, PJ Šafárik University, Košice, Republic of Slovakia.
| |
Collapse
|
38
|
Kang H, Kim HG, Ju JK, Kim DY, Kim YJ. Fulminant gangrenous ischemic colitis: is it the solely severe type of ischemic colitis? Int J Colorectal Dis 2012; 27:125-6. [PMID: 21503659 DOI: 10.1007/s00384-011-1204-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2011] [Indexed: 02/04/2023]
|
39
|
|
40
|
Striapukhin VV, Lishchenko AN. [Surgical treatment of the <<diabetic>> foot]. Khirurgiia (Mosk) 2011:73-78. [PMID: 21462595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
41
|
Shen Z, Ye Q. Images in clinical medicine. Ischemic gangrene. N Engl J Med 2010; 363:2651. [PMID: 21190459 DOI: 10.1056/nejmicm1001755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Zhu Shen
- Southwest Hospital of Third Military Medical University, Chongqing, China.
| | | |
Collapse
|
42
|
Vestergaard LS, Thybo S, Obel N. [Picture of the month: imported malaria]. Ugeskr Laeger 2010; 172:2774. [PMID: 20926052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
|
43
|
Paul SP, Paulie N, Hawes D. Appendicitis presenting as gastroenteritis: the importance of making a correct diagnosis. Nurs Times 2010; 106:20. [PMID: 20836477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
44
|
Alonso E, Krypciak S, Taillandier E, Tahmasebi F, Paillaud E. [A big purple leg]. Rev Med Interne 2010; 32:116-7. [PMID: 20541854 DOI: 10.1016/j.revmed.2010.03.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Accepted: 03/06/2010] [Indexed: 11/19/2022]
Affiliation(s)
- E Alonso
- Département de médecine interne et gériatrie, hôpital Chenevier-Mondor, 40, rue de Mesly, 94010 Créteil cedex, France.
| | | | | | | | | |
Collapse
|
45
|
Takac I, Kvolik S, Divkovic D, Kalajdzic-Candrlic J, Puseljic S, Izakovic S. Conservative surgical management of necrotic tissues following meningococcal sepsis: case report of a child treated with hyperbaric oxygen. Undersea Hyperb Med 2010; 37:95-99. [PMID: 20462141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This article presents the case of a 5-month-old infant, who survived a fulminant meningococcal sepsis with purpura fulminans, septic shock and severe DIC with gastrointestinal bleeding. Amputation and reconstructive surgery were considered to treat the multiple skin and limb necroses at high risk of superinfection, but the surgical intervention was delayed due to the extremely doubtful outcome. On Day 10 after the onset of the disease, a hemodynamic improvement was achieved. The baby overcame early critical period, but was still in poor general condition. The hyperbaric oxygenation (HBO2) as adjuvant therapy was started in the monoplace chamber using the following protocol: from first through fifth day 45 minutes twice a day on 1.5 atmosphere absolute (ATA); after a two-day break, once a day on 1.8 ATA for 60 minutes. During 52 HBO2 treatments multiple areas of necrotic skin and subcutaneous tissue, together with fingertips and toes, detached spontaneously. All wounds healed without reinfections. An increased oxygen concentration during HBO2 therapy promoted spontaneous wound healing. Bacterial superinfection was not observed in numerous low-perfused lesions. Since repeated anesthesia and surgical interventions were not needed, a final invalidity was minimized. To the best of our knowledge, this is the first report on the successful conservative surgical treatment of this mutilating disease without aggressive reconstructive surgery in an infant with the help of HBO2.
Collapse
Affiliation(s)
- Ines Takac
- Department of Anesthesiology & ICU, Clinical Hospital Osijek, J Huttlera 4, Osijek, Croatia
| | | | | | | | | | | |
Collapse
|
46
|
Mehrabi Bahar M, Jangjoo A, Amouzeshi A, Kavianifar K. Wound infection incidence in patients with simple and gangrenous or perforated appendicitis. Arch Iran Med 2010; 13:13-16. [PMID: 20039763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Performing a delayed primary wound closure is often recommended in patients with gangrenous or perforated appendicitis who have undergone an appendectomy. It can result in increased pain as well as an extended hospital stay which, in turn, increases hospital costs. Delayed primary wound closure remains controversial. The general policy in our institution is to perform a primary wound closure. In this study, we have compared the incidence of wound infection in patients with simple appendicitis to those with gangrenous or perforated appendicitis whose wounds were primarily closed. METHODS This is an observational study which was carried out on 400 patients with gangrenous or perforated (50%) and simple appendicitis (50%). Both groups underwent primary wound closure. Patients were followed for wound infection for at least one month after surgery. Data including age, sex, operating time, pathologic report and wound infection were collected. A comparison between the studied groups was made using Student's t-test for continuous variables and 2 test for categorical variables. RESULTS The median age of the patients was 23 years. There were 141 (35.2%) females and 259 (64.8%) males. The median operating time was 30 minutes. Wound infections were observed in 15 patients (3.7%), including 6 cases of simple and 9 cases of gangrenous or perforated appendicitis which was not statistically significant. CONCLUSION There was no statistically significant difference in wound infection between the simple and gangrenous or perforated appendicitis groups.
