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1

Iatrogenic Duodenal Perforation Treated with Endoscopic Placement of Metallic Clips: A Case Report  

PubMed Central

Perforation is one of the major complications encountered during endoscopic procedures. The standard of care for these complications is either surgical intervention or nonoperative medical approach with antibiotics and bowel rest with or without parenteral alimentation. Metallic clips, initially developed to secure hemostasis in bleeding, have been successfully used to close perforations in the gastrointestinal tract (GI) including the duodenum. This avoids perioperative morbidities associated with surgical intervention while limiting the leakage of intestinal contents and peritoneal contamination that is possible with medical management. We present a case of a patient with a lateral duodenal perforation during an endoscopic retrograde cholangiopancreatography (ERCP) which was successfully treated with immediate placement of metallic endoclips.

Solomon, Missale; Schlachterman, Alexander; Morgenstern, Ricardo

2012-01-01

2

Endoscopic Treatments of Endoscopic Retrograde Cholangiopancreatography-Related Duodenal Perforations  

PubMed Central

Iatrogenic duodenal perforation associated with endoscopic retrograde cholangiopancreatography (ERCP) is a very uncommon complication that is often lethal. Perforations during ERCP are caused by endoscopic sphincterotomy, placement of biliary or duodenal stents, guidewire-related causes, and endoscopy itself. In particular, perforation of the medial or lateral duodenal wall usually requires prompt diagnosis and surgical management. Perforation can follow various clinical courses, and management depends on the cause of the perforation. Cases resulting from sphincterotomy or guidewire-induced perforation can be managed by conservative treatment and biliary diversion. The current standard treatment for perforation of the duodenal free wall is early surgical repair. However, several reports of primary endoscopic closure techniques using endoclip, endoloop, or newly developed endoscopic devices have recently been described, even for use in direct perforation of the duodenal wall.

Han, Joung-Ho; Park, Sang-Heum

2013-01-01

3

Initial repair of iatrogenic colon perforation using laparoscopic methods  

Microsoft Academic Search

Background Iatrogenic perforation of the colon during elective colonoscopy is a rare but serious complication. Treatment using laparoscopic methods is a novel approach, only described in the recent literature. We hypothesized that laparoscopic treatment of iatrogenic colon perforation would result in equal therapeutic efficacy, less perioperative morbidity, smaller incisions and decreased length of stay, and an overall better short-term outcome

J. I. Bleier; Victor Moon; Daniel Feingold; Richard L. Whelan; Tracy Arnell; Toyooki Sonoda; J. W. Milsom; Sang W. Lee

2008-01-01

4

Endoscopic retrieval of a duodenal perforating teaspoon  

PubMed Central

Foreign objects ingestion occur commonly in pediatric patients. The majority of ingested foreign bodies pass spontaneously the gastrointestinal tract and surgery is rarely required for extraction. Endoscopic removal of foreign bodies larger than 10 cm has not yet been described. We present the case of a 16 years old bulimic girl that swallowed a 12 cm long teaspoon in order to provoke vomiting. The teaspoon perforated the duodenum. However, it was removed during gastroscopy and the site of perforation was closed endoscopically. This particular case shows the importance of endoscopy for retrieval of large foreign bodies, and the possibility to endoscopically close a perforated duodenal wall.

Boskoski, Ivo; Tringali, Andrea; Landi, Rosario; Familiari, Pietro; Contini, Anna Chiara Iolanda; Pintus, Claudio; Costamagna, Guido

2013-01-01

5

Duodenal tuberculosis presenting as acute ulcer perforation.  

PubMed

Gastrointestinal tuberculosis (TB) is rare, but its incidence is increasing in industrialized countries because of the growing numbers of individuals at risk for TB. Herein, we report the exceptional case of a young, HIV-negative, African refugee who presented with acute perforation of an isolated duodenal tuberculous ulcer. Clinical patterns of duodenal TB are discussed. The difficulty of obtaining a diagnosis on the basis of clinical features, endoscopy, and imaging is emphasized, as well as the importance of obtaining a biopsy specimen and its limitations. PMID:9772074

Berney, T; Badaoui, E; Tötsch, M; Mentha, G; Morel, P

1998-10-01

6

Perforated Duodenal Ulcer in a Cow  

PubMed Central

A case report of perforated duodenal ulcer in a ten year old Holstein cow is presented. On three occasions, sudden anorexia and rapidly progressing abdominal fluid distension were associated with metabolic alkalosis, hypochloremia and hypokalemia. Rumen fluid at the time of the second episode was acidic and contained an excessive amount of chloride ion. An abdominal mass dorsal to the abomasum involving the pylorus and several loops of small bowel was identified but not corrected at surgery. Necropsy confirmed a 1.5 cm diameter duodenal ulcer 6 cm distal to the pylorus.

Fatimah, I.; Butler, D. G.; Physick-Sheard, P. W.

1982-01-01

7

[Duodenal perforation after blunt abdominal trauma].  

PubMed

Duodenal perforation after a blunt abdominal trauma is a rare emergency situation that can result in life-threatening complications. We report on a woman who had a perforation of the duodenum after a supposed mild blunt abdominal trauma. Unremarkable at the initial presentation, the patient presented with acute abdominal pain and a retroperitoneal abscess five days after the initial trauma. The duodenal repair was performed with a Roux-Y anastomosis. Difficulties in diagnosis are very common, but the early recognition of the rupture is essential. The contrast-enhanced CT scan is the gold standard for diagnosis. Surgical management depends on the severity of the trauma and must be chosen on an individual basis. PMID:20020392

Schneider, R; Moebius, C; Thelen, A; Jonas, S

2009-12-17

8

Medical management of iatrogenic esophageal perforations  

Microsoft Academic Search

Opinion statement  Esophageal perforation is an uncommon, potentially disastrous occurrence with high mortality rates even when managed with\\u000a surgery. Over the past few decades, several case series have shown that nonoperative management is a feasible option in some\\u000a patients, although the criteria for selecting such patients are neither firmly established nor accepted by all those who manage\\u000a these critical patients. The

Ryan D. Madanick

2008-01-01

9

Perforated duodenal ulcer: a rare complication of deferasirox in children.  

PubMed

Duodenal ulcer perforation in pediatric age group is an uncommon entity; hence, it is not usually considered in the differential diagnosis of acute abdomen in these patients. It is important for the emergency physician to consider perforated peptic ulcer in the differential diagnosis of children presenting with acute abdominal pain, gastrointestinal bleeding, or shock. We report a 6½-year-old male child with thalassemia major who presented to emergency room with an acute abdomen and shock, who was subsequently found to have a perforated duodenal ulcer, probably related to use of oral chelating agent, deferasirox. Although, gastrointestinal symptoms like nausea, vomiting, and abdominal pain has been mentioned as infrequent adverse event in the scientific product information of deferasirox, in our current knowledge this is the first case report of perforated duodenal ulcer after oral deferasirox. The severity of this event justifies the reporting of this case. This patient had an atypical presentation in that there were no signs or symptoms of peptic ulcer disease before perforation and shock he was successfully managed with open surgery after initial resuscitation and stabilization of his general condition. PMID:23833377

Yadav, Sunil Kumar; Gupta, Vipul; El Kohly, Ashraf; Al Fadhli, Wasmi

10

Perforated duodenal ulcer: A rare complication of deferasirox in children  

PubMed Central

Duodenal ulcer perforation in pediatric age group is an uncommon entity; hence, it is not usually considered in the differential diagnosis of acute abdomen in these patients. It is important for the emergency physician to consider perforated peptic ulcer in the differential diagnosis of children presenting with acute abdominal pain, gastrointestinal bleeding, or shock. We report a 6½-year-old male child with thalassemia major who presented to emergency room with an acute abdomen and shock, who was subsequently found to have a perforated duodenal ulcer, probably related to use of oral chelating agent, deferasirox. Although, gastrointestinal symptoms like nausea, vomiting, and abdominal pain has been mentioned as infrequent adverse event in the scientific product information of deferasirox, in our current knowledge this is the first case report of perforated duodenal ulcer after oral deferasirox. The severity of this event justifies the reporting of this case. This patient had an atypical presentation in that there were no signs or symptoms of peptic ulcer disease before perforation and shock he was successfully managed with open surgery after initial resuscitation and stabilization of his general condition.

Yadav, Sunil Kumar; Gupta, Vipul; El Kohly, Ashraf; Al Fadhli, Wasmi

2013-01-01

11

Surgeons' attitudes to the operative management of duodenal ulcer perforation and haemorrhage.  

PubMed Central

The currently preferred operative management of duodenal ulcer haemorrhage and perforation was assessed by means of a questionnaire sent to 274 consultant general surgeons in England. A 70% response rate was achieved. Simple closure, with or without H2 antagonist treatment, was the most popular management of a perforated acute duodenal ulcer. For perforation of a chronic duodenal ulcer occurring during H2 antagonist therapy, truncal vagotomy and drainage was the definitive procedure of choice. There was no consensus about the operative management of perforation complicating non-steroidal anti-inflammatory drug treatment in the elderly patient. Proximal gastric vagotomy appears to have few advocates in the definitive management of either duodenal ulcer perforation or haemorrhage. Of our sample 70% selected truncal vagotomy and drainage with underrunning of the ulcer as the operative treatment of choice for bleeding. Endoscopic coagulation appears to be used only rarely.

Stringer, M. D.; Cameron, A. E.

1988-01-01

12

Rescue endoscopic band ligation of iatrogenic gastric perforations following failed endoclip closure  

PubMed Central

Iatrogenic gastric perforation is one of the most serious complications during therapeutic endoscopy, despite significant advances in endoscopic techniques and devices. This case study evaluated the clinical efficacy and safety of the rescue endoscopic band ligation (EBL) technique in iatrogenic gastric wall perforation following the failure of primary endoclip closure. Five patients were enrolled in this study. These patients underwent emergency endoscopy following the onset of acute gastric wall perforation during endoscopic procedures. The outcome measurements were primary technical success and immediate or delayed procedure-related complications. Successful endoscopic closure using band ligation was reported in all patients, with no complication occurring. We conclude that EBL may be a feasible and safe alternate technique for the management of acute gastric perforation, especially in cases where closure is difficult with endoclips.

Han, Joung-Ho; Lee, Tae Hoon; Jung, Yunho; Lee, Suck-Ho; Kim, Hyun; Han, Hye-Suk; Chae, Heebok; Park, Seon Mee; Youn, Seijin

2013-01-01

13

Clinical course and proposed treatment strategy for ERCP-related duodenal perforation: a multicenter analysis.  

