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Shiomi D, Sumi K, Kawasaki Y, Nomura N, Ushio J, Ito T, Inoue H. Endoscopic hand suturing of a covered self-expandable metal stent to prevent migration in malignant gastric outlet obstruction. Endoscopy 2024; 56:E422-E423. [PMID: 38759971 DOI: 10.1055/a-2313-3869] [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: 05/19/2024]
Affiliation(s)
- Daijiro Shiomi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Kazuya Sumi
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Yuki Kawasaki
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Norihiro Nomura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Jun Ushio
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Takayoshi Ito
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
| | - Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Koto-ku, Japan
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2
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Montoya C, Rey J, Polania-Sandoval CA, Bornak A, Shao T, Kenel-Pierre S. Inferior Vena Cava Filter Long Term Complications and Retrieval Techniques: A Case Series and Literature Review. Vasc Endovascular Surg 2024; 58:559-566. [PMID: 38196287 DOI: 10.1177/15385744231226048] [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] [Indexed: 01/11/2024]
Abstract
INTRODUCTION AND IMPORTANCE Long-term mechanical complications after inferior vena cava (IVC) filter placement include embedded or tilted filters, erosion of the vena cava, filter thrombosis. In the setting of caval thrombosis, patients may subsequently develop venous hypertension and post-thrombotic syndrome (PTS). Here we present three unique cases of IVC filter complications and surgical management. CASE PRESENTATION A 30-year-old female presented with acute abdominal pain, revealing a duodenal perforation caused by an IVC filter eroding into her duodenum. A 42-year-old female with an IVC filter in place for 20 years due to a prior pulmonary embolism underwent laser-assisted retrieval of the filter due to concerns of caval adherence. A 48-year-old male with a history of DVT, venous stasis ulcer, and an IVC filter presented for filter retrieval. CLINICAL FINDINGS AND INVESTIGATIONS The surgical techniques described in this report include complicated IVC filter retrieval, performed in cases of filter complications including migration, fracture, duodenal perforation and IVC thrombosis resulting in PTS. One case, requiring open retrieval, is explained and the surgical technique is provided. There are images and videos of these procedures to enrich the learning experience. INTERVENTION AND OUTCOMES The surgical techniques described in this report include complicated inferior vena cava filter retrieval, performed in cases of filter complications including migration, fracture, duodenal perforation and IVC thrombosis. One case, requiring open retrieval, is explained and the surgical technique is provided. There are images and videos of these procedures to enrich the learning experience. RELEVANCE AND IMPACT Endovascular retrieval of long-term complicated IVC filters is challenging, but it can be a safely performed in many patients. However, open surgery may be necessary in selected patients.
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Affiliation(s)
- Christopher Montoya
- Division of Vascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Jorge Rey
- Division of Vascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | | | - Arash Bornak
- Division of Vascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Tony Shao
- Division of Vascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Stefan Kenel-Pierre
- Division of Vascular Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Leonard M. Miller School of Medicine, Miami, FL, USA
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3
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Beal T, Say C, Ghasemi Rad M, Leon D. A Novel Microsnare and Microwire Coil Retrieval Technique. Vasc Endovascular Surg 2024; 58:567-570. [PMID: 38240584 DOI: 10.1177/15385744241229599] [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] [Indexed: 05/15/2024]
Abstract
Coil migration during endovascular embolization is a complication that can result in thromboembolic occlusion leading to potentially large infarcts if not removed. Microsnares are commonly used to remove migrated coils. Current techniques, however, struggle in cases where the microsnare is unable to loop over and secure a free end of the coil. We present a case in which a microsnare combined with a microwire successfully removed a migrated coil in a patient with a bleeding hepatic pseudoaneurysm post-embolization. This technique proved beneficial when traditional methods were insufficient, especially in small vessels or coil packs that cannot be snared. The synergy of the microsnare and microwire technique presents a promising solution for challenging migrated coil retrievals.
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Affiliation(s)
- Taylor Beal
- Department of Student Affairs, Baylor College of Medicine, Houston, TX, USA
| | - Conrad Say
- Department of Student Affairs, Baylor College of Medicine, Houston, TX, USA
| | | | - David Leon
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA
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4
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Maybury EK, Affrin ZC, Popa C, Fowler M, Laliberte BD, Clarke SC. Nexplanonectomy-the surgical removal of an embolized implanted contraceptive device: a case report and review of the literature. J Med Case Rep 2024; 18:234. [PMID: 38698425 PMCID: PMC11064350 DOI: 10.1186/s13256-024-04547-7] [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: 01/30/2024] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Nexplanon implants are a common hormonal contraceptive modality. Though rare, these devices can embolize into the injured wall of the basilic vein, through the right heart, and finally wedge itself into a pulmonary artery. With adherence to the arterial wall over time, it becomes less amenable to endovascular retrieval. Patients may present with symptoms mimicking a pulmonary embolism, or without any symptoms at all. In asymptomatic cases, endovascular retrieval and/or surgery is required when patients wish to begin having children prior to biological inactivity. The current literature showed as little as nine case reports detailing lung tissue removal in the aim of reversing a patient's implanted contraceptive device. CASE PRESENTATION A 22-year-old asymptomatic active-duty Caucasian female presented for elective outpatient Nexplanon removal. The suspicion of possible implant migration arose when it was discovered to be non-palpable in her left arm. After plain film x-rays failed to localize the implant, a chest x-ray and follow-up Computed Tomography (CT) scan revealed that the Nexplanon had migrated to a distal branch of the left pulmonary artery. Due to the patient's strong desires to begin having children, the decision was made for removal. Initial endovascular retrieval failed due to Nexplanon encapsulation within the arterial wall. Ultimately, the patient underwent a left video-assisted thoracoscopic surgery (VATS) for exploration and left lower lobe basilar S7-9 segmentectomy, which successfully removed the Nexplanon. CONCLUSIONS Implanted contraceptive devices can rarely result in migration to the pulmonary vasculature. These radiopaque devices are detectable on imaging studies if patients and clinicians are unable to palpate them. An endovascular approach should be considered first to spare lung tissue and avoid chest-wall incisions, but can be complicated by encapsulation and adherence to adjacent tissue. A VATS procedure with single-lung ventilation via a double-lumen endotracheal tube allows surgeons to safely operate on an immobilized lung while anesthesiologists facilitate single-lung ventilation. This patient's case details the uncommon phenomenon of Nexplanon migration, and the exceedingly rare treatment resolution of lung resection to remove an embolized device.
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Affiliation(s)
- Edward K Maybury
- Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA.
| | - Zachary C Affrin
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
| | - Christian Popa
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
| | - Max Fowler
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
| | - Bryan D Laliberte
- Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
| | - Sarah C Clarke
- Darnall Medical Library, Walter Reed National Military Medical Center, Bethesda, MD, 20814, USA
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5
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Vergara-Fernández O, Tueme de la Peña D, Canto-Losa J. Plastic biliary stent migration as a cause of ascending colon perforation. Rev Esp Enferm Dig 2024; 116:283-284. [PMID: 37170587 DOI: 10.17235/reed.2023.9696/2023] [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] [Indexed: 05/13/2023]
Abstract
A 65-year-old male with pancreatic cancer stage IV and history of endoscopic retrograde cholangiopancreatography (ERCP) and plastic biliary stent placement 43 days earlier, arrived to the emergency department with 8-hour right upper quadrant pain, fever, and shivering. Contrast enhanced computed tomography showed migration of the biliary stent to the ascending colon, with signs of perforation on its antimesenteric edge. A surgical approach by laparotomy was decided. The biliary stent was found perforating the ascending colon and in contact with the abdominal wall. The stent contained the colonic perforation, avoiding leakage. Removal of migrated endoprosthesis and primary closure was made. The patient remained in observation and with IV antibiotics, a new was performed ERCP with placement of an 8 cm by 10 Fr Amsterdam-type plastic stent on the 7th day due to cholangitis, with subsequent complete recovery. Endoscopic placement of stents has become a well-established procedure for biliary disease. Stent migration may be present in up to 6-8% of the cases. In most cases, distal migration has an uncomplicated passage, but it may cause bowel injury in up to 1%. This life-threatening complication requires prompt evaluation and management either by endoscopic or surgical approach.