Collapse
Affiliation(s)
- Mostafa Mehrabi Bahar
- MUMS Surgical Research Center, Department of General Surgery, Imam Reza University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | | |
Collapse
|
47
|
Nasirov MI, Efendieva FM, Ismaĭlova DA. [The influence of peloids from volcanic deposits in Azerbaijan on the dynamics of sugar content in blood and urine and the wound healing in patients at the early stages of diabetic gangrene of the lower extremities]. Vopr Kurortol Fizioter Lech Fiz Kult 2009:42-43. [PMID: 20050166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The treatment of diabetic patients with pyonecrotic lesions in the lower extremities requires prolonged reflexo-segmental balneophysiotherapy to normalize functions of the nerve centres. Curative volcanic mud solutions (15-24 g/l) enriched with organic and nonorganic biologically active compounds from volcanic deposits in Azerbaijan were used for the first time to treat such patients. Peloids were applied to the lumbar region (location of sympathetic nerve nodes) and the lower legs above and beneath the affected sites. The patients were subjected to 12-15 seances of peloidotherapy (at 40-41 degrees Celsius) each lasting 20-30 minutes. The treatment was preceded by wound sanation using the standard procedure and a course of antibiotic therapy based on individual antibiotocograms. A total of 86 daibetic patients with leg gangrene underwent rheovasographic thermovision examination that revealed enhanced blood supply to the affected extremities under the action of the applied peloids. Peloidotherapy resulted in the normalization of blood and urine glucose levels in 53 (63%) of the patients. Simultaneously, the doses of medicamentous therapy could be lowered. Wound and ulcer healing was completed in the majority of the patients (86%) by the end of balneophysiotherapy when fresh granulation tissue began to develop and signs of oedema to disappear. These patients no longer needed amputation.
Collapse
|
48
|
Palaniswamy C, Selvaraj DR, Selvaraj T. Gangrenous cholecystitis caused by Hafnia alvei: a case report and review of literature. J Am Med Dir Assoc 2009; 10:361-3. [PMID: 19497550 DOI: 10.1016/j.jamda.2009.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2009] [Accepted: 03/03/2009] [Indexed: 11/20/2022]
|
49
|
Affiliation(s)
- Ernesto Reggio
- Centro Hospitalar Unimed, Uroclínica de Joinville - Jonville/SC, Brazil
- Pontifícia Universidade Católica do Paraná (PUC PR) - Paraná, Brazil
- , Tel.: 55 47 3441.9555
| | - Odival Timm
- Centro Hospitalar Unimed, Uroclínica de Joinville - Jonville/SC, Brazil
| | | | | | - Jose Bessa
- Centro Hospitalar Unimed, Uroclínica de Joinville - Jonville/SC, Brazil
- Universidade Estadual de Feira de Santana (UEFS) - Feira de Santana/BA, Brazil
| |
Collapse
|
50
|
Abstract
Over a period of eight years, 247 unselected patients with more or less widespread areas of obvious cutaneous erythema on the lower legs and/or feet (incipient gangrene) or corresponding areas with cutaneous necrosis (manifest gangrene) were examined at our department. Of these patients, 34% had incipient and 66% manifest gangrene. It was found that 75% had open diabetes; the other were classified as non-open diabetics. In 75% of the 247 patients these lesions accompanied cardiac decompensation with or without edema, edema of other causes or--in some cases--arterial insufficiency. The gangrene developed in most patients a short time after the onset of these precipitating factors. Arterial insufficiency alone or together with other precipitating factors was seen considerably less often. Edema was thus the main precipitating factor for these lesions. Cardiac decompensation as well as edema of the legs due to other causes respond well to treatment. When treating such patients with open or nonopen diabetes, it should be taken into consideration that gangrene is a serious condition.
Collapse
|