PubMed

Background and study aims: Endoscopic retrograde cholangiopancreatography (ERCP)-related duodenal perforation is rare but can cause high mortality. Our aim was to assess the clinical outcomes of these events.Method: A total of 59 patients who were diagnosed as having ERCP-related duodenal perforation at six institutions between 2000 and 2007 were enrolled in this multicenter retrospective study. We evaluated complications and mortality associated with ERCP-related duodenal perforation according to injury detection time (IDT), peritoneal irritation signs (PIS), systemic inflammation signs (SIS), and treatment modality in these patients. Results: Of the 59 patients, 41 (69.5 %) and 18 (30.5 %) underwent medical and surgical treatment, respectively. Duodenal perforation-related death was observed in five patients, who had received medical therapy (n = 2) and surgical therapy (n = 3). Among medically treated patients, seven patients (17.1 %) underwent endoscopic clipping immediately after the injury; surgery was not required as a salvage therapy and there were no complications or deaths among these patients. The remaining 34 patients received antibiotics combined with therapeutic fasting and intravenous hydration. Duodenal perforation-related complications depended significantly on IDT (P = 0.0001), treatment modality (P = 0.008), PIS (P = 0.003), and SIS (P = 0.010). The duodenal perforation-related mortality was significantly related to IDT (P = 0.008) and PIS (P = 0.001). Conclusions: IDT, PIS, and SIS appear to be important prognostic factors following ERCP-related duodenal perforation. Medical therapy can be suggested as an initial treatment strategy for ERCP-related duodenal perforation, and if possible, endoscopic clipping is strongly recommended. However, surgical treatment should be considered if the perforation is not expected to seal spontaneously, or if the continuing leakage causes PIS or SIS. PMID:23907814

Jin, Young-Joo; Jeong, Seok; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Moon, Jong Ho; Park, Sang Heum; Kim, Ho Gak; Lee, Dong Ki; Jeon, Yong Sun; Lee, Don Haeng

2013-08-01

14

Laparoscopic Repair of a Large Duodenal Perforation Secondary to an Indwelling Nasogastric Tube in a Tracheotomized Adult  

PubMed Central

Laparoscopic repair of perforated duodenal ulcers is safe and effective in centers with experience and increasingly performed by laparoscopic surgeons. However, the role of laparoscopy for the management of large duodenal perforations (>1?cm) is unclear. To date, no experience has been reported with emergency laparoscopic repair of large perforations for gastroduodenal ulcers. The commonest reason for conversion to open surgery is a perforation size of more than 1?cm. This paper reports a case of a large duodenal perforation due to a nasogastric tube in a 26-year-old male who had undergone a tracheostomy, following a cut-throat injury. This large perforation was successfully diagnosed and repaired laparoscopically. This is probably the first paper in the English literature to report duodenal perforation due to a nasogastric tube in an adult and also the first report of a successful laparoscopic repair of a large duodenal perforation.

Zachariah, Sanoop Koshy

2013-01-01

15

Migration of a biliary stent causing duodenal perforation and biliary peritonitis.  

PubMed

Migration of endoscopically placed biliary stents is a well-recognized complication of endoscopic retrograde cholangiopancreatography. Less than 1% of migrated stents however cause intestinal perforation. We present a case of a migrated biliary stent that resulted in duodenal perforation and biliary peritonitis. PMID:24147198

Issa, Hussain; Nahawi, Mamdouh; Bseiso, Bahaa; Al-Salem, Ahmed

2013-10-16

16

Migration of a biliary stent causing duodenal perforation and biliary peritonitis  

PubMed Central

Migration of endoscopically placed biliary stents is a well-recognized complication of endoscopic retrograde cholangiopancreatography. Less than 1% of migrated stents however cause intestinal perforation. We present a case of a migrated biliary stent that resulted in duodenal perforation and biliary peritonitis.

Issa, Hussain; Nahawi, Mamdouh; Bseiso, Bahaa; Al-Salem, Ahmed

2013-01-01

17

Late anastomotic perforation following surgery for gastric neuroendocrine tumor complicated by perforated duodenal ulcer: a case report  

PubMed Central

Neuroendocrine tumors (NETs) are a group of neoplasms that are characterized by the secretion of a variety of hormones and diverse clinical syndromes. NETs are considered to be rare, but the incidence of NETs has increased rapidly in recent years. NETs provide a clinical challenge for physicians because they comprise a heterogeneous group of malignancies with a wide range of morphological, functional, and behavioral characteristics. Subtotal gastrectomy with Billroth II reconstruction is the mainstay of therapy in the management of gastric NETs complicated by perforated duodenal ulcer. Late perforation of anastomotic stoma as a long-term complication has been rarely reported. Here, we report a case of anastomotic perforation 5 years after subtotal gastrectomy due to perforated duodenal ulcer and gastric NETs.

Han, Jun; He, Zhenyu

2013-01-01

18

Management of an iatrogenic radial artery perforation: a case report.  

PubMed

A 73-year-old female patient underwent transradial coronary angiography with stable angina and signs of significant myocardial ischemia revealed by exercise stress test. After insertion of a 6F radial sheath into the right radial artery and intra-arterial administration of heparin plus verapamil, the hydrophilic guidewire could not be advanced under fluoroscopic guidance. Immediately afterwards, radial angiography was performed, which displayed a radial artery perforation with significant contrast extravasation. The perforated segment was crossed meticulously with the same guidewire after additional vasodilator drug administration. Afterwards, a 5F TIG catheter was advanced to the axillary artery and held in place for 20 minutes with application of external compression with a sphygmomanometer cuff at the level of systolic blood pressure. The same maneuver was again performed following cuff deflation and completion of coronary angiography with the 5F catheter. Final angiography displayed complete sealing of the perforation without a need for neutralization of heparin. External compression was continued for two hours, and after documentation of normal triphasic radial artery flow by Doppler ultrasound (DUS), the radial sheath was removed. The patient was discharged the following day with no evidence of hand ischemia and well-palpable radial artery pulse. DUS demonstrated normal radial artery flow one month later. This unusual complication was managed successfully with a simple and easily applicable technique that can be performed in such cases. PMID:23760121

Buturak, Ali; Demirci, Yasemin; Da?delen, Sinan

2013-06-01

19

Neuroleptic malignant syndrome occurring after an emergency operation for traumatic duodenal perforation: Report of a case  

Microsoft Academic Search

Neuroleptic malignant syndrome (NMS) is a potentially fatal complication which may develop in psychiatric patients taking neuroleptic drugs. We report herein the successful treatment of a 33-year-old schizophrenic man, prescribed neuroleptic drugs, who underwent an emergency operation for traumatic duodenal perforation with a retroperitoneal infection. Five days after the operation, he began to demonstrate clinical features consistent with NMS such

Masayuki Honda; Hiroaki Ueo; Hiroshi Inoue; Shigeru Nanbara; Shinya Arinaga; Tsukasa Asoh; Tsuyoshi Akiyoshi

1994-01-01

20

Laparoscopic repair\\/peritoneal toilet of perforated duodenal ulcer  

Microsoft Academic Search

Laparoscopic techniques have been refined to the point where exposure, haemostasis and tissue approximation by suture approach those obtained at open access surgery. We report a patient with acute perforation of an ulcer in the first part of the duodenum who was successfully treated by laparoscopic oversewing and omental patching. The clinical indications for contemplating use of laparoscopic surgery for

Leslie K. Nathanson; David W. Easter; Alfred Cuschieri

1990-01-01

21

Perforated tubular duodenal duplication in a 79 year old woman: Case report and review of the literature  

PubMed Central

INTRODUCTION Enteric duplications are rare congenital anomalies of the digestive tract that can occur anywhere along its length, with the majority being found in the small intestine. The duodenum is the least common site. Almost all symptomatic duodenal duplications present early in life with abdominal pain and pancreatitis. To the best of our knowledge this is the first described case of a perforated tubular duodenal duplication in an elderly adult. PRESENTATION OF CASE We present a case of a perforated tubular duodenal duplication in an elderly woman. She presented with diffuse abdominal pain, fever, and tachycardia. Emergent exploratory laparotomy revealed a perforated duodenal duplication. Excision of the duodenal duplication and primary closure of the defect was performed successfully. The patient recovered well. DISCUSSION Enteric duplications are poorly understood anomalies of embryonic development. They can be cystic or tubular dorsal enteric remnants lying in communication with the alimentary tract that are distinct from diverticula. A tubular duodenal duplication is exceedingly rare, and this case is made even more notable in that such an anomaly presented with sepsis and occurred in a 79 year old woman. We are unsure why the duplication ruptured. To the best of our knowledge this case represents the first report of a ruptured tubular duodenal duplication in an elderly adult. CONCLUSION This is a very rare occurrence and has never been described in an elderly patient before. Excision and primary closure led to a good outcome.

Lopez, Matthew J.; Bradley, Tabetha H.; Harrison, Andrew J.; Alseidi, Adnan A.

2013-01-01

22

Immediate definitive surgery for perforated duodenal ulcers: a prospective controlled trial.  

PubMed Central

A prospective, randomized, double-blind trial was conducted in 101 patients to evaluate the safety and benefits of immediate definitive surgery for perforated duodenal ulcers. These patients, who were judged by predefined criteria to be medically fit and to have perforations in chronic ulcers, were randomized to undergo simple closure (35 patients), truncal vagotomy and drainage (VD) (32 patients), or proximal gastric vagotomy with closure (PGV) (34 patients). Patients were followed with endoscopic assessment for up to 39 months. There was no mortality and only a few minor postoperative complications. At 39 months follow-up, the cumulative rates of recurrence were 63.3%, 11.8% and 3.8% after closure, VD, and PGV, respectively (p less than 0.001). With the exception of the one recurrence after PGV, all relapses were symptomatic, and eight of these 18 required reoperation. Relapse rates and Visick scores between VD and PGV were significantly different. Both safe as well as effective, immediate, nonresective, definitive operation is indicated for good-risk patients who have perforations in chronic duodenal ulcers.

Boey, J; Lee, N W; Koo, J; Lam, P H; Wong, J; Ong, G B

1982-01-01

23

[Perforation and haemorrhage duodenal bulbar ulcers in a child: a case report].  

PubMed

A perforation rarely reveals a primary duodenal ulcer. The occurring of digestive haemorrhage in post operative followings evokes spontaneously a stress ulcer. We report an observation of a child who presented on fourth day delay after operation an ulcer of the anterior duodenal bulbar face and a haemorrhage of the posterior bulbar face. A 7-year-old girl with no particular pathological antecedent was admitted for abdominal pain, bile vomiting and constipation evolving since 6 days. Clinical examination revealed a general state thickening, an infectious syndrome, a meteoric and general abdominal sensitivity. The abdominal radiography without preparation showed a pneumoperitoneum. The surgical exploration discovered a perforated ulcer on the bulbar anterior face. A simple closure associated with omental patch was performed. Four days after operation, she presented an abundant digestive haemorrhage with shock. The resuscitation did not improve the patient's general state. The upper digestive endoscopy revealed a haemorrhage of the posterior bulbar face. An adrenalin injection stopped the bleeding. The treatment by neutron pump inhibitors and an eradicating treatment of Helicobacter pylori permitted the healing of the ulcers. The occurring of digestive haemorrhage in the followings of surgical intervention for perforated ulcer involves an upper digestive endoscopy. This examination can reveal misdiagnosed ulcer during the surgical exploration and permits to perform a haemostatic act. PMID:19102114

Ngom, G; Diouf, M L; Fall, M; Konaté, I; Sankalé, A A; Diop, M; Fall, I; Ndoye, M

2008-01-01

24

Migratory surgical gossypiboma-cause of iatrogenic perforation: case report with review of literature.  