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Affiliation(s)
- Omar Vergara-Fernández
- Colorectal Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México
| | - Danilo Tueme de la Peña
- Colorectal Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
| | - Jorge Canto-Losa
- General Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
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Batıhan G, Kına S. Foreign Body in the Posterior Mediastinum: Successful Minimally Invasive Removal of a Transesophageally Migrated Piece of Dishwashing Scourer. Arch Bronconeumol 2024; 60:238-241. [PMID: 38310074 DOI: 10.1016/j.arbres.2024.01.005] [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: 12/11/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 02/05/2024]
Affiliation(s)
- Güntuğ Batıhan
- Kafkas University Medical Faculty, Department of Thoracic Surgery, Turkey.
| | - Soner Kına
- Kafkas University Medical Faculty, Department of Anesthesiology, Turkey
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Cho YJ, Jeong YT, Lee TH, Cho HW. Delayed Implant Fixture Displacement into the Maxillary Sinus Five Years Post-Loading: Unraveling the Causes - A Case Report. J ORAL IMPLANTOL 2024; 50:81-86. [PMID: 38353278 DOI: 10.1563/aaid-joi-d-23-00073] [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] [Indexed: 05/05/2024]
Abstract
Reports of implant fixtures dislocating into the maxillary sinus during sinus graft procedures are well-documented. However, cases of fixtures migrating into the sinus long after placement have yet to be reported. This case report details the surgical extraction of a displaced screw and cement-retained prosthesis, including a fixture and its abutment, from the maxillary sinus after a minimum of 5 years under functional load. The extracted implant was subsequently examined using scanning electron microscopy and energy-dispersive x-ray spectroscopy. We found that the migration commenced with peri-implantitis surrounding the implant, replacing the second molar. This was accompanied by a loss of cement from the crown on this implant and concurrent loosening of the abutment screw on the implant, replacing the first molar. We hypothesize that the inability of the bony tissue surrounding the second molar implant to withstand occlusal forces resulted in forming a bony sequestrum. This process ultimately precipitated the migration of the fixture, along with its abutment and adjacent necrotic bone, into the sinus cavity.
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Affiliation(s)
- Young Joon Cho
- Mac Dental Clinic, Daegu, South Korea
- Department of Periodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Yong Tak Jeong
- Mac Dental Clinic, Daegu, South Korea
- Department of Periodontics, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | | | - Hyun Woo Cho
- College of Dentistry, New York University, New York, New York, USA
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8
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Depond CC, Elhairech D, Metellus P. Cardiac ventriculoperitoneal shunt migration. J Clin Neurosci 2024; 121:75-76. [PMID: 38367403 DOI: 10.1016/j.jocn.2024.02.006] [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: 02/06/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Charles Champeaux Depond
- Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, 317 Bd du Redon, 13009 Marseille, France.
| | - Dahmane Elhairech
- Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, 317 Bd du Redon, 13009 Marseille, France
| | - Philippe Metellus
- Department of Neurosurgery, Hôpital privé Clairval - Ramsay Santé, 317 Bd du Redon, 13009 Marseille, France
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9
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Seo KW, Park JS. Migration of central vein stent into the right atrium. Korean J Intern Med 2024; 39:364-365. [PMID: 37946450 PMCID: PMC10918383 DOI: 10.3904/kjim.2023.282] [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] [Received: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 11/12/2023] Open
Affiliation(s)
- Kyoung-Woo Seo
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
| | - Jin-Sun Park
- Department of Cardiology, Ajou University School of Medicine, Suwon, Korea
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10
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Hobbs E, Thompson DNP, Muthialu N, Silva AHD. Intracardiac migration of distal catheter-a rare complication of VP shunt insertion: case report and literature review. Childs Nerv Syst 2024; 40:587-591. [PMID: 37855877 PMCID: PMC10837212 DOI: 10.1007/s00381-023-06187-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
Intracardiac migration is a rare complication of ventriculoperitoneal shunt insertion. Only 15 cases have been reported, 7 of which were paediatric cases, treated with techniques including interventional radiography, open thoracotomies and direct extraction through the initial shunt incision. The authors report the youngest case of intracardiac shunt migration complicated by significant coiling and knotting within the cardiac chambers and pulmonary vasculature. Migration likely began when the SVC was pierced during initial shunt placement and progressed due to negative intrathoracic pressure. Extrusion was achieved combining thoracoscopic endoscopy, interventional fluoroscopy screening and a posterolateral neck incision with uncoiling of the shunt via a Seldinger guide wire. This offered a minimally invasive solution with rapid post-operative recovery.
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Affiliation(s)
- Ella Hobbs
- School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Dominic N P Thompson
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Nagarajan Muthialu
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital for Children, London, UK
| | - Adikarige Haritha Dulanka Silva
- Department of Neurosurgery, Great Ormond Street Hospital for Children, London, UK
- Great Ormond Street Institute of Child Health, University College London, London, UK
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11
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Sato T, Kato Y, Kataba H, Yoshida K, Hayashi H, Kakihana M, Ikeda N. Intrathoracic Needle Migration from the Mediastinum into the Thoracic Cavity. Ann Thorac Cardiovasc Surg 2024; 30:24-00039. [PMID: 38631862 PMCID: PMC11082495 DOI: 10.5761/atcs.cr.24-00039] [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: 03/05/2024] [Accepted: 03/31/2024] [Indexed: 04/19/2024] Open
Abstract
Intrathoracic needles are rarely used in clinical practice. They can migrate within the body, injure large blood vessels and other organs, and cause severe complications. We report an interesting case of intrathoracic needle removal using video-assisted thoracoscopic surgery. The needle was inserted under the left clavicle, penetrated the mediastinum, and migrated into the right thoracic cavity. Although pneumothorax developed during the disease course, no severe complications were observed. This rare case illustrates the course of needle migration from the mediastinum into the thoracic cavity. Prompt imaging and surgical removal of foreign bodies are necessary in cases of intrathoracic foreign bodies.
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Affiliation(s)
- Tomo Sato
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | - Yasufumi Kato
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | - Hiroaki Kataba
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | | | - Hiroki Hayashi
- Department of Thoracic Surgery, Kanto Central Hospital, Tokyo, Japan
| | | | - Norihiko Ikeda
- Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan
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12
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Wu Y, Chen Y, Ng LP, Low SYY. Spontaneous regression of migrated ventriculoperitoneal shunt catheter from scrotum to peritoneum: a case-based review. Childs Nerv Syst 2024; 40:19-25. [PMID: 37857859 DOI: 10.1007/s00381-023-06192-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE The incidence of scrotal migration of a ventriculoperitoneal shunt (VPS) catheter is rare and may lead to life-threatening visceral complications. Management requires prompt removal of the migrated portion of the shunt and closure of the scrotal sac. We report an interesting case of a young child who presented with asymptomatic unilateral swelling of his scrotum secondary to a migrated VPS catheter. A repeat X-ray prior to his surgery to remove the migrated catheter showed that the entire length of the distal VPS catheter was back in the peritoneal cavity. In view of this unusual phenomenon, the case is discussed in corroboration with published literature. METHODS AND RESULTS A systematic search of publications in the English language is performed in PubMed and Google Scholar. Our findings show that there are 49 reported cases (including our patient) of scrotal migration of shunt catheters in patients less than 18 years old. There is only 1 other case of spontaneous resolution of shunt catheter from the scrotum. Favoured management of choice is repositioning the distal shunt catheter back into the peritoneal cavity and herniotomy in the same setting, if possible. Overall, the literature suggests this is a shunt-related complication that has a good prognosis if intervention is timely. CONCLUSION Scrotal migration of a VPS catheter is a rare but potentially life-threatening complication in children. Our case report highlights the role of updated preoperative imaging and the need for consistent long-term shunt surveillance in children.
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Affiliation(s)
- Yilong Wu
- Neurosurgical Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Yong Chen
- Department of Paediatric Surgery, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Lee Ping Ng
- Neurosurgical Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Sharon Y Y Low
- Neurosurgical Service, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
- Department of Neurosurgery, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- SingHealth Duke-NUS Neuroscience Academic Clinical Program, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- SingHealth Duke-NUS Paediatrics Academic Clinical Program, 100 Bukit Timah Road, Singapore, 229899, Singapore.
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13
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Ghirardelli L, Beneduce AA, Gusmini S. A Rare Case of Small Bowel Obstruction due to Migration of a Percutaneous Biliary Stent. J Investig Med High Impact Case Rep 2024; 12:23247096241238527. [PMID: 38646799 PMCID: PMC11036911 DOI: 10.1177/23247096241238527] [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: 12/17/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 04/23/2024] Open
Abstract
Biliary endoprostheses are widely used in the treatment of biliary lithiasis, malignant and benign strictures, and occasionally in long-lasting biliary fistulas. They can be placed endoscopically during endoscopic retrograde cholangiopancreatography and radiologically (percutaneous) when the endoscopic route is not feasible. Complications associated with the endoscopic placement of biliary endoprostheses are well described in the literature, with migration being the most common. Intestinal obstruction is a rare complication associated with the migration of these devices. There are no reports in the literature of this complication occurring after percutaneous placement. We present a case of a patient who arrived at the emergency department with ileal obstruction secondary to the migration and concurrent embedding of a covered stent placed radiologically to treat a biliary leak after surgery. The patient underwent diagnostic laparoscopic and ileal resection, revealing a lithiasic concretion at the tip of the stent, causing the small bowel obstruction.
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14
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Yamada M, Okamoto T, Sasahira N. Successful removal of a migrated plastic stent using a new endoscopic sheath. Endoscopy 2023; 55:E1250-E1251. [PMID: 38092059 PMCID: PMC10718943 DOI: 10.1055/a-2215-1232] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Affiliation(s)
- Manabu Yamada
- Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Japan
| | - Takeshi Okamoto
- Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Japan
| | - Naoki Sasahira
- Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Japan
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15
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Tang Y, Zhou X, Deng X, Zhong X. Novel application of clips and a loop to facilitate endoscopic retrieval of a migrated esophageal metal stent. Clin Res Hepatol Gastroenterol 2023; 47:102234. [PMID: 37879534 DOI: 10.1016/j.clinre.2023.102234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Yu Tang
- Department of Gastroenterology, People's Hospital of Leshan, No.238 White Tower Road, Leshan 614000, Sichuan, China
| | - Xiaoling Zhou
- Health Check Centre, People's Hospital of Leshan, No.238 White Tower Road, Leshan 614000, Sichuan, China
| | - Xuejie Deng
- Department of Gastroenterology, People's Hospital of Leshan, No.238 White Tower Road, Leshan 614000, Sichuan, China
| | - Xianfei Zhong
- Department of Gastroenterology, People's Hospital of Leshan, No.238 White Tower Road, Leshan 614000, Sichuan, China
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Alsabbagh Q, Kanaan T, Dumour EA, Hadidi F, Al-Sabbagh MQ. An incidental migrating intra-spinal bullet: the silent victim of celebratory gunfire. Br J Neurosurg 2023; 37:1358-1361. [PMID: 33063544 DOI: 10.1080/02688697.2020.1834505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/05/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Incidentally found intra-spinal bullets are extremely rare, and have never been reported in the literature. The aim of this study is to report a rare case of an asymptomatic migrating intra-spinal bullet, emphasizing the role of cultural context in history taking, and describing its surgical retrieval technique. CASE PRESENTATION We discuss a case of a 10-years old boy with an incidentally discovered intra-spinal bullet opposite to the L5 vertebral level, who presented 3 months after the suspected initial insult. Following its migration to the L3/L4 level intraoperatively, the bullet was forced to spontaneously return to its preoperative position by reverse Trendelenburg Position, Valsalva maneuver and Intrathecal saline infusion, thus avoiding extending the previously performed laminectomy. CONCLUSION The authors remind the readers that history is the cornerstone of the clinical practice, even in the most obscure cases. Many convoluted intra-operative situations could be resolved by utilizing basic anatomical and physiological principles.
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Affiliation(s)
- Qussay Alsabbagh
- Division of neurological surgery, department of Special Surgery, The University of Jordan School of Medicine, Amman, Jordan
| | - Tareq Kanaan
- Division of neurological surgery, department of Special Surgery, The University of Jordan School of Medicine, Amman, Jordan
| | - Elias A Dumour
- Division of neurological surgery, department of Special Surgery, The University of Jordan School of Medicine, Amman, Jordan
| | - Fadi Hadidi
- Division of Orthopedics, department of Special Surgery, The University of Jordan School of Medicine, Amman, Jordan
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Chirinos-Vega JA, Vesco-Monteagudo E, Valera-Luján P, Barboza-Beraún A. [Endoscopic retrieval of migrated gastric band]. Rev Gastroenterol Peru 2023; 43:273-276. [PMID: 37890854] [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: 10/29/2023]
Abstract
This is a case report of a 47-year-old woman, carrier of an adjustable gastric band since 2018, that developed abdominal pain due to partial migration into the stomach. which was successfully removed endoscopically using Sohendra's lithotriptor.
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18
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Ahuja AS, Jaraki JA, Halperin LS. OFFICE MANAGEMENT OF OZURDEX IMPLANT DISLOCATION INTO THE ANTERIOR CHAMBER. Retin Cases Brief Rep 2023; 17:170-172. [PMID: 33731604 DOI: 10.1097/icb.0000000000001140] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To describe a novel office procedure that permits the repositioning of an Ozurdex implant from the anterior chamber back into the vitreous cavity. METHODS Description of an office technique for Ozurdex repositioning using a 30-gauge needle. RESULTS In both cases, the Ozurdex implant was successfully returned to the vitreous cavity. In Case 1, the patient's visual acuities 1 and 2 weeks after this were 20/70 and 20/40, respectively, and had no further complications. In Case 2, the patient returned 1 week later, with the implant remaining posterior and a visual acuity of 20/40. CONCLUSION The success of this novel technique in these cases demonstrates the potential to avoid a surgical procedure in the event of Ozurdex implant migration to the anterior chamber, while at the same time allowing the Ozurdex implant to remain effective in the eye.
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Affiliation(s)
- Abhimanyu S Ahuja
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; and
| | - Jude A Jaraki
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; and
| | - Lawrence S Halperin
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; and
- Retina Group of Florida, Ft. Lauderdale, Florida
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19
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Dewhurst S, Kyang LS, Jardeleza C, Pham T. Fishing for a fish bone: migratory foreign body in a regional hospital. ANZ J Surg 2023; 93:762-763. [PMID: 36001746 DOI: 10.1111/ans.18003] [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: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Suzannah Dewhurst
- Department of Surgery, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lee S Kyang
- Department of Surgery, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
- Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Camille Jardeleza
- Department of Surgery, Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
| | - Tuan Pham
- Otolaryngology Head and Neck Surgery Unit, The Canberra Hospital, Garran, Australian Capital Territory, Australia
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20
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Spoor J, de Jong D, van Leeuwen FE. Silicone Particle Migration: A Misleading Report. Aesthet Surg J 2022; 42:NP261-NP262. [PMID: 34695179 PMCID: PMC8922711 DOI: 10.1093/asj/sjab377] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Jonathan Spoor
- Department of Epidemiology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Corresponding Author: Dr Flora E. van Leeuwen, Department of Epidemiology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Plesmanlaan 121, 1066CX Amsterdam, the Netherlands. E-mail:
| | - Daphne de Jong
- Department of Pathology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Flora E van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute Antoni van Leeuwenhoek, Amsterdam, the Netherlands
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21
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Nguyen P, Sirinit J, Milia D, Davis CS. Management of intracardiac bullet embolisation and review of literature. BMJ Case Rep 2022; 15:e247252. [PMID: 35260401 PMCID: PMC8905873 DOI: 10.1136/bcr-2021-247252] [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] [Accepted: 02/25/2022] [Indexed: 11/03/2022] Open
Abstract
Vascular injury is a common complication in firearm injuries; however, intravascular missile embolism is relatively rare. There are only 38 documented cases of intravascular missile embolisation to the heart. Bullet embolisms are difficult to diagnose even with multiple diagnostic modalities and even once identified, the most optimal choice of surgical management is debated. Our patient presented with a gunshot wound to the right posterior shoulder. Cardiac focused assessment with sonography for trauma, chest X-ray, CT and echocardiogram were performed, showing missile location adjacent to the right ventricle with inconclusive evidence of pericardial injury. Exploratory median sternotomy was performed, revealing intact pericardium and injury to the superior vena cava (SVC) with bullet embolisation to the right ventricle. The patient became temporarily asystolic secondary to haemorrhage from the SVC injury. Cardiac massage was performed, dislodging the missile into the inferior vena cava. A venotomy was performed to retrieve the bullet and vascular injuries were primarily repaired.