PubMed

Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. "Gossypiboma" denotes a mass of cotton that is accidentally retained in the body postoperatively. This study's goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation. PMID:24027390

Malhotra, Mohinder Kumar

2012-01-01

25

Migratory Surgical Gossypiboma--Cause of Iatrogenic Perforation: Case Report with Review of Literature  

PubMed Central

Forgotten foreign bodies, such as cotton sponges, gauze, or instruments, after any surgical procedure is considered a misadventure but avoidable complication. “Gossypiboma” denotes a mass of cotton that is accidentally retained in the body postoperatively. This study’s goal was to systematically review the literature on retained sponges to identify incidence, site of occurrence, time of discovery, methods for detection, pathogenesis for intraluminal migration and risk factors. Author is reporting this case in which a 45-year old woman presented with features of chronic pain abdomen following abdominal hysterectomy (first surgery) which lead to open cholecystectomy (second surgery) after two and half year of first surgery. As patients continued to have persistent abdominal pain in spite of second surgery patient went to medical gastroenterologist who advised her series of tests including colonoscopy examination. The whole colon was normal on examination but on examination of terminal portion of small bowel some intraluminal mass was visualized. Attempt to retrieve this mass lead to iatrogenic ileal perforation.

Malhotra, Mohinder Kumar

2012-01-01

26

Extrauterine translocated contraceptive device: a presentation of five cases and revisit of the enigmatic issues of iatrogenic perforation and migration.  

PubMed

Translocation of an intrauterine contraceptive device to an extrauterine site in the peritoneal cavity is an uncommon complication. In cases reported in literature, the timing of extrauterine presentation and the distant sites of translocation often raise the issue of whether iatrogenic uterine perforation or migration of the device was responsible. We present and discuss five referred cases of the extrauterine device inserted in centres outside the University of Port Harcourt Teaching Hospital. The indication for insertion of the intrauterine contraceptive device in the patients (mean age 25.6 years) was contraception in four patients and adhesiolysis for Asherman's syndrome in the fifth. The most common presenting symptom was inability to feel the device's string (in three patients). Four of the patients presented within one month of the insertion. Three of the five translocated intraperitoneal devices were recovered by laparotomy and the forth by laparoscopy. The fifth patient, pregnant, defaulted with the device still retained. We are of the opinion that primary iatrogenic uterine perforation occurs occasionally. Other possible translocatory mechanisms include spontaneous uterine contractions, urinary bladder contractions, gut peristalsis and movement of peritoneal fluid. PMID:15055154

Eke, N; Okpani, A O

2003-12-01

27

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain.  

PubMed

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully. PMID:23772413

Kim, Dongmin; Lim, Seong-Hoon; Seo, Pil Won

2013-06-05

28

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain  

PubMed Central

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

Kim, Dongmin; Lim, Seong-Hoon

2013-01-01

29

[Perforated duodenal ulcer in a Roux-en-Y gastric bypass operated patient can be a diagnostic challenge].  

PubMed

Roux-en-Y gastric bypass (RYGBP) is an increasingly used procedure when treating morbid obesity. Due to the extensive gastrointestinal rearrangement, diagnostic evaluation of patients with gastric bypass and acute abdominal pain can be difficult. We present a case of a perforated duodenal ulcer in a RYGBP operated patient, where free abdominal fluid, but hardly any pneumoperitoneum was seen on a computed tomography. Free intraperitoneal fluid is an important finding and should give suspicion of the need for emergency surgery in RYGBP operated patients with abdominal pain. PMID:23608012

Wied, Christian; Akralið, Guðny B; Lauritsen, Morten Laksáfoss; Naver, Lars Peter Skat

2013-02-25

30

Coincidental Occurrence of Acute In-stent Thrombosis and Iatrogenic Vessel Perforation During a Wingspan Stent Placement: Management with a Stent In-stent Technique  

PubMed Central

We presented a case that an acute in-stent thrombosis after the deployment of a Wingspan stent was successfully managed with a stent in-stent technique. Because vessel perforation and subarachnoid hemorrhage were iatrogenically developed during the procedure, we were unable to use the thrombolytic agents to correct the in-stent thrombosis. When a thrombotic complication following an intracranial stent placement occurs with a coincidentally hemorrhagic complication, the stent in-stent technique should be considered as a treatment option.

Lee, Sun Joo; Shin, Hee Sup; Lee, Seung Hwan

2012-01-01

31

Coincidental Occurrence of Acute In-stent Thrombosis and Iatrogenic Vessel Perforation During a Wingspan Stent Placement: Management with a Stent In-stent Technique.  

PubMed

We presented a case that an acute in-stent thrombosis after the deployment of a Wingspan stent was successfully managed with a stent in-stent technique. Because vessel perforation and subarachnoid hemorrhage were iatrogenically developed during the procedure, we were unable to use the thrombolytic agents to correct the in-stent thrombosis. When a thrombotic complication following an intracranial stent placement occurs with a coincidentally hemorrhagic complication, the stent in-stent technique should be considered as a treatment option. PMID:22454784

Lee, Sun Joo; Shin, Hee Sup; Lee, Seung Hwan; Koh, Jun Seok

2012-02-29

32

Partial avulsion of common bile duct and duodenal perforation in a blunt abdominal trauma.  

PubMed

Complete or partial avulsion of common bile duct is a very rare injury following blunt abdominal trauma in children. A 7-year old boy presented to ER following blunt abdominal trauma by a moving motorcycle. X ray abdomen revealed free air under diaphragm and CT scan showed pancreatic contusion injury. At operation anterior wall of common bile duct (CBD) along with a 2mm rim of duodenal tissue on either side of anterior wall of CBD were found avulsed from the duodenum. The avulsed portion of CBD and duodenum were reanastomosed and a tube cholecystostomy performed. The patient had an uneventful recovery. PMID:22953262

Mirza, Bilal; Ijaz, Lubna; Iqbal, Shahid; Sheikh, Afzal

2010-12-01

33

Bacterial peritonitis due to duodenal perforation by a fish bone in an elderly peritoneal dialysis patient.  

PubMed

The patient, a 77-year-old-man, began peritoneal dialysis (PD) in August 2005. In January 2009, he developed lower abdominal pain and cloudy PD effluent. A diagnosis of peritonitis was made and Escherichia coli was detected in cultures of the PD effluent. An abdominal computed tomography scan showed a fish bone in the duodenal wall. An upper gastrointestinal endoscopy was performed, and a 3-cm fish bone was removed. We thus recommend careful investigation with the possibility of enteric peritonitis from the intestinal tract when E. coli is detected in effluent cultures during PD. PMID:22790132

Nishino, Tomoya; Shinzato, Takeaki; Uramatsu, Tadashi; Obata, Yoko; Arai, Hideyuki; Hayashida, Takeshi; Kohno, Shigeru

2012-07-01

34

Duodenal perforation because of swallowed ballpoint pen and its laparoscopic management: report of a case.  

PubMed

Accidental ingestion of foreign objects by teenagers or young adults without mental impairment is a rare event. We present a case of a patient who unintentionally swallowed a ballpoint pen several days before seeking medical attention. She concealed the event until abdominal radiographs revealed the foreign object. Because swallowed foreign objects can be potentially harmful, they should be removed endoscopically as soon as possible to prevent development of complications. At times, they need to be removed operatively. This report describes the laparoscopic removal of a ballpoint pen that perforated the duodenum. PMID:19302873

Golffier, Claudio; Holguin, Francia; Kobayashi, Akihiko

2009-03-01

35

Ingested Fish Bone: An Unusual Mechanism of Duodenal Perforation and Pancreatic Trauma  

PubMed Central

Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment.

Symeonidis, Dimitrios; Koukoulis, Georgios; Baloyiannis, Ioannis; Rizos, Apostolos; Mamaloudis, Ioannis; Tepetes, Konstantinos

2012-01-01

36

Ingested fish bone: an unusual mechanism of duodenal perforation and pancreatic trauma.  

PubMed

Ingestion of gastrointestinal foreign bodies represents a challenging clinical scenario. Increased morbidity is the price for the delayed diagnosis of complications and timely treatment. We present a case of 57-year-old female patient which was admitted in the emergency room department complaining of a mid-epigastric pain over the last twenty-four hours. Based on the patient's history, physical examination and elevated serum amylase levels, a false diagnosis of pancreatitis, was initially adopted. However, a CT scan confirmed the presence of a radiopaque foreign body in the pancreatic head and the presence of air bubbles outside the intestinal lumen. The patient was unaware of the ingestion of the foreign body. At laparotomy, after an oblique duodenotomy, a fish bone pinned in the pancreatic head after the penetration of the medial aspect of the second portion of the duodenal wall was identified and successfully removed. The patient had an uneventful postoperative recovery. Wide variation in clinical presentation characterizes the complicated fish bone ingestions. The strategically located site of penetration in the visceral wall is responsible for the often extraordinary gastrointestinal tract injury patterns. Increased level of suspicion is of paramount importance for the timely diagnosis and treatment. PMID:22919520

Symeonidis, Dimitrios; Koukoulis, Georgios; Baloyiannis, Ioannis; Rizos, Apostolos; Mamaloudis, Ioannis; Tepetes, Konstantinos

2012-08-05

37

[The surgical treatment of perforated gastric and duodenal ulcers in middle-aged and elderly patients--an analysis of the 1985-1996 period].  

PubMed

The problem relating to perforated gastric and duodenal ulcers (PGDU) treatment is still pressing nowadays not only on account of the constant mortality rate (6.7-14.55 per cent according to personal data), but also on account of the lack of universally accepted tenets for their management, irrespective of the fact that the first operative interventions were done more than 100 years earlier, and so far, more than 50 palliative and radical procedures have been suggested. Between 20 and 40 per cent of all ulcer patients are individuals in advanced and senile age. In this contingent a characteristic feature is the elevated incidence of complications, one of them being perforation, necessitating operative treatment and exposing elderly patients to serious surgical and anesthesiological hazards. PMID:9974023

Radenovski, D; Tsekov, Kh; Savov, I; Borisova, M

1998-01-01

38

Successful IVUS-guided reentry from iatrogenic coronary arteriovenous fistula related to wire perforation following wiring of a totally occluded vessel.  

PubMed

We experienced a rare case in which a guidewire was advanced into a coronary vein through an arteriovenous fistula caused by wire perforation. The patient, who had chronic total occlusion (CTO) of the left circumflex coronary artery, was treated successfully with a procedure guided by intravascular ultrasound (IVUS). The IVUS-guided parallel-wire technique allowed recrossing of the guidewire into the distal true lumen of the CTO by identifying the anatomy of the occluded segment and the appropriate re-entry point. Angiography demonstrated that the fistula was completely sealed after stent deployment, and there was no extravasation. PMID:23813071

Ohya, Hidefumi; Kyo, Eisho; Katoh, Osamu

2013-07-01

39

Iatrogenic meningitis.  