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Affiliation(s)
- Peter Nguyen
- Department of Surgery, Division of Trauma/Acute Care Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Jitsupa Sirinit
- Department of Surgery, Division of Trauma/Acute Care Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - David Milia
- Department of Surgery, Division of Trauma/Acute Care Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Christopher Stephen Davis
- Department of Surgery, Division of Trauma/Acute Care Surgery, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
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22
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Datta D, Bansal S, Sahu RN. Spontaneous Intrathoracic Migration of Ventriculoperitoneal Shunt: A Report. Neurol India 2022; 70:464-465. [PMID: 35263954 DOI: 10.4103/0028-3886.338693] [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: 06/14/2023]
Affiliation(s)
- Debajyoti Datta
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Rabi N Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
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23
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O'Callaghan J, Penninga L, Skettrup M. [K-wire migration 28 years after operation]. Ugeskr Laeger 2021; 183:V10210782. [PMID: 34895431] [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: 06/14/2023]
Abstract
We present a case report of K-wire migration in a 64-year-old woman 28 years after insertion in the right pelvic bone. Two K-wires migrated to the contralateral side of the abdomen and right gluteus maximus, respectively. The K-wires were removed without complications. This case confirms the unpredictability of retained K-wires. The migration of the K-wires may have been triggered by recent cemented cuprevision. To our knowledge, K-wire migration in relation to aseptic loosening after cuprevision has not previously been reported in the literature.
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24
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Wu KH, Young YR, Guo DY, Chang KC, Hsiao CT, Chang CP. A Woman with Acute Right Upper Abdominal Pain. Ann Emerg Med 2021; 78:e77-e78. [PMID: 34688447 DOI: 10.1016/j.annemergmed.2021.05.005] [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: 04/10/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Kai-Hsiang Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
| | - Yui-Rwei Young
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan
| | - Di-You Guo
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan
| | - Kao-Chi Chang
- Department of Gastroenterology, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan
| | - Chia-Peng Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County 613, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Chiayi, Taiwan
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Brodén C, Sandberg O, Olivecrona H, Emery R, Sköldenberg O. Precision of CT-based micromotion analysis is comparable to radiostereometry for early migration measurements in cemented acetabular cups. Acta Orthop 2021; 92:419-423. [PMID: 33821746 PMCID: PMC8381926 DOI: 10.1080/17453674.2021.1906082] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - CT (computed tomography) based methods have lately been considered an alternative to radiostereometry (RSA) for assessing early implant migration. However, no study has directly compared the 2 methods in a clinical setting. We estimated the precision and effective radiation dose of a CT-based method and compared it with marker-based RSA in 10 patients with hip arthroplasty.Patients and methods - We included 10 patients who underwent total hip replacement with a cemented cup. CT and RSA double examinations were performed postoperatively, and precision and effective dose data were compared. The CT data was analyzed with CT micromotion analysis (CTMA) software both with and without the use of bone markers. The RSA images were analyzed with RSA software with the use of bone markers.Results - The precision of CTMA with bone markers was 0.10-0.16 mm in translation and 0.31°-0.37° in rotation. Without bone markers, the precision of CTMA was 0.10-0.16 mm in translation and 0.21°-0.31° in rotation. In comparison, the precision of RSA was 0.09-0.26 mm and 0.43°-1.69°. The mean CTMA and RSA effective dose was estimated at 0.2 mSv and 0.04 mSv, respectively.Interpretation - CTMA, with and without the use of bone markers, had a comparable precision to RSA. CT radiation doses were slightly higher than RSA doses but still at a considerably low effective dose.
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Affiliation(s)
- Cyrus Brodén
- Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital, London, UK
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Division of Orthopaedics, Stockholm, Sweden
| | | | - Henrik Olivecrona
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Roger Emery
- Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital, London, UK
| | - Olof Sköldenberg
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Division of Orthopaedics, Stockholm, Sweden
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Gokbulut V, Kaplan M, Odemis B, Disibeyaz S, Parlak E, Kilic ZMY, Oztas E. Incidence, Risk Factors, and Treatment of Proximally Migrated Pancreatic Stents. Surg Laparosc Endosc Percutan Tech 2021; 31:697-702. [PMID: 34166326 DOI: 10.1097/sle.0000000000000966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
AIM The aim of this study was to investigate the incidence, risk factors, and treatment strategies of proximally migrated pancreatic stents. MATERIALS AND METHODS The data of 626 sessions of 421 patients with pancreatic duct stenting were retrospectively analyzed between 2010 and 2018, and patients with proximally migrated stents were included in the study. RESULTS Of 626 stents examined, 77 migrated proximally (12%). The migration rate (MR) was 16%, 2%, and 7%, respectively, in patients treated with chronic pancreatitis, malignancy, and pancreatic leakage indication. The MR was 14% in procedures with pancreatic duct stenosis, 21% in procedures with pancreatic sphincterotomy, and 27% in procedures performed from minor papillae. The MR of the 5, 7, and 10 Fr stents was 4%, 17%, and 10%, respectively. Of the 77 migrated stents, 64 were successfully removed (83%). This success rate (SR) was 84% in procedures with chronic pancreatitis indication, 83% in procedures with pancreatic duct stenosis, 79% in procedures with sphincterotomy, and 75% in procedures performed from minor papillae. The SR of the 5, 7, and 10 Fr stents was 100%, 79%, and 92%, respectively. It was also determined that 33 stents were fractured and migrated (43%). The SR of the fractured stents was 76%. Moreover, of the stents that were successfully removed, 35 were removed with forceps (55%) and 15 (23%) were removed with a balloon. Furthermore, in 47 cases, the stent was removed in the first session (73%). Acute pancreatitis occurred in 5 patients (8%) and perforation occurred in 1 patient (2%). CONCLUSION In this study, it was shown that proximal migration of pancreatic stents is frequent and most of these stents can be removed successfully.
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Affiliation(s)
| | - Mustafa Kaplan
- Department of Gastroenterology, Memorial Kayseri Hospital, Kayseri
| | - Bulent Odemis
- Department of Gastroenterology, Ankara City Hospital
| | - Selcuk Disibeyaz
- Department of Gastroenterology, Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Erkan Parlak
- Department of Gastroenterology, Hacettepe University Faculty of Medicine, Ankara
| | | | - Erkin Oztas
- Department of Gastroenterology, Osmangazi University Faculty of Medicine, Eskişehir, Turkey
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27
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Kagiya T, Ogasawara K, Kawasaki K, Takigami R, Yamamoto T, Ozaki N. [Intrathoracic Migration of a Kirschner Wire Successfully Removed by Video-assisted Thoracic Surgery:Report of a Case]. Kyobu Geka 2021; 74:481-483. [PMID: 34059598] [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: 06/12/2023]
Abstract
A 40-year-old man who had been surgically treated for the fracture of the right humerus with two Kirschner wires (K-wires) complained of chest pain and difficulty in breathing at fourth day after surgery and visited our hospital. Chest radiography revealed dislocation of the K-wire and right pneumothorax. Video-assisted thoracic surgery( VATS) was performed immediately, and the K-wire was removed safely.
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Affiliation(s)
- Takuji Kagiya
- Department of Surgery, Okinawa Prefectural Yaeyama Hospital, Ishigaki, Japan
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28
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Tailor BV, Collins R, Mohammed A, Bath A. Paediatric case of endobronchial foreign body migration to the gastrointestinal tract. BMJ Case Rep 2021; 14:e240858. [PMID: 33758049 PMCID: PMC7993250 DOI: 10.1136/bcr-2020-240858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Bhavesh Vijay Tailor
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
- Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Rachael Collins
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
- Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Abdul Mohammed
- Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - Andrew Bath
- Department of Otolaryngology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
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29
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Fikani A, Tresson P. Traumatic Aortic Dissection Complicating Retrieval of an Embolised Atrial Septal Defect Closure Device. Eur J Vasc Endovasc Surg 2021; 61:578. [PMID: 33642135 DOI: 10.1016/j.ejvs.2021.02.006] [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: 12/16/2020] [Revised: 01/12/2021] [Accepted: 02/03/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Amine Fikani
- Department of Vascular and Endovascular Surgery, Hopital cardiologique Louis Pradel, Bron, France.
| | - Philippe Tresson
- Department of Vascular and Endovascular Surgery, Hopital cardiologique Louis Pradel, Bron, France
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30
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Lin PL, Wang YL, Weng SS, Huang WC. Laparoscopic Repair of the Bladder: A Case of Intrauterine Device Migration to the Urinary Bladder. J Minim Invasive Gynecol 2021; 28:1433-1435. [PMID: 33549733 DOI: 10.1016/j.jmig.2021.01.023] [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: 11/27/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Ping-Lun Lin
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
| | - Yeou-Lih Wang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)..
| | - Shih-Shien Weng
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
| | - Wen-Chu Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Mackay Medicine, Nursing, and Management College, and Mackay Medical College, Taipei, Taiwan (all authors)
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31
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Koc C, Akbulut S, Bilgic Y, Otan E, Sarici B, Isik B, Bayindir Y, Kutlu R, Jeng LB, Yilmaz S. Artificial vascular graft migration into hollow viscus organs in patients who underwent right lobe living donor liver transplantation. Acta Chir Belg 2020; 120:404-412. [PMID: 32496869 DOI: 10.1080/00015458.2020.1778266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 02/07/2023]
Abstract
BACKGROUND To share our experience with hollow viscus migration of artificial vascular grafts (AVG) used for venous reconstruction of the right anterior sector in living donor liver transplantations (LDLT). METHODS Clinical, radiological, and endoscopic data of 13 right lobe LDLT patients (range: 26-67 years) with a diagnosis of postoperative AVG migration into adjacent hollow viscus were analyzed. RESULTS Biliary complications were detected in 12 patients. A median of four times endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in 11 patients prior to AVG migration diagnosis. A median of 2.5 times various percutaneous radiological interventional procedures were performed in eight patients prior to AVG migration diagnosis. The site of migration was the duodenum in eight patients, gastric antrum in four, and Roux limb in the remaining one patient. The migrated AVS were made of polytetrafluoroethylene (PTFE) in 10 patients and polyethylene terephthalate (Dacron) in three. The migrated AVGs were endoscopically removed in seven patients and surgically removed in six. Only one patient died due to sepsis unrelated to AVG migration. CONCLUSION AVG migration into the adjacent hollow viscus following right lobe LDLT is a rare and serious complication. Repetitive ERCP, interventional radiological procedures, infection related to biliary leakage, and thrombosis of AVGs are among the possible risk factors.
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Affiliation(s)
- Cemalettin Koc
- Liver Transplant Institute, Inonu University, Malatya, Turkey
| | - Sami Akbulut
- Liver Transplant Institute, Inonu University, Malatya, Turkey
| | - Yilmaz Bilgic
- Department of Gastroenterology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Emrah Otan
- Liver Transplant Institute, Inonu University, Malatya, Turkey
| | - Baris Sarici
- Liver Transplant Institute, Inonu University, Malatya, Turkey
| | - Burak Isik
- Liver Transplant Institute, Inonu University, Malatya, Turkey
| | - Yasar Bayindir
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ramazan Kutlu
- Department of Radiology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Long-Bin Jeng
- Department of Surgery and Organ Transplant Center, China Medical University Hospital, Taichung, Taiwan
| | - Sezai Yilmaz
- Liver Transplant Institute, Inonu University, Malatya, Turkey
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Angelescu M, Enciu O, Florescu V, Miron A. Obstructive Jaundice Secondary to Clip Migration in the Common Bile Duct 9 Years after Laparoscopic Cholecystectomy. Chirurgia (Bucur) 2020; 115:526-529. [PMID: 32876027 DOI: 10.21614/chirurgia.115.4.526] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 11/23/2022]
Abstract
Surgical clip migration in the common bile duct with consecutive stone formation is a rare occurrence after laparoscopic cholecystectomy, less than 100 cases being reported so far. We report a case of a 55-year-old woman with obstructive jaundice due to bile duct stone formed around a migrated surgical clip 9 years after laparoscopic cholecystectomy. The patient presented with pain in the upper abdomen and jaundice. Abdominal ultrasound diagnosed dilation of the common bile duct and intrahepatic bile ducts. The diagnosis was confirmed by computed tomography which revealed a metal clip in the distal part of the common bile duct. The patient was managed successfully by endoscopic retrograde cholangiopancreatography (ERCP) and the surgical clip was retrieved using the Dormia basket. The exact mechanism of clip migration is not fully understood but may be explained by local inflammation and ineffective clipping. Although a rare occurrence, clip migration should not be excluded when considering the differential diagnosis of patients presenting with obstructive jaundice or cholangitis after laparoscopic cholecystectomy. Minimally invasive management by ERCP is the procedure of choice for migrated clips related complications but surgical common bile duct exploration may be necessary.
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Karakida K, Takahashi M, Sakamoto H, Nakanishi Y, Tamura M. Subcutaneous Migration of a Broken Dental Needle from the Mandibular Gingiva to the Neck: A Case Report. Tokai J Exp Clin Med 2020; 45:108-112. [PMID: 32901896] [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: 04/01/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
A 33G, 12-mm needle broke and entered the soft tissue in a 60-year old man. Panoramic X-ray imaging and cone-beam computed tomography (CT), which we performed a few hours after the breakage, revealed the needle in the soft tissue of the lower right mandibular molar. We immediately made an incision in the buccal gingiva of the lower right mandibular molar under local anesthesia and attempted to remove the needle but could not locate it. Thereafter, we adopted a watch-and-wait approach, as the patient had no subjective symptoms. Nine months later, we confirmed via CT that the needle had migrated subcutaneously to the right side of the neck. Two months later, we identified its location using C-arm fluoroscopy and removed it under general anesthesia. This report is a rare case and we are the first to document the subcutaneous migration of a fractured needle.
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Affiliation(s)
- Kazunari Karakida
- Department of Oral and Maxillofacial Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo 192-0032, Japan.
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34
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Tamrakar R, Chapagain D. Migration of a Broken Kirschner Wire from Lateral End of Clavicle to the Cervical Spine. J Nepal Health Res Counc 2020; 18:327-329. [PMID: 32969404 DOI: 10.33314/jnhrc.v18i2.2515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
Kirschner wire (K-wire) is commonly used in orthopaedics to treat various fractures. Migration of K-wire from the shoulder to different vital organs have been documented in many case reports. The possible explanations for such migration have been mentioned in the various literatures with the recommendations to prevent such complication. We report a case of migration of a broken K-wire to the cervical spine, which was used for the treatment of displaced lateral end fracture of right clavicle Keywords: Cervical spine; kirschner wire; migration.