PubMed

Iatrogenic meningitis can be caused by a number of mechanisms. The recent case reports of fungal meningitis after application of epidural methylprednisolone caused warning in the medical community. Cases were caused by contaminated lots of methylprednisolone from a single compounding pharmacy. Several medications can cause meninigitis by probable hypersensitivity mechanism. Neurologists should be alert to the recent description of the use of lamotrigine and development of aseptic meningitis. PMID:24141499

Mutarelli, Eduardo Genaro; Adoni, Tarso

2013-09-01

40

Esophageal Perforation in Adults  

PubMed Central

Objective: To evaluate the outcome of aggressive conservative therapy in patients with esophageal perforation. Summary Background Data: The treatment of esophageal perforation remains controversial with a bias toward early primary repair, resection, and/or proximal diversion. This review evaluates an alternate approach with a bias toward aggressive drainage of fluid collections and frequent CT and gastographin UGI examinations to evaluate progress. Methods: From 1992 to 2004, 47 patients with esophageal perforation (10 proximal, 37 thoracic) were treated (18 patients early [<24 hours], 29 late). There were 31 male and 16 females (ages 18–90 years). The etiology was iatrogenic (25), spontaneous (14), trauma (3), dissecting thoracic aneurysm (3), and 1 each following a Stretta procedure and Blakemore tube placement. Results: Six of 10 cervical perforations underwent surgery (3 primary repair, 3 abscess drainage). Nine of 10 perforations healed at discharge. In 37 thoracic perforations, 2 underwent primary repair (1 iatrogenic, 1 spontaneous) and 4 underwent limited thoracotomy. Thirty-4 patients (4 cervical, 28 thoracic) underwent nonoperative treatment. Thirteen of the 14 patients with spontaneous perforation (thoracic) underwent initial nonoperative care. Overall mortality was 4.2% (2 of 47 patients). These deaths represent 2 of 37 thoracic perforations (5.4%). There were no deaths in the 34 patients treated nonoperatively. Esophageal healing occurred in 43 of 45 surviving patients (96%). Subsequent operations included colon interposition in 2, esophagectomy for malignancy in 3, and esophagectomy for benign stricture in 2. Conclusions: Aggressive treatment of sepsis and control of esophageal leaks leak lowers mortality and morbidity, allow esophageal healing, and avoid major surgery in most patients.

Vogel, Stephen B.; Rout, W Robert; Martin, Tomas D.; Abbitt, Patricia L.

2005-01-01

41

Urinary bladder perforation in a premature infant with Down syndrome  

Microsoft Academic Search

Urinary bladder perforation due to bladder catheterization in neonates is a rare iatrogenic complication. It has been reported secondary to various causes and a variety of surgical settings in neonates. A case of urinary bladder perforation due to catheterization in a premature baby with Down syndrome, who presented with progressive renal failure and mild-to-moderate ascites, is reported. Urinary bladder perforation

Mahaboob Basha; Muhammad Subhani; Ali Mersal; SaadAl Saedi; J. Williamson Balfe

2003-01-01

42

Operative treatment of periampullary retroperitoneal perforation complicating endoscopic sphincterotomy  

Microsoft Academic Search

Background. Evidence-based strategies are lacking regarding the appropriate management of periampullary retroperitoneal perforations complicating endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (ES). We propose a transduodenal operative repair of periampullary retroperitoneal perforation. Methods. Six patients with duodenal periampullary perforation induced by endoscopic sphincterotomy underwent operation after failure of an attempt of conservative management. After mobilization of the second and

Leopoldo Sarli; Cristina Porrini; Renato Costi; Gabriele Regina

43

Iatrogenic Sinistral Hypertension Complicating Screening Colonoscopy  

PubMed Central

Colonoscopy is widely accepted as the gold-standard screening technique for detecting malignancies in the distal gastrointestinal tract in patients with symptoms suggestive of colon cancer. However, this procedure is not without risk, including colonic perforation. We report a patient who was managed conservatively after colonoscopy induced perforation. Eighteen months after appearing to make a full recovery, he presented with an upper gastrointestinal bleed. Oesophago-gastro-duodenoscopy (OGD) revealed large gastric fundal varices and computed tomography (CT) revealed splenic vein thrombosis. The ensuing left-sided (sinistral) hypertension explains the development of the fundal varices in the presence of normal liver function. At surgery, a persistent abscess cavity was identified and cultures from this site grew Streptococcus anginosus. Curative splenectomy was performed and the patient made a full recovery. We advocate more prompt operative intervention in selected cases of iatrogenic colonic perforation with primary repair to prevent late complications.

Ziff, Oliver J.; Shapiro, A. M. James

2013-01-01

44

Gastrointestinal perforation  

MedlinePLUS

Intestinal perforation; Perforation of the intestines ... Perforation of the intestine causes the contents of the intestines to leak into the abdominal cavity. This causes a serious infection called peritonitis . ...

45

Gastrointestinal perforation: ultrasonographic diagnosis.  

PubMed

Gastrointestinal tract perforations can occur for various causes such as peptic ulcer, inflammatory disease, blunt or penetrating trauma, iatrogenic factors, foreign body or a neoplasm that require an early recognition and, often, a surgical treatment.Ultrasonography could be useful as an initial diagnostic test to determine, in various cases the presence and, sometimes, the cause of the pneumoperitoneum.The main sonographic sign of perforation is free intraperitoneal air, resulting in an increased echogenicity of a peritoneal stripe associated with multiple reflection artifacts and characteristic comet-tail appearance.It is best detected using linear probes in the right upper quadrant between the anterior abdominal wall, in the prehepatic space.Direct sign of perforation may be detectable, particularly if they are associated with other sonographic abnormalities, called indirect signs, like thickened bowel loop and air bubbles in ascitic fluid or in a localized fluid collection, bowel or gallbladder thickened wall associated with decreased bowel motility or ileus.Neverthless, this exam has its own pitfalls. It is strongly operator-dependant; some machines have low-quality images that may not able to detect intraperitoneal free air; furthermore, some patients may be less cooperative to allow for scanning of different regions; sonography is also difficult in obese patients and with those having subcutaneous emphysema. Although CT has more accuracy in the detection of the site of perforation, ultrasound may be particularly useful also in patient groups where radiation burden should be limited notably children and pregnant women. PMID:23902744

Coppolino, Ff; Gatta, G; Di Grezia, G; Reginelli, A; Iacobellis, F; Vallone, G; Giganti, M; Genovese, Ea

2013-07-15

46

Laparoscopic Repair of Perforated peptic ulcers versus conventional open surgery  

Microsoft Academic Search

Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery causes great controversy regarding the choice of procedure for perforated duodenal ulcer. In this study the safety and efficacy of laparoscopic surgery was evaluated, different types of procedures were described and early outcomes in comparison with open surgery were assessed. In addition

Nita Zaji

2007-01-01

47

Iatrogenic femoral arteriovenous fistula  

Microsoft Academic Search

Twelve iatrogenic femoral arteriovenous fistulas are reported, 11 of which arose from the superficial or deep femoral arteries.\\u000a All but two occurred in association with cardiac angiographic procedures. It appears that the femoral crease was used as a\\u000a landmark to establish the cutaneous entry point for vascular puncture and resulted in an excessively distal puncture site.\\u000a The femoral crease is

Richard E. Marsan; Virginia McDonald; Subramanian Ramamurthy

1990-01-01

48

Esophageal atresia, duodenal atresia, and unilateral lung agenesis: A case report  

Microsoft Academic Search

The association of pure esophageal atresia, duodenal atresia, and unilateral lung agenesis has not been reported previously. Here the authors present a case of a newborn with this constellation of anomalies that underwent staged repair. The primary principle guiding treatment was the avoidance of iatrogenic injury to the single lung. Therefore, the order of operations proceeded as follows: (1) placement

Cynthia D. Downard; Heung Bae Kim; Fred Laningham; Steven J. Fishman

2004-01-01

49

Endocrinology of duodenal ulcer  

Microsoft Academic Search

Several gastrointestinal peptides with proven or suggested endocrine or paracrine functions influence gastric acid secretion, gastrointestinal motility, and mucosal blood flow. Increased or decreased release of such factors could participate in the pathogenesis of duodenal ulcer disease by inducing increased gastric acid concentration in the duodenal bulb. To date, increased stimulation of parietal cells by gastrin has been demonstrated only

W. Creutzfeldt; R. Arnold

1979-01-01

50

Management Strategies, Early Results, Benefits, and Risk Factors of Laparoscopic Repair of Perforated Peptic Ulcer  

Microsoft Academic Search

The primary goal of this study was to describe epidemiology and management strategies of the perforated duodenal ulcer, as\\u000a well as the most common methods of laparoscopic perforated duodenal ulcer repair. The secondary goal was to demonstrate the\\u000a value of prospective and retrospective studies regarding the early results of surgery and the risk factors. The tertiary goal\\u000a was to emphasize

Raimundas Lunevicius; Matas Morkevicius

2005-01-01

51

Scoping a perforated bleeding peptic ulcer: learning points.  

PubMed

Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy. PMID:22699475

Wani, Abdul Majid; Hussain, Waleed Mohd; AlMiamini, Wail; Khoujah, Amer M; Diari, Mohd S; Akhtar, Mubeena; Alharbi, Zeyad S

2011-03-24

52

Successful Endoscopic Decompression for Intramural Duodenal Hematoma with Gastric Outlet Obstruction Complicating Acute Pancreatitis  

PubMed Central

Non-traumatic intramural duodenal hematoma (IDH) with duodenal obstruction caused by acute pancreatitis is rare. Most patients with non-extensive hematoma show improvement with non-operative treatments. Percutaneous drainage or surgery may be necessary in cases with suspected malignancy, perforation, or intestinal tract obstruction. We present a case of IDH caused by acute pancreatitis that led to obstruction of the duodenum and an experience of successful endoscopic decompression of the hematoma.

Lee, Jun Young; Chung, Jin Soo

2012-01-01

53

Surgical Treatment of Complicated Duodenal Ulcers: Controlled Trials  

Microsoft Academic Search

.   Indications for surgery of duodenal ulcer (DU) have changed radically because of the efficacy of H2-antagonists, endoscopic procedures, and eradication of Helicobacter pylorus. The aim of this study was to analyze the current literature to determine if definitive surgery is still relevant for complicated\\u000a DU (bleeding, perforation, gastric outlet obstruction). Two studies have compared early to late surgery in

Bertrand Millat; Abe Fingerhut; Fredéric Borie

2000-01-01

54

Iatrogenic nutritional deficiencies.  

PubMed

This article catalogs the nutritional deficiencies inadvertently introduced by certain treatment regimens. Specifically, the iatrogenic effects on nutrition of surgery, hemodialysis, irradiation, and drugs are reviewed. Nutritional problems are particularly frequent consequences of surgery on the gastrointestinal tract. Gastric surgery can lead to deficiencies of vitamin B12, folate, iron, and thiamine, as well as to metabolic bone disease. The benefits of small bowel bypass are limited by the potentially severe nutritional consequences of this procedure. Following bypass surgery, patients should be monitored for signs of possible nutritional probems such as weight loss, neuropathy, cardiac arrhythmias, loss of stamina, or changes in mental status. Minimal laboratory tests should include hematologic evaluation, B12, folate, iron, albumin, calcium, phosphorus, alkaline phosphatase, transaminases, sodium, potassium, chloride, and carbon dioxide levels. Roentgenologic examination of the bone should also be obtained. Loss of bone substance is a major consequence of many forms of treatment, and dietary supplementation with calcium is warranted. Patients undergoing hemodialysis have shown carnitine and choline deficiencies, potassium depletion, and hypovitaminosis, as well as osteomalacia. Chronic drug use may alter intake, synthesis, absorption, transport, storage, metabolism, or excretion of nutrients. Patients vary markedly in the metabolic effects of drugs, and recommendations for nutrition must be related to age, sex, reproductive status, and genetic endowment. Moreover, the illness being treated can itself alter nutritional requirements and the effect of the treatment on nutrient status. The changes in nutritional levels induced by use of estrogen-containing oral contraceptives (OCs) are obscure; however, the effects on folate matabolism appear to be of less clinical import than previously suggested. Reduction in pyridoxine and serum vitamin B12 levels has been reported among OC users, and requirements of thiamine and riboflavin may be increased. In cases where the therapy is justified, the nutritional consequences can often be justified. However, every effort should be made to identify nutritional side effects by proper assessment procedures and to manage them by oral or parenteral supplementation where feasible. PMID:6764730

Young, R C; Blass, J P

1982-01-01

55

Iatrogenic Limbal Stem Cell Deficiency  

Microsoft Academic Search

Although little has been written about iatrogenic limbal stem cell deficiency, patients with this disorder are probably more common than the literature might suggest. It is important to recognize this disorder as a limbal deficiency, since standard medical therapies will not address its etiology. The sequelae of this condition include stromal scarring and significant loss of vision. Fortunately, phacoemulsification has

Gary S. Schwartz; Edward J. Holland

56

Giant duodenal ulcers  

Microsoft Academic Search

Giant duodenal ulcers (GDU) have been associated with a high incidence of morbidity and mortality unless early operative intervention is undertaken. There are few published reports of successful medical management of GDU. Therefore, we reviewed 14 consecutive patients with GDU at our institution. Excluding the following cases: Two patients who had elective surgery, two patients who died from unrelated causes,

Richard Jaszewski; Steven A. Crane; Arturo A. Cid

1983-01-01

57

Perforation of the cecum by a toothpick. Case report and review of the literature.  

PubMed

Perforation of the colon can have any number of causes. Most often, it is the result of carcinoma or diverticulitis; specific inflammatory disease of the large intestine is a less common cause. Other possibilities are iatrogenic perforation, perforation as a result of blunt or penetrating abdominal trauma, and ingestion of a foreign body. A case of perforation of the cecum by a toothpick 3 weeks after consumption of a beef olive is reported; possible diagnostic problems, other conditions that need to be considered in the differential diagnosis and treatment are discussed. PMID:7934581

Hauser, H; Pfeifer, J; Uranüs, S; Klimpfinger, M

1994-01-01

58

A Case of Duodenal Anisakiasis with Duodenal Ulcer  

PubMed Central

Humans can be incidentally parasitized by third-stage larvae of Anisakis species following the ingestion of raw or undercooked seafood. Acute gastric anisakiasis is one of the most frequently encountered complaints in Korea. However, duodenal anisakiasis with duodenal ulcer had not been reported in Korea, despite the habit of eating raw fish. In this case, a 47-year-old man was hospitalized because of sharp epigastric pain and repeated vomiting after eating raw fish 3 days previously. On admission, esophagogastroduodenoscopic examination revealed an active duodenal bulb ulcer. At 5 mm away from the ulcer margin, a whitish linear worm was found with half of its body penetrating the duodenal mucosa. Herein, we report this case of duodenal anisakiasis accompanied by duodenal ulcer.

Hwang, David; Park, Seong Il; Pack, Seung Chul; Lee, Ki Sang; Choi, Sung Kyu; Kang, Hoon; Park, Chan Woong

2012-01-01

59

A case of duodenal anisakiasis with duodenal ulcer.  

PubMed

Humans can be incidentally parasitized by third-stage larvae of Anisakis species following the ingestion of raw or undercooked seafood. Acute gastric anisakiasis is one of the most frequently encountered complaints in Korea. However, duodenal anisakiasis with duodenal ulcer had not been reported in Korea, despite the habit of eating raw fish. In this case, a 47-year-old man was hospitalized because of sharp epigastric pain and repeated vomiting after eating raw fish 3 days previously. On admission, esophagogastroduodenoscopic examination revealed an active duodenal bulb ulcer. At 5 mm away from the ulcer margin, a whitish linear worm was found with half of its body penetrating the duodenal mucosa. Herein, we report this case of duodenal anisakiasis accompanied by duodenal ulcer. PMID:22570821

Hwang, David; Park, Seong Il; Pack, Seung Chul; Lee, Ki Sang; Choi, Sung Kyu; Kang, Hoon; Park, Chan Woong; Lee, Soong

2012-04-26

60

Esophageal atresia, duodenal atresia, and unilateral lung agenesis: a case report.  

PubMed

The association of pure esophageal atresia, duodenal atresia, and unilateral lung agenesis has not been reported previously. Here the authors present a case of a newborn with this constellation of anomalies that underwent staged repair. The primary principle guiding treatment was the avoidance of iatrogenic injury to the single lung. Therefore, the order of operations proceeded as follows: (1) placement of a decompressing gastrostomy tube, (2) repair of the duodenal atresia, and (3) repair of the esophageal atresia. The congenital closed loop obstruction caused by the esophageal and duodenal atresias was beneficial in that it resulted in growth by stretching of the distal esophagus, allowing a tension-free primary repair of the esophageal atresia. PMID:15300548

Downard, Cynthia D; Kim, Heung Bae; Laningham, Fred; Fishman, Steven J

2004-08-01

61

Giant duodenal ulcer  

PubMed Central

Twenty-five cases of benign giant duodenal ulcer have been studied. In every case a barium meal examination showed an ulcer crater with a radiographic diameter of at least 2 centimetres. Abdominal pain was the commonest symptom but less than half of the patients had had pain characteristic of chronic peptic ulcer. Haemorrhage from the ulcer occurred in a large majority of them. The radiological appearances are described, and it has been shown that the giant ulcer may be missed through being mistaken for the duodenal cap or else misdiagnosed. It appears that the death rate in this condition has been falling but it is still high. The management of patients with giant ulcers is discussed. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6

Lumsden, K.; MacLarnon, J. C.; Dawson, J.

1970-01-01

62

Perforated monolayers  

SciTech Connect

Goal of this research program is to create ultrathin organic membranes that possess uniform and adjustable pores ( < 7[angstrom] diameter). Such membranes are expected to possess high permeation selectivity (permselectivity) and high permeability, and to provide the basis for energy-efficient methods of molecular separation. Work carried out has demonstrated feasibility of using perforated monolayer''-based composites as molecular sieve membranes. Specifically, composite membranes derived from Langmuir-Blodgett multilayers of the calix[6]arene-based surfactant shown below plus poly[l-(trimethylsilyl)-l-propyne] (PTMSP) were found to exhibit sieving behavior towards He, N[sub 2] and SF[sub 6]. Results of derivative studies that have also been completed are also described in this report.

Regen, S.L.

1992-12-01

63

[Congenital duodenal obstruction -- Part I].  

PubMed

Congenital duodenal obstruction is a cause of 40% of congenital intestinal obstructions in newborns. In the first part of this study authors describe the etiology, types of this anomaly, clinical symptoms, diagnostic investigation, surgical treatment and problems in postoperative management in the newborns suffering from congenital duodenal obstruction. PMID:15858246

Sawicka, Ewa; Boczar, Maria; Michalak, Jerzy; P?oska-Urbanek, Barbara

64

[Philosophical perspectives of iatrogenic abortion].  

PubMed

The doctor's task is to heal where possible, to relieve suffering and always to comfort. He attempts to prevent illness and to promote health, within the framework of primum non nocere ('do no harm'). Therapeutic abortion for fetal indications cannot be considered therapeutic, and should therefore be called iatrogenic abortion. The doctor has sufficient responsibilities of his own, and should not take over the responsibilities of other people or help them shirk their own. The philosophies of materialism, totalitarianism and hedonism are evil, and very dangerous for society. PMID:7089763

de Muelenaere, C W

1982-06-19

65

Iatrogenic disease in late life.  

PubMed

Iatrogenic diseases are common in the elderly, particularly in the hospitalized patient. Adverse outcomes may be induced by poor communication with patients, inadequate history and examination, and inappropriate use of diagnostic resources. However, even when resources are used appropriately, adverse outcomes do occur, hence the price paid for sophisticated medical and surgical techniques. Medications offer a great potential for adverse reactions, and careful prescribing and knowledge of the pharmacokinetic changes that occur with aging, particularly impaired renal excretion of drugs, together with the use of the minimum number of drugs and maneuvers to improve compliance, can reduce this risk. Complications of surgery should be anticipated and promptly recognized and managed. PMID:3513932

Patterson, C

1986-02-01

66

Band ligation of the perforated gall bladder during laparoscopic cholecystectomy.  

PubMed

Perforation of the gall bladder is a frequent complication during laparoscopic cholecystectomy. Grasping the perforated part of the gall bladder, clip application, or endoscopic loop application are possible solutions to prevent spillage. We propose laparoscopic rubber band application to close the perforated part of the gall bladder as an easy and safe method. We performed rubber band application after iatrogenic perforation of the gall bladder during laparoscopic cholecystectomy in 5 patients. Two-millimeter-wide multiple rubber rings, cut from a 14-Fr Foley catheter, are loaded on a grasper. When a perforation occurred during the dissection of the gall bladder, the hole is grasped with this instrument and 1 of the rings is placed on the gall bladder by the aid of a dissector. Thus, the grasper remained available for traction of the Hartmann's pouch during further dissection of the gall bladder. The rubber bands were placed successfully in all cases. Two perforations occurred in 1 case, and 2 bands were placed with ease. Bile leakage or gall stone spillage did not occur. Operation time was not prolonged. Rubber band ligation of perforation of the gall bladder is a simple, safe, inexpensive, and effective method to prevent spillage of the bile or gallstones in laparoscopic surgery. PMID:18097314

Derici, Hayrullah; Bozda?, Ali Do?an; Tansug, Tugrul; Nazli, Okay; Reyhan, Enver

2007-12-01

67

Complication of a percutaneous endoscopic gastrostomy tube causing duodenal ischemia.  

PubMed

A 33-year-old woman with a percutaneous endoscopic gastrostomy tube was admitted with bilious vomiting, 1 month after her feeding tube was replaced by a temporary Foley catheter. A computed tomography scan of her abdomen revealed a 4.5 cm by 7.5 cm fluid-filled structure in the distal duodenum surrounding the Foley feeding tube. Approximately 100 mL of fluid was aspirated from the Foley's balloon port. We hypothesized that the Foley catheter was flushed inappropriately through the balloon port, causing an iatrogenic ischemic duodenal injury. Conservative management was successful in the intensive care unit. This case highlights an unusual complication of percutaneous endoscopic gastrostomy tubes. In addition, it emphasizes the temporary nature of Foley catheters as replacement gastrostomy tubes, and the importance of training in the handling of feeding tubes. PMID:17277666

Martel, Guillaume; Lingas, Rania I; Gutauskas, Andrea; Clark, Heather D

2006-12-01

68

Iatrogenic superior vena caval syndrome.  