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Affiliation(s)
- Rojan Tamrakar
- Department of Orthopaedics and Trauma, National Trauma Centre, National Academy of Medical Sciences, Mahankal, Kathmandu, Nepal
| | - Dinesh Chapagain
- Department of Cardiothoracic and Vascular Surgery, Bir Hospital, National Academy of Medical Sciences, Mahankal, Kathmandu, Nepal
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35
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Pillay T, Allopi L, Tariq HA. Retrograde venous bullet embolism into renal vein. S AFR J SURG 2020; 58:165. [PMID: 33231015] [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: 06/11/2023]
Abstract
The unpredictable nature and behaviour of bullet emboli can pose unique diagnostic and management challenges, related to the absence of exit wounds or variable trajectories. However, embolisation into the vascular system is an extremely unusual occurrence, with fewer than 200 such cases described since 1900. Given the relative paucity of such literature reports, it is not surprising that guidelines for the optimal management of some of these emboli are neither clear cut, nor universally accepted. We report the second case of retrograde venous bullet embolism to the right renal vein following a gunshot injury to the right chest and the surgical solution.
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Affiliation(s)
- T Pillay
- Department of Surgery, University of KwaZulu-Natal, South Africa
| | - L Allopi
- King Edward VII Hospital, South Africa
| | - H A Tariq
- Prince Mshiyeni Memorial Hospital, South Africa
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Ktari O, Frassanito P, Gessi M, Bianchi F, Tamburrini G, Massimi L. Gelfoam Migration: A Potential Cause of Recurrent Hydrocephalus. World Neurosurg 2020; 142:212-217. [PMID: 32634637 DOI: 10.1016/j.wneu.2020.06.214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/20/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Gelfoam is a simple and effective hemostatic agent that is used to seal brain corticotomies or skull burr holes. Owing to its low cost, it is one of the most widely used tools in neurosurgical daily practice. However, migration of Gelfoam fragments can cause occlusion of endoscopic third ventriculostomy (ETV) or shunt, leading to hydrocephalus recurrence. CASE DESCRIPTION Two cases of Gelfoam migration causing recurrent hydrocephalus are presented: a 12-year-old girl who underwent surgery for posterior fossa tumor removal and ETV for associated hydrocephalus, where a portion of Gelfoam (used to seal the burr hole) migrated up to close the ETV, and a preterm 8-month-old boy who was treated by neuroendoscopic brain lavage and afterward by ventriculoperitoneal shunt for posthemorrhagic hydrocephalus, where all the Gelfoam used to close the corticotomy migrated into the lateral ventricle, thus reopening the corticotomy and releasing small fragments that ultimately obstructed the shunt. A new endoscopic procedure was required in both patients (the second patient also required a shunt revision). CONCLUSIONS Review of the pertinent literature discloses other complications of Gelfoam migration (e.g., mass effect, granulomatous reaction) as well as other causes of uncommon ETV/shunt obstruction. Nonetheless, Gelfoam will remain an indispensable tool for neurosurgeons. The present report emphasizes the importance of its correct use to avoid complications.
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Affiliation(s)
- Omar Ktari
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paolo Frassanito
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Marco Gessi
- Neuropathology Unit, Division of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federico Bianchi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Massimi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy.
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Ambrosanio G, Arthimulam G, Leone G, Guarnieri G, Muto M, Muto M. Bailouts During Neurointervention; Novel Techniques in Tackling Coil Migration and Premature Intravascular Detachment of Microcatheter Tip. World Neurosurg 2020; 142:167-170. [PMID: 32615295 DOI: 10.1016/j.wneu.2020.06.190] [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: 02/21/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intracranial vascular malformations are increasingly being treated via the endovascular route. Though generally safe, a multitude of intraprocedural complications that potentially lead to disastrous clinical outcomes may arise. It is crucial for the operators to be well versed with the various techniques that are available to overcome any procedure-specific complications. METHODS We present 2 cases in which we encountered premature intravascular detachment of the microcatheter tip and coil migration while treating a dural arteriovenous fistula and aneurysm, respectively. We used a stentriever to remove the detached microcatheter tip and suction using the reperfusion catheter to remove the migrated coil, both techniques that have not been reported in the literature thus far. RESULTS Detached microcatheter tip and migrated coil were successfully retrieved using a stentriever and aspiration catheter. CONCLUSIONS These novel techniques could potentially reduce mortality and morbidity associated with neurointervention.
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Affiliation(s)
| | - Ganesan Arthimulam
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy; Neurointerventional Unit, Department of Diagnostic Imaging, Kuala Lumpur General Hospital, Malaysia.
| | - Giuseppe Leone
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | | | - Massimo Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
| | - Mario Muto
- Department of Neuroradiology, A.O.R.N. Cardarelli, Naples, Italy
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Rivera F, Bianciotto A. Contraceptive subcutaneous device migration: what does an orthopaedic surgeon need to know? A case report and literature review. Acta Biomed 2020; 91:232-237. [PMID: 32555102 PMCID: PMC7944845 DOI: 10.23750/abm.v91i4-s.9498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/10/2020] [Indexed: 11/23/2022]
Abstract
Subdermal contraceptive implant is approved in more than 60 countries and used by millions of women around the world. Although relatively safe in nature, their implantation and removal may be associated with potential complications, some of which may require surgical intervention. Two types of peripheral neurological complications are reported: complications related to compressive neuropathy caused by device decubitus and complications related to device improper removal. An healthy 35-year-old woman come to our attention for paresthesia from medial side of right elbow to fourth and fifth fingers. Tinel sign was positive on medial side of distal third of right arm, above the elbow, as well. Clinical history of patients revealed a subcutaneous placement of a etonogestrel implant 3 years before. Patients reported disappearing of tactile feeling of subcutaneous contraceptive implant since two months. At clinical examination, implant was not felt in its original subcutaneous place. X-rays control revealed its proximal and deep migration. Surgical exploration for subcutaneous contraceptive implant removal revealed it lying on the ulnar nerve. Patient referred immediate paresthesia disappearing after surgery. At 1 month follow up no motor or sensory alteration were evident. Removal of implants inserted too deeply must be carefully performed to prevent damages to nervous and vascular structures and it should be performed by operators who are very familiar with the anatomy of the arm. In case of chronic neuropathy caused by implant nerve compression only an appropriate patients information about rare but possible neuropathic symptoms related to device migration and a careful medical history collecting can avoid a mistaken diagnosis of canalicular syndrome.
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Affiliation(s)
- Fabrizio Rivera
- Orthopedics and Trauma Department, SS Annunziata Hospital, Savigliano (CN), Italy.
| | - Andrea Bianciotto
- Department of Obstetrics and Gynaecology, SS Annunziata Hospital, Savigliano, CN, Italy.
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Afzal MR, Ellis CR, Gabriels J, El-Chami M, Amin A, Fanari Z, Delurgio D, John RM, Patel A, Haldis TA, Goldstein JA, Yakubov S, Daoud EG, Hummel JD. Percutaneous approaches for retrieval of an embolized or malpositioned left atrial appendage closure device: A multicenter experience. Heart Rhythm 2020; 17:1545-1553. [PMID: 32464184 DOI: 10.1016/j.hrthm.2020.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Experience with retrieval of a Watchman left atrial (LA) appendage (LAA) closure device (WD) is limited. An embolized or grossly malpositioned WD warrants retrieval to minimize the risk of thromboembolic complications and vascular occlusion. OBJECTIVE The purpose of this study was to report approaches for percutaneous retrieval of a WD from multicenter experience. METHODS Data on successful WD retrievals were obtained from high-volume operators. Data included clinical characteristics; structural characteristics of the LA and LAA; and procedural details of the deployment and retrieval procedure, type of retrieval (immediate: during the same procedure; delayed: during a separate procedure after the successful deployment), equipment used, complications, and postretrieval management. RESULTS Ten successful percutaneous and 1 surgical retrievals comprised this study. Seven patients had immediate retrieval, while 4 had delayed retrieval. The median duration before delayed retrieval was 45 days (range 1-45 days). The median LAA diameter and size of a successfully deployed WD was 16 mm (range 14-24 mm) and 21 mm (range 21-30 mm), respectively. A WD was retrieved from the LA (n = 1), LAA (n = 2), left ventricle (n = 2), and aorta (n = 6). The reason for retrieval from the LAA was inadequate deployment, resulting in a significant peri-device leak. Retrieval from the LA or LAA was successfully performed using snares (n = 2) and a Raptor grasping device (n = 1). Retrieval from the left ventricle was achieved with a snare (n = 1) and surgery (n = 1). Retrieval from the aorta required snares (n = 5) and retrieval forceps (n = 1). Five patients were successfully reimplanted with a larger size WD. The only complication during percutaneous retrieval was a pseudoaneurysm. CONCLUSION Retrieval of an embolized or malpositioned WD is feasible, and familiarity with snares and grasping tools can facilitate a successful removal.