PubMed

The superior vena caval (SVC) syndrome is a common oncological emergency requiring the quick initiation of appropriate therapy. However, it may also result from a medical procedure e.g. central catheter or temporary pacing wire insertion, with symptoms usually developing acutely and dramatically. If symptoms persist despite removal of the offending device, chemotherapy and radiotherapy are obviously precluded. Alternative treatment modalities include thrombolysis, thrombectomy devices, stents, and surgery. Clinically covert thrombosis is not uncommon, and as interventions and invasive procedures requiring central venous cannulations become commonplace, this iatrogenic complications will inevitably occur more often. Even the use of ultrasound guided insertion does not avoid catheter related obstruction. A case of an iatrogenc haemodialysis catheter related SVCS is presented and the aetiopathogensis, signs and symptoms, diagnosis, and management are discussed. PMID:19813691

Khan, Burhan Ahmad; Mahmood, Qasim

2009-10-01

69

An approach to duodenal biopsies  

PubMed Central

The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis.

Serra, S; Jani, P A

2006-01-01

70

Neonatal urinary ascites complicated by ileal perforation in a recipient of twin-to-twin transfusion syndrome.  

PubMed

We present a case of iatrogenic neonatal urinary ascites following antenatal amnioreduction in one of the monochorionic diamniotic recipient twin 2 of twin-to-twin transfusion syndrome (TTTS). He had ileal perforation following postnatal abdominal paracentesis. The patient had an uneventful recovery following exploratory laparotomy, resection of perforated segment of ileum with end-to-end anastomosis and open vesicostomy with subsequent closure of the vesicostomy. PMID:23255026

Patel, Ramnik; Frost, Jodie; Ninan, G K

2012-12-20

71

Retroperitoneal perforation of a peptic ulcer situated in the second part of the duodenum.  

PubMed

Retroperitoneal perforation of a peptic ulcer of the second part of the duodenum is an extremely uncommon complication producing both diagnostic and management difficulties. The tenth recorded case of this condition--the first managed successfully by the technique of primary closure and 'duodenal diverticulization'--is reported. PMID:2751550

Vellar, I D; Vellar, D

1989-07-01

72

Iatrogenic Obliteration of Ureter with Spontaneous Recanalization  

PubMed Central

We report an unusual case of spontaneous and complete healing of a severe iatrogenic midureteral injury. Following percutaneous nephrostomy and 3 months on our surgical waiting list, the injured ureter underwent complete spontaneous recanalization. The patient is clinically well with no evidence of recurrent obstruction after 2 years of followup. To our knowledge, this is the first reported case of spontaneous recanalization of an iatrogenically induced complete ureteral obliteration.

Mussari, Ben

2013-01-01

73

Iatrogenic Cushing's Syndrome Induced by Posaconazole.  

PubMed

Iatrogenic Cushing's syndrome is an undesirable outcome of glucocorticoids treatment. It can be increased by pharmacologic interactions. Glucocorticoid therapy, given in association with ritonavir, and some azole treatments are causes of iatrogenic Cushing's syndrome. We present a patient with common-variable immunodeficiency who received 7 years of itraconazole therapy for bronchial colonization with Aspergillus in combination with inhaled fluticasone without any Cushingoid symptoms. After a switch to posaconazole, the patient developed Cushingoid symptoms. PMID:23979730

Pilmis, Benoit; Coignard-Biehler, Hélène; Jullien, Vincent; Hermine, Olivier; Touraine, Philippe; Lecuit, Marc; Lortholary, Olivier

2013-08-26

74

Traumatic duodenal rupture in a soccer player  

PubMed Central

Traumatic duodenal rupture resulting from blunt trauma during soccer is an extremely rare occurrence. A case report of this unusual condition is presented together with a review of the literature. Key Words: soccer; football; duodenal rupture; trauma

Houshian, S.

2000-01-01

75

Perforator flap breast reconstruction.  

PubMed

A perforator flap consists of skin and fat harvested from a donor site nourished by myocutaneous perforators while sparing the donor muscle for function and strength. This flap type has revolutionized microvascular free tissue transfer and the technique has been successfully applied to well-established donor sites for autologous breast reconstruction namely the lower abdomen, upper and lower buttock, the upper back, and the lateral thigh. Although these flaps are technically more demanding than conventional myocutaneous free flaps, their minimal impact on the donor site muscle function significantly reduces local morbidity, postoperative pain and hospital stay. Perforator flap breast reconstruction has an increased operating time because of the meticulous dissection of the perforators, the possible anatomical variation in their location and, once these are located, the difficulty in selecting suitable perforator(s) to base the flap on. Although it has been suggested that perforator flaps may have a higher incidence of fat necrosis and partial flap loss than conventional free myocutaneous flaps, this has not been borne out by clinical results. There is, however, a learning curve and careful patient selection is important. The role of perforator flap technique in breast reconstruction is evolving. While its indications are similar to those of free TRAM and gluteal flaps, it is clearly a better alternative to these. The choice of perforator flap depends on where the patient has the most abundant donor tissue and the surgeon's experience. These flaps may in the future become the standard of care in free flap breast reconstruction. PMID:15687662

Weiler-Mithoff, Eva; Hodgson, Elaine L B; Malata, Charles M

2002-01-01

76

Tuberculous Duodenal Stenosis: Report of Two Cases  

PubMed Central

Duodenal tuberculosis is a rare clinical entity. The authors report and emphasize the lack of special clinical, radiological and endoscopic signs of duodenal tuberculosis. The diagnosis is affirmed, at laparotomy, out of the findings of peritoneal granulations or histology of lymphatic nodes. We report our experience of two cases of duodenal tuberculosis presenting with proximal intestinal obstruction and review the available literature.

Benzekri, O.; Mouhadi, S. El; Chourak, M.; Boussetta, S.; Absi, M. El; Echarab, M.; Elouanani, M.; Amraoui, M.; Errougani, A.; El Alami, F.H.; Chkoff, R.

2008-01-01

77

Tuberculous duodenal stenosis: report of two cases.  

PubMed

Duodenal tuberculosis is a rare clinical entity. The authors report and emphasize the lack of special clinical, radiological and endoscopic signs of duodenal tuberculosis. The diagnosis is affirmed, at laparotomy, out of the findings of peritoneal granulations or histology of lymphatic nodes. We report our experience of two cases of duodenal tuberculosis presenting with proximal intestinal obstruction and review the available literature. PMID:21897797

Benzekri, O; Mouhadi, S El; Chourak, M; Boussetta, S; Absi, M El; Echarab, M; Elouanani, M; Amraoui, M; Errougani, A; El Alami, F H; Chkoff, R

2008-11-15

78

Duodenal adenomatosis in familial adenomatous polyposis  

Microsoft Academic Search

Background: The prevalence of duodenal carcinoma is much higher in familial adenomatous polyposis (FAP) than in the background population, and duodenal adenomatosis is found in most polyposis patients.Aims: To describe the long term natural history of duodenal adenomatosis in FAP and evaluate if cancer prophylactic surveillance of the duodenum is indicated.Methods: A prospective five nation study was carried out in

S Bu?low; J Bjo?rk; I J Christensen; O Fausa; H Ja?rvinen; F Moesgaard; H F A Vasen

2004-01-01

79

[Iatrogenic disease: the clinical and social aspects].  

PubMed

Iatrogenic disease is considered as an unintentional or occasionally inevitable damage to the patient which is caused by the medical personnel during the patient management or at examinations, diagnostic and therapeutic procedures. Iatrogenesis, being the reverse side of medicine, is an essential part of medical progress. Any therapeutic exposures, especially to invasive techniques, are prone to both positive and negative effects. The development of the physician's skill, cultural standard, refinement, continuing self-education and analysis of errors in line with governmental program to improve public health are to warrant iatrogenic disease control. PMID:3415504

Doletski?, S Ia

1988-01-01

80

Iatrogenic Cushing's Syndrome in an Infant  

PubMed Central

A high potency, long acting and/or the extended use of oral corticosteroids, particularly in children, may cause suppression of the hypothalamo-pituitary-adrenal axis. However, the iatrogenic Cushing’s syndrome in the infantile age group is rare and only few patients have been reported to date in the literature. Here, we are reporting a case of iatrogenic Cushing’s syndrome in a 5-month-old male child, whose parents brought him to the hospital for puffiness of the face and overweight.

Namburu, Rajendra Prasad; T.S., Karthik; Reddy P., Amaresh

2013-01-01

81

[Case of intrapancreatic duodenal diverticulum].  

PubMed

A case of intrapancreatic duodenal diverticulum is presented and the possibility of pancreatitis is considered. A digital manoeuvre is described for the non-invasive location of a large diverticulum in case where Kocher's manoeuvre is insufficient. The usefulness of surgery as a mean of preventing what may prove dramatic complications is recognised. PMID:112507

Pamich, G; Governa, A

1979-05-31

82

Extrinsic duodenal obstruction and halitosis  

Microsoft Academic Search

Two siblings with extrinsic duodenal obstruction caused by congenital peritoneal bands are reported. Attention is drawn to the unusual physical sign of halitosis as a presenting feature. It is suggested that this physical sign may be an indication for barium studies.

B. M. Stephenson; B. I. Rees

1990-01-01

83

A retrospective study on endovascular management of iatrogenic vascular injuries.  

PubMed

The purpose of this study was to evaluate the outcome of endovascular management of iatrogenic vascular injuries (IVIs). We retrospectively reviewed the clinical records of 19 consecutive patients who underwent endovascular therapy of IVIs. Endograft implantation was conducted in 13 patients, intravascular embolization using coil was performed in four patients, combined treatment involving endovascular balloon intervention and percutaneous thrombin injection was done in one patient and the remaining one patient received balloon compression for hemostasis. There were no deaths after the operation. In the patients with vessel rupture (n = 9) or perforation (n = 4), cessation of bleeding and restoration of blood flow were achieved following the endovascular treatments. Four cases of pseudoaneurysm and one case of arteriovenous fistula were successfully eliminated. At a median follow-up of 23.8 months (range 4-84), one patient suffered a mild cerebral infarction secondary to covered stent placement and one patient developed a partial renal infarction secondary to coil embolization. Additionally, stent collapse was found in one patient with stenosis of the iliofemoral vein, accounting for the failure to resolve the lower limb edema. In conclusion, endovascular therapy is an effective technique in the management of different types of IVIs, but is associated with minor ischemic complications. PMID:22490785

Xiong, Jiang; Liu, Meng; Guo, Wei; Liu, Xiaoping; Yin, Tai; Jia, Xin; Wang, Lijun; Ma, Xiaohui; Zhang, Hongpeng

2012-04-04

84

Successful Conservative Management in Iatrogenic Tracheobronchial Injury  

Microsoft Academic Search

Background. The aim of this study was to describe and to assess the effectiveness of conservative treatment as the chosen treatment for managing iatrogenic tracheo- bronchial injuries (ITBI). Methods. Between January 1993 and December 2003, 33 tracheobronchial injuries were treated in our hospital. Eighteen (54.5%) were ITBI and 15 (45.5%) were trau- matic noniatrogenic injuries. Of the ITBI patients, sex