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Affiliation(s)
| | | | - James Gabriels
- Northwell Health, North Shore University Hospital, Manhasset, New York
| | | | - Anish Amin
- OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital, Columbus, Ohio
| | - Zaher Fanari
- University of Kansas Medical Center, Wichita, Kansas
| | | | - Roy M John
- Northwell Health, North Shore University Hospital, Manhasset, New York
| | - Apoor Patel
- Northwell Health, North Shore University Hospital, Manhasset, New York
| | | | | | - Steven Yakubov
- OhioHealth Heart and Vascular Physicians, Riverside Methodist Hospital, Columbus, Ohio
| | - Emile G Daoud
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John D Hummel
- The Ohio State University Wexner Medical Center, Columbus, Ohio.
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Ascoli Marchetti A, Oddi FM, Vacca F, Orellana Dàvila B, Ippoliti A. The Safety of EVAS Surgical Conversion in a Comparative Monocentric Analysis. Ann Vasc Surg 2020; 68:310-315. [PMID: 32439532 DOI: 10.1016/j.avsg.2020.04.071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Endovascular aneurysm sealing (EVAS) was a widespread technology to treat abdominal aortic aneurysm. However, the particular morphology and structure of this endoprosthesis predisposed to proximal sealing defects with a high rate of reintervention or conversion to open surgery treatments. The purpose of this article is to report our experience on late open conversion of Nellix device, compared with the previous reported experience. MATERIALS AND METHODS Between September 2013 and February 2020, eight late open surgical conversions for endoleak (EL) were performed in our center: four of these were for EVAR. Four of these were EVAS devices required explantation and were included in the study. All excisions of infected abdominal aortic endograft were excluded. RESULTS All patients were treated within the original instructions for use. Aorto-bi-iliac reconstruction was performed with a bifurcated Dacron graft in all the four cases. At 12 months Doppler ultrasonography follow-up, good results at short term with preserved primary patency and freedom of re-intervention in three cases were reported. Only one patient died 16 days after the procedure. Nevertheless, the endoprosthetic structure allows in three of our cases to clamp down the renal level, with a decrease of the time of lower limbs ischemia and greater safety of the open surgery repair procedure. CONCLUSIONS The EVAS conversion is common, and a closer follow-up is required. The most recurrent open surgery indication is its migration and the EL type 1. The procedure is influenced by multiple comorbidities; emergency graft excision appears to increase morbidity and mortality, compared with elective surgical setting.
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Affiliation(s)
| | - Fabio Massimo Oddi
- Biomedicine and Prevention Department, Vascular Surgery Unit, Rome, Italy
| | - Fabio Vacca
- Biomedicine and Prevention Department, Vascular Surgery Unit, Rome, Italy
| | | | - Arnaldo Ippoliti
- Biomedicine and Prevention Department, Vascular Surgery Unit, Rome, Italy
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Wang X, Qu J, Li K. Duodenal perforations secondary to a migrated biliary plastic stent successfully treated by endoscope: case-report and review of the literature. BMC Gastroenterol 2020; 20:149. [PMID: 32398025 PMCID: PMC7216602 DOI: 10.1186/s12876-020-01294-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Endoscopic retrograde biliary drainage (ERBD) is the most frequently performed procedure for treating benign or malignant biliary obstruction. Although duodenal perforations secondary to the biliary plastic stent are quite rare, they can be life-threatening. The treatment strategies for such perforations are diverse and continue to be debated. CASE PRESENTATION We report three cases of duodenal perforation due to the migration of biliary plastic stents that were successfully managed using an endoscope. The three patients were admitted on complaints of abdominal pain after they underwent ERBD. Abdominal computerized tomography (CT) revealed migration of the biliary plastic stents and perforation of the duodenum. Endoscopy was immediately performed, and perforation was confirmed. All migrated stents were successfully extracted endoscopically by using snares. In two of the three cases, the duodenal defects were successfully closed with haemostatic clips after stent retrieval, and subsequently, endoscopic nasobiliary drainage tubes were inserted. After the endoscopy and medical treatment, all three patients recovered completely. CONCLUSIONS Duodenal perforations due to the migration of biliary stents are rare, and the treatment strategies remain controversial. Our cases and cases in the literature demonstrate that abdominal CT is the preferred method of examination for such perforations, and endoscopic management is appropriate as a first-line treatment approach.
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Affiliation(s)
- Xiaopeng Wang
- Department of Biliary- Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong New Area, Shanghai, 200127, China
| | - Junwen Qu
- Department of Biliary- Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong New Area, Shanghai, 200127, China
| | - Kewei Li
- Department of Biliary- Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Pudong New Area, Shanghai, 200127, China.
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Abstract
RATIONALE Tooth extraction is a common dental surgical procedure. There is a possibility that various complications often occur during third molar tooth extractions. PATIENT CONCERNS The authors report herein 2 cases of migration of a high-speed dental hand-piece bur during mandibular third molar extraction-one case with the iatrogenic foreign body migrating into the mandibular body and another case with the iatrogenic foreign body migrating into the floor of mouth are reported. DIAGNOSIS The patient was diagnosed with the iatrogenic foreign body associated with mandibular third molar extraction by imaging examinations. INTERVENTIONS The authors performed elective surgery to remove the foreign body under general anesthesia in Case 1, and performed emergency surgery to remove the foreign body under local anesthesia in Case 2. OUTCOMES The foreign bodies were removed, and complete removal of the foreign bodies was confirmed by postoperative x-ray examination. The patients' postoperative courses were uneventful. LESSONS The selection of adequate surgical procedures and instruments will prevent the occurrence of iatrogenic foreign bodies. If migration accidents occur, their positions should first be confirmed by imaging examinations. Dentists and/or oral surgeons should perform removal operations considering the degree of emergency based on the results of imaging examinations.
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Affiliation(s)
- Shinpei Matsuda
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hitoshi Yoshimura
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui
| | - Hisato Yoshida
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui
| | - Kazuo Sano
- Department of Dentistry and Oral Surgery, Unit of Sensory and Locomotor Medicine, Division of Medicine, Faculty of Medical Sciences, University of Fukui
- Oral Care Support Center, Fukui Dental Association, Fukui, Japan
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Quiroga-Garza A, Teran-Garza R, Elizondo-Omaña RE, Guzmán-López S. The Use of Clinical Reasoning Skills in the Setting of Uncertainty: A Case of Trial Femoral Head Migration. Anat Sci Educ 2020; 13:102-106. [PMID: 30763453 DOI: 10.1002/ase.1869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/26/2019] [Accepted: 02/11/2019] [Indexed: 06/09/2023]
Abstract
Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine (EBM) has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.