Abel Gómez-Caro Andrés; Francisco Javier Moradiellos Díez; Pilar Ausín Herrero; Vicente Díaz-Hellín Gude; Emilio Larrú Cabrero; Eduardo de Miguel Porch; José Luis Martín De Nicolás

2005-01-01

85

Gracilis Muscle Transposition for Iatrogenic Rectourethral Fistula  

PubMed Central

Objective To assess the utility of gracilis muscle transposition in the treatment of iatrogenic rectourethral fistula. Summary Background Data Iatrogenic rectourethral fistula poses a rare but challenging complication of treatment for prostate cancer. A variety of procedures have been described to treat this condition, none of which has gained acceptance as the procedure of choice. The aim of this study was to review the authors’ experience with gracilis muscle transposition in the treatment of iatrogenic rectourethral fistula. Methods A retrospective chart review of all patients who underwent gracilis muscle transposition for iatrogenic rectourethral fistula was performed, and follow-up was established by telephone interview. Successful repair was defined as absence of a fistula after reversal of fecal and urinary diversions. Results Eleven men, mean age of 62 years, underwent 12 gracilis muscle transpositions for rectourethral fistula between 1996 and 2001. Six patients had a history of pelvic radiotherapy, and five patients had previous failed attempts to repair the fistula. In nine patients, the fistula healed following gracilis muscle transposition. One patient developed a rectocutaneous fistula that healed with fibrin glue injection, and one developed perineal sepsis requiring debridement of the transposed gracilis. This patient underwent a second gracilis transposition, which uneventfully healed. Overall, all of the patients had closure of their diverting stomas and maintained healed rectourethral fistulas. There were no intraoperative complications, and the only long-term complication of this procedure was mild medial thigh numbness in two patients. Conclusions Gracilis muscle transposition is an effective surgical treatment for iatrogenic rectourethral fistula. It is associated with low morbidity and a high success rate.

Zmora, Oded; Potenti, Fabio M.; Wexner, Steven D.; Pikarsky, Alon J.; Efron, Jonathan E.; Nogueras, Juan J.; Pricolo, Victor E.; Weiss, Eric G.

2003-01-01

86

Pseudotumoural gastric lesion caused by fish bone perforation  

PubMed Central

We report the case of a 34-year-old previously fit and healthy male who presented to the accident & emergency department with non-specific abdominal pain. The patient proceeded to undergo laparotomy at which a large mass was found adjacent to the stomach. The impression at surgery was of a lymphoma or gastric carcinoma though CT had reported the likelihood of a fish bone or foreign body causing duodenal perforation. Histology later confirmed the presence of a fish bone surrounded by reactive tissue.

Al-Deeb, Walid; Dua, Roopi Sascha; Borgstein, Rudi; Firth, John

2009-01-01

87

[Surgical treatment of duodenal fistulae].  

PubMed

The experience of surgical treatment of 10 patients with external intestinal fistulae was analyzed. The plot of the operation was to exlude the duodenum from the digestion by performing the retrocolic gastroenteroanastomosis after Roux or on the ultrashort loop. Early operation prevent septic complications and electrolyte disbalance. Duodenal fistulae, developed on the background of pancreonecrosis or after endoscopic retrograde cholangiopancreaticography, necessitate the external choledochial drainage. PMID:22678537

Zakharash, M P; Bekmuradov, A R; Zakharash, Iu M; Stetsenko, A P; Tarasiuk, T V; Moroz, V V

2012-01-01

88

Highly selective vagotomy in duodenal ulceration and its complications. A 12-year review.  

PubMed Central

Highly selective vagotomy (HSV) was performed in 509 patients over 12 years for the surgical management of duodenal ulceration; 103 HSVs were carried out during the treatment of complications. The overall rate of ulcer recurrence was 7%, ranging from 10% in the first 4 years to 4% in the 6 years between 1975 and 1980. Highly selective vagotomy was performed in addition to closure of a perforated ulcer in 16 patients, with no recurrent ulcers or re-perforations. After the control of their bleeding duodenal ulcers, 25 patients had HSV with no rebleeding, although two patients had recurrent ulceration. Highly selective vagotomy was performed in 62 patients with stenosis in addition to dilatation (44) or duodenoplasty (18). There was a high incidence of recurrent ulceration (7) and stenosis (9) with digital dilatation while duodenoplasty gave better results with one recurrent stenosis and no recurrent ulceration. The authors conclude that HSV is justified by its late results as a definitive operation in chronic duodenal ulceration that allows preservation of the pylorus during surgery for complications.

Gorey, T F; Lennon, F; Heffernan, S J

1984-01-01

89

Perforation Following Colorectal Endoscopy: What Happens Beyond the Endoscopy Suite?  

PubMed Central

Background: The risk factors for perforation from colorectal endoscopy have been well studied, but little is known about clinical outcomes beyond the immediate event. Objective: To evaluate short- and long-term outcomes of iatrogenic colorectal perforation following colorectal endoscopy. Design: Retrospective review over 16 years at a single tertiary care institution. Main Outcome Measures: Treatment interventions, morbidity and mortality rates, hospital length of stay, stoma closure rate, and long-term complications. Results: Of 132,259 colorectal endoscopies, 26 patients (0.02%) had a perforation (54% males; mean age, 67 years). The rectosigmoid colon was the most common site of perforation (65%). Thirty-eight percent of the perforations were recognized at the time of procedure, 31% presented within 24 hours, and 31% presented beyond 24 hours. Operative repair was undertaken in 85% of the patients, and 15% were managed with inpatient hospital observation. Primary repair was performed in 68% (defunctioning stoma in 18%). Mean hospital length of stay was 10.1 days. The overall postoperative complications rate was 55%, and wound complications were noted in 45%. The 30-day mortality rate was 19%. No death was observed beyond the first month. American Society of Anesthesiologists physical status Classes 3 and 4 were associated with mortality (p = 0.004). Of 7 patients who received a stoma, only 2 patients (29%) had stoma reversal. Long-term complications included incisional hernia (10%) and small-bowel obstruction (5%). Conclusions: Perforation following colorectal endoscopy was uncommon in this study but was associated with significant morbidity and mortality. An increased risk of death was noted with higher American Society of Anesthesiologists physical status class.

Tam, Michael S; Abbas, Maher A

2013-01-01

90

Cryoballoon ablation for iatrogenic left atrial tachycardia  

PubMed Central

Percutaneous and surgical left atrial ablation has been widely used to treat paroxysmal and persistent atrial fibrillation. However, left atrial ablation may result in left atrial tachycardia due to an iatrogenic substrate created by the ablation lesion sets. Ablation of these iatrogenic arrhythmias can be technically challenging, requiring prolonged procedures and the use of three-dimensional electroanatomical mapping systems. In some cases, the atrial tachycardia may terminate during mapping, or may degenerate into atrial fibrillation during the procedure before adequate mapping. Some patients also have several arrhythmia circuits, each requiring separate mapping, which may be time consuming. The present article reports the cases of three patients in whom a large cryoballoon was used to empirically ablate the pulmonary vein antral region, which is important for the initiation and maintenance of these arrhythmias.

Dhillon, Paramdeep S; Chen, Zhong; Sunni, Nadia; Norman, Mark; Ward, David E

2012-01-01

91

Efficacy and Long-Term Outcome of Endoscopic Treatment of Sporadic Nonampullary Duodenal Adenoma  

PubMed Central

Background/Aims Endoscopic resection has proven to be a safe and effective alternative to surgery for duodenal adenomas. However, few data are available on the adequacy of resection and long-term outcomes. This study evaluated the efficacy and longterm endoscopic findings in a cohort of Korean patients who underwent endoscopic mucosal resection (EMR) of sporadic duodenal adenomas. Methods Seventeen patients with nonampullary duodenal adenomas without familial polyposis syndrome and who were treated by EMR between January 2001 and December 2007 were evaluated retrospectively. Their management, follow-up, and outcomes were reviewed. Results In total, seventeen lesions were removed from EMR in 17 patients (mean age, 59.3 years; 6 women, 11 men). The mean size of the tumors was 15.1 mm (median, 13 mm, range, 8-27 mm). Of these 17 adenomas, 16 adenomas were tubulous and 1 was tubulovillous. The EMR was performed successfully in all 17 patients in a single session. After a median follow-up period of 29 months (range, 13-72 months), all patients remained in remission. One patient had bleeding at the site of the EMR. There were no perforations after the EMR. Conclusions EMR for sporadic duodenal adenomas seemed to be a safe and effective treatment modality.

Kim, Hyung-Keun; Chung, Woo Chul; Lee, Bo-In

2010-01-01

92

Radiation of a perforated cylinder  

Microsoft Academic Search

The generalized zonal method is used to find the energy radiated by a perforated cylinder. The existence of a range of geometric optical parameters is established, where in the perforated cylinder radiates more energy than a continuous cylinder.

A. V. Rumyantsev; O. N. Bryukhanov; V. E. Fedyanin

1978-01-01

93

Perforation cleaning tool  

Microsoft Academic Search

This patent describes a well tool for use in cleaning a perforation that extends from a well bore into a formation, the well tool having an elongated tubular body with upper and lower chambers therein, fluidic oscillator means in the upper chamber having first and second outlets, the oscillator means being responsive to the flow of fluids in the running

D. M. Facteau; T. A. Cobb; M. D. Hyman

1992-01-01

94

Perforation cleaning tools  

Microsoft Academic Search

A well tool is described for use in cleaning a perforation that communicates a well bore with a formation, said well tool having an elongated tubular body that is adapted to be lowered into a well on a running-in string, comprising: fluidic oscillator means in said body having first and second outlets, said oscillator means being responsive to the flow

D. M. Facteau; T. A. Cobb; M. D. Hyman

1993-01-01

95

PERFORATED WAFER FUEL ELEMENTS  

Microsoft Academic Search

A method of compacting perforated wafers from a mixture of stainless ; steel and 30 wt.% UOâ its described. A die containing 68 core pins was ; constructed tc compact wafers 5\\/8 in. square, 1\\/4 in. thick containing 68 holes. ; These holes are 0.068 in. in diameter and the distance between adjacent holes is ; 0.012 in. From results

H. S. Kalish; E. N. Mazza; G. Zuromsky

1954-01-01

96

Perforated diode neutron sensors  

NASA Astrophysics Data System (ADS)

A novel design of neutron sensor was investigated and developed. The perforated, or micro-structured, diode neutron sensor is a concept that has the potential to enhance neutron sensitivity of a common solid-state sensor configuration. The common thin-film coated diode neutron sensor is the only semiconductor-based neutron sensor that has proven feasible for commercial use. However, the thin-film coating restricts neutron counting efficiency and severely limits the usefulness of the sensor. This research has shown that the perforated design, when properly implemented, can increase the neutron counting efficiency by greater than a factor of 4. Methods developed in this work enable detectors to be fabricated to meet needs such as miniaturization, portability, ruggedness, and adaptability. The new detectors may be used for unique applications such as neutron imaging or the search for special nuclear materials. The research and developments described in the work include the successful fabrication of variant perforated diode neutron detector designs, general explanations of fundamental radiation detector design (with added focus on neutron detection and compactness), as well as descriptive theory and sensor design modeling useful in predicting performance of these unique solid-state radiation sensors. Several aspects in design, fabrication, and operational performance have been considered and tested including neutron counting efficiency, gamma-ray response, perforation shapes and depths, and silicon processing variations. Finally, the successfully proven technology was applied to a 1-dimensional neutron sensor array system.

McNeil, Walter J.

97

Tricholithobezoar causing gastric perforation.  

PubMed

A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar) is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment. PMID:22379468

Santos Valenciano, Juliana; Nonose, Ronaldo; Bragattini Cruz, Rodrigo; Tiemi Sato, Daniela; Monteiro Fernandes, Felipecappellette; Fabrício Nascimento, Enzo; Real Martinez, Carlos Augusto

2012-01-13

98

Tricholithobezoar Causing Gastric Perforation  

PubMed Central

A bezoar is an intraluminal mass formed by the accumulation of undigested material in the gastrointestinal tract. Trichobezoar is a rare condition seen almost exclusively in young women with trichotillomania and trichotillophagia. When not recognized, the trichobezoar continues to grow, which increases the risk of severe complications such as gastric ulceration and even perforation. Formation of a gallstone within the trichobezoar (tricholithobezoar) is an event that has not yet been described. We report the case of a 22-year-old woman admitted to the emergency room with signals and symptoms of an epigastric mass and perforative acute abdomen. Radiological study revealed bilateral pneumoperitoneum. Personal history revealed depressive syndrome, trichotillomania and trichophagia. With a diagnosis of visceral perforation, an urgent exploratory laparotomy was performed. This confirmed the diagnosis of gastric perforation due to a large trichobezoar with the formation of a gastrolith that was removed by anterior gastrotomy. Biochemical study of the gastric stone revealed that it was composed of bile salts. There were no complications. The patient was discharged on the 5th postoperative day and was referred for psychiatric treatment.

Santos Valenciano, Juliana; Nonose, Ronaldo; Bragattini Cruz, Rodrigo; Tiemi Sato, Daniela; Monteiro Fernandes, FelipeCappellette; Fabricio Nascimento, Enzo; Real Martinez, Carlos Augusto

2012-01-01

99

Gastrointestinal Tract Perforation: MDCT Findings according to the Perforation Sites  

PubMed Central

Our objective is to describe the characteristic CT findings of gastrointestinal (GI) tract perforations at various levels of the gastrointestinal system. It is beneficial to localize the perforation site as well as to diagnose the presence of bowel perforation for planning the correct surgery. CT has been established as the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. The amount and location of extraluminal free air usually differ among various perforation sites. Further, CT findings such as discontinuity of the bowel wall and concentrated free air bubbles in close proximity to the bowel wall can help predict the perforation site. Multidetector CT with the multiplanar reformation images has improved the accuracy of CT for predicting the perforation sites.

Kim, Sung Hwan; Jeong, Yong Yeon; Heo, Suk Hee; Kim, Jin Woong; Kang, Heoung Keun

2009-01-01

100

Iatrogenic delirium and coma: a "near miss".  

PubMed

A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likelihood of improvement existed, prompting clinical consideration of withdrawal of care. The correct diagnosis of iatrogenic drug-induced coma alternating with drug-induced delirium only became apparent after the IV administration of repeated doses of a benzodiazepine antagonist. The patient and husband (co-authors) provide insights often unheard within care circles. PMID:18460520

Dunn, William F; Adams, Shirley C; Adams, Robert W

2008-05-01

101

Iatrogenic lumbar meningocoele: report of three cases  

PubMed Central

We have reported three cases of iatrogenic lumbar meningocoeles after surgery for herniated lumbar intervertebral discs. We reject the term spurious, pseudo, or false as given by earlier writers. We feel that, in reality, these sacs are true meningocoeles, with complete arachnoidal lining and freely communicating with the intraspinal subarachnoid space. We have also given a brief outline of the clinical features, elucidated the mechanisms operative in the production of symptoms, and suggested the cardinal features of radiographic diagnosis. Prevention is, of course, the best way to avoid this complication. If a dural tear does occur, every effort should be made to suture it in a watertight manner. Images

Rinaldi, Italo; Hodges, Thomas O.

1970-01-01

102

Takotsubo cardiomyopathy due to iatrogenic methadone withdrawal.  

PubMed

Takotsubo cardiomyopathy is a syndrome characterized by transient apical ballooning or reversible midventricular systolic dysfunction. Most cases occur in postmenopausal women and are typically triggered by an acute medical illness or emotional or physical stress. Its presentation is highly suggestive of myocardial ischemia, but there is little or no evidence of epicardial coronary artery disease. To our knowledge there are only three reported cases in the literature of Takotsubo cardiomyopathy induced by opioid agonist withdrawal in adults; ours is the first reported case of iatrogenic methadone withdrawal leading to Takotsubo cardiomyopathy. PMID:22080928

Saiful, Faisal B; Lafferty, James; Jun, Chin Hee; Teli, Sumaya; Duvvuri, Srinivas; Khattri, Saakshi; Bhat, Tariq

2011-01-01

103

Annular pancreas associated with duodenal carcinoma  

PubMed Central

Annular pancreas (AP) is a rare congenital anomaly. Coexisting malignancy has been reported only in a few cases. We report what is, to the best of our knowledge, the first case in the English literature of duodenal adenocarcinoma in a patient with AP. In a 55-year old woman with duodenal outlet stenosis magnetic resonance cholangiopancreatography showed an aberrant pancreatic duct encircling the duodenum. Duodenojejunostomy was performed. Eight weeks later she presented with painless jaundice. Duodenopancreatectomy revealed a duodenal adenocarcinoma, surrounded by an incomplete AP. Thus, co-existent malignancy with AP can be present without obstructive jaundice and without being visible through preoperative diagnostics.

Bronnimann, Enrico; Potthast, Silke; Vlajnic, Tatjana; Oertli, Daniel; Heizmann, Oleg

2010-01-01

104

[Complex prevention of suture incompetence of the duodenal stump in penetrating duodenal ulcers].  

PubMed

Data on 323 patients operated upon for penetrating duodenal ulcers (resection of the stomach) are presented. New procedures are described which elevate hermeticity of the duodenal stump as well as prophylactic measures against incompetence of sutures of the duodenum stump. Six patients had incompetent sutures of the duodenum stump which was of limited character and was completed by the formation of a duodenal fistula. Lethality from this complication was not noted. PMID:2665306

Godlevski?, A I

1989-03-01

105

Laparoscopic duodenoduodenostomy for duodenal atresia.  

PubMed

A 3,220-g newborn baby with trisomy 21 presented with duodenal atresia. No other congenital malformations were diagnosed. Informed consent for a laparoscopic approach was obtained. The child was placed in a supine, head-up position slightly rotated to the left at the end of a shortened operating table. The surgeon stood at the bottom end with the cameraperson to his left and the scrub nurse to his right. The screen was at the right upper end. Open insertion of a cannula for a 5-mm 30 degrees telescope through the inferior umbilical fold was performed. A carbon dioxide (CO2) pneumoperitoneum with a pressure of 8 mmHg and a flow of 2l/min was established. Two 3.3-mm working cannulas were inserted; one in the left hypogastrium and one pararectally on the right at the umbilical level. Two more such cannulas were inserted; one under the xyphoid for a liver elevator and one in the right hypogastrium for a sucker. Mobilization of the dilated upper and collapsed lower duodenum was easy. After transverse enterotomy of the upper duodenum and longitudinal enterotomy of the distal duodenum, a diamond-shaped anastomosis with interrupted 5 zero Vicryl sutures were performed. The absence of air in the bowel beyond the atresia increased the working space and greatly facilitated the procedure. The technique proved to be easy, and the child did very well. Laparoscopic bowel anastomosis in newborn babies had not been described previously. Recently, a diamond-shaped duodenoduodenostomy for duodenal atresia was performed. The technique proved to be simple and is described in detail. The child did very well. PMID:12200660

Bax, N M; Ure, B M; van der Zee, D C; van Tuijl, I

2000-12-21

106

Iatrogenic fungal infections of central nervous system.  

PubMed

Iatrogenic fungal infections of the central nervous system had been considered a medical curiosity. Generally, they are a rare isolated complication of neurosurgical procedures, but periodically these infections are observed in larger populations as a result of exposure to contaminated materials during diagnostic or therapeutic procedures. In the last year, an epidemic of iatrogenic fungal central nervous system disease accompanied the use of fungal-contaminated compounded methylprednisolone distributed by one facility, heightening the attention given to this infectious disorder. As of May 6, 2013, 758 individuals from 20 US states have developed meningitis and/or spinal or paraspinal infection because of contaminated methylprednisolone from the New England Compounding Center in Framingham, Massachusetts, and 58 deaths have been reported. A total of 12 different fungi have been identified; Exserohilum rostratum, a filamentous environmental fungus rarely associated with human disease previously, has been the most commonly isolated pathogen. Meningitis has dominated the clinical presentation, accounting for more than half of the cases, but spinal and paraspinal infections, arachnoiditis, and stroke have also been observed. The diagnosis can be challenging as the organisms may be fastidious. An assay for ?-D-glycan has been proposed as an effective adjunctive test for E. rostratum infection. The current therapeutic recommendation is a 6 mg/kg dose of voriconazole every 12 h followed by liposomal amphotericin B. In some instances, surgical debridement and drainage may be necessary. PMID:24078440

Lahoti, Sourabh; Berger, Joseph R

2013-11-01

107

Esophageal perforation complicating with spinal epidural abscess, iatrogenic or secondary to first thoracic spine fracture?  

Microsoft Academic Search

Summary A 49-year-old drunken man was involved in a motorbike crash. He presented with cervical spine injury and multiple limbs fracture. Neuro-imaging demonstrated disruption of the C5–6 anterior longitudinal ligament, herniation of C3–4 and C5–6 discs, and Th1 compression fracture. The neurological deficits improved after anterior cervical decompression, fusion and fixation. One week later, he suffered from fever and severe

H.-C. Chen; W.-C. Tzaan; T.-Y. Chen; P.-H. Tu

2005-01-01

108

[Duodenal somatostatinomas associated with von Recklinghausen disease].  

PubMed

A case of von Recklinghausen's disease with double somatostatin producing neuroendocrine tumour of the ampulla and duodenum is reported. A search of the world's literature revealed 28 patients with immunohistologically proven duodenal somatostatinoma associated with type I neurofibromatosis. These tumours are seldom associated with a recognizable "somatostatin syndrome", but often present with obstructive jaundice, duodenal obstruction, weight loss or gastrointestinal bleeding. Histologically, psammoma bodies are frequently encountered in the glandular lumina of duodenal somatostatinomas (66%), whereas their presence in other neuroendocrine tumours of the gastrointestinal tract is very rare. Metastatization is rare (27%) and mainly confined to lymph nodes (88%). In the world literature duodenal somatostatinoma is associated with von Recklinghausen's disease in 50%. PMID:9888169

Blaser, A; Vajda, P; Rosset, P

1998-12-12

109

Protection against duodenal ulceration by somatostatins.  

PubMed

The purpose of our investigation was to study the effect of two somatostatin analogs (SMS 201-995 and 008) on duodenal ulcer disease induced by cysteamine in rats. Male Wistar rats were