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Affiliation(s)
- Alejandro Quiroga-Garza
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Rodrigo Teran-Garza
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - Santos Guzmán-López
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
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Abstract
INTRODUCTION Nexplanon is a 4 cm rod-shaped barium sulphate coated contraceptive implant with a usual subdermal insertion in the inner non-dominant upper arm. Complications proper to subdermal contraceptive implants are unusual and principally localized and minor, comprising infection at the site of implantation, hematoma, abnormal scar development, or local nerve and blood vessel injuries. Infrequently, contraceptive implant migration can happen, though habitually not far from the site of insertion. Pulmonary embolization of the device is remarkably rare and can present with symptoms such as chest pain or dyspnea. PATIENT CONCERNS AND DIAGNOSIS We report one of the rare cases of asymptomatic Nexplanon pulmonary embolism in a 26-year-old female. INTERVENTIONS AND OUTCOMES An endovascular intervention successfully retrieved the device from the lateral segment right middle lobe pulmonary artery without any complications. CONCLUSION Several cases of contraceptive implant migration into the pulmonary artery have been reported to this day. Preventing this life-threatening complication is challenging, and yet, no clear guidelines have been established.
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Affiliation(s)
- Joya-Rita Hindy
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Tarek Souaid
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | | - Joanne Glanville
- Department of General Surgery at Johnston-Willis Hospital, Richmond, VA, USA
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Compton J, Yanik J, Hendrickson N, Bagrodia N, Nau P, Pugley AJ. Unstable Lumbar Spine Osteomyelitis Caused by Trans-Foraminal Migration of Laparoscopic Adjustable Gastric Band Connection Tubing: A Case Report. Iowa Orthop J 2020; 40:101-103. [PMID: 32742215 PMCID: PMC7368515] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Disconnection of the tubing between the port and LAGB is a well-known complication in general surgery and accounts for up to 17% of LAGB complications. Typically, when this complication occurs patients present with abdominal or pelvic complaints. A complication of spinal infection due to trans-foraminal migration has not been previously reported. The aim of this study is to highlight an unusual infection of the thoracolumbar spine due to laparoscopic adjustable gastric band (LAGB) intragastric erosion, and migration into the lumbar spine causing epidural abscesses, discitis, and osteomyelitis. This case underscores the importance of a thorough surgical history, complete imaging, and multi-disciplinary approach in management of complex spine infections. METHODS We report a case of LAGB tubing migration into the spinal canal through the left L2/L3 neural foramen resulting in symptomatic epidural abscesses and osteomyelitis. RESULTS Although dislodgement and migration of LAGB tubing has been reported previously, this is the first report of trans-foraminal migration and erosion of lumbar vertebrae, causing osteomyelitis of the spine and epidural abscess formation, subsequent instability and neurologic deficit requiring urgent operative intervention. CONCLUSIONS Dislodgement and migration of LAGB tubing is a known complication. While it most commonly leads to abdominal and pelvic sequelae, in rare circumstances it may acutely affect the spine. Careful history, imaging, and multidisciplinary approach are paramount for the successful management.Level of Evidence: V.
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Affiliation(s)
- Jocelyn Compton
- University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
| | - John Yanik
- University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
| | - Nathan Hendrickson
- University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
| | - Naina Bagrodia
- University of Iowa Hospitals and Clinics, Department of General Surgery, Iowa City, IA
| | - Peter Nau
- University of Iowa Hospitals and Clinics, Department of General Surgery, Iowa City, IA
| | - Andrew J. Pugley
- University of Iowa Hospitals and Clinics, Department of Orthopedics and Rehabilitation, Iowa City, IA
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Ma IH, Tsai CY, Yang CM, Lai TT. Modified Cow-Hitch Suture for Repositioning of Subluxated Scleral-Fixated Rigid Intraocular Lens. Ophthalmic Surg Lasers Imaging Retina 2019; 50:179-182. [PMID: 30893452 DOI: 10.3928/23258160-20190301-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/06/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe a new technique for repositioning a subluxated scleral-fixated rigid intraocular lens (IOL). PATIENTS AND METHODS The authors present a modified intraocular threading technique to tie a cow-hitch knot around the eyelet on the dislocated haptic of a scleral-fixated rigid IOL. This technique uses three small corneal incisions to eliminate the need for IOL externalization and minimized the size and number of wounds. RESULTS Three consecutive cases of subluxated haptics in two patients underwent this procedure. Postoperative IOL centration and alignment were satisfactory without tilt. No surgical-related complication was observed 1 year after surgery. CONCLUSION A rigid IOL could be repositioned to a desired axis and centration via this modified cow-hitch technique, with better IOL support as compared with a single tie. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:179-182.].
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Krapf S, von Scheidt W, Thilo C. Periprocedural embolisation of a Sapien 3 TAVI prosthesis: failure and success. Clin Res Cardiol 2019; 109:649-651. [PMID: 31784902 DOI: 10.1007/s00392-019-01573-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/12/2019] [Accepted: 11/11/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Stephan Krapf
- Department of Cardiac and Thoracic Surgery, University Hospital Augsburg, Herzzentrum Augsburg-Schwaben, Augsburg, Germany
| | - Wolfgang von Scheidt
- Department of Cardiology, I. Medizinische Klinik, Universitätsklinikum Augsburg, Herzzentrum Augsburg-Schwaben, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Christian Thilo
- Department of Cardiology, I. Medizinische Klinik, Universitätsklinikum Augsburg, Herzzentrum Augsburg-Schwaben, Stenglinstr. 2, 86156, Augsburg, Germany.
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Özgür A, Dursun E, Beyazal Çeliker F, Terzi S. Magnet dislocation during 3 T magnetic resonance imaging in a pediatric case with cochlear implant. Braz J Otorhinolaryngol 2019; 85:799-802. [PMID: 27388957 PMCID: PMC9443000 DOI: 10.1016/j.bjorl.2016.04.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/09/2016] [Accepted: 04/12/2016] [Indexed: 11/19/2022] Open
Affiliation(s)
- Abdulkadir Özgür
- Recep Tayyip Erdogan University, Medical Faculty, Department of Otorhinolaryngology, Rize, Turkey.
| | - Engin Dursun
- Recep Tayyip Erdogan University, Medical Faculty, Department of Otorhinolaryngology, Rize, Turkey
| | - Fatma Beyazal Çeliker
- Recep Tayyip Erdogan University, Medical Faculty, Department of Radiology, Rize, Turkey
| | - Suat Terzi
- Recep Tayyip Erdogan University, Medical Faculty, Department of Otorhinolaryngology, Rize, Turkey
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Grand JG. Laparoscopic retrieval of a hepatic foreign body in a dog. Can Vet J 2019; 60:1161-1165. [PMID: 31692542 PMCID: PMC6805041] [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: 06/10/2023]
Abstract
A 4-year-old female pointer dog was presented with a 10-day history of tensed abdomen. Migration of a metallic foreign body to the liver was diagnosed using radiography and ultrasonography. Surgical retrieval of a sewing needle was successfully performed by laparoscopy using a 3-trocar technique, thus avoiding laparotomy. No intra- or post-operative complications occurred. The dog was discharged 24 hours after surgery. Ten months after surgery, the dog was in excellent physical condition with no recurrence of clinical signs. This is the first reported case of laparoscopic retrieval of a hepatic foreign body in a dog.
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Affiliation(s)
- Jean-Guillaume Grand
- Clinique Vétérinaire Aquivet, Parc d'activités Mermoz, 19 Avenue de la Forêt, 33320 Eysines, France
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Trahanas JM, Kwolek CJ, Tolis G. Open Tacking of a Migrated Thoracic Endovascular Aortic Graft. Ann Vasc Surg 2019; 63:461.e7-461.e9. [PMID: 31629854 DOI: 10.1016/j.avsg.2019.09.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/01/2019] [Accepted: 09/13/2019] [Indexed: 11/18/2022]
Abstract
Complications of thoracic endovascular aortic repair (TEVAR) are beginning to emerge as novel vascular issues. While endovascular solutions exist for most, some graft complications require a more traditional open solution. These operations are most commonly performed for endoleak or disease progression. Much less frequently observed is the migration of the endograft requiring open reintervention. Herein we present a case of a proximally migrated TEVAR graft, which required open fixation under deep hypothermic circulatory arrest (DHCA).
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Affiliation(s)
- John M Trahanas
- Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MA.
| | - Christopher J Kwolek
- Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA
| | - George Tolis
- Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MA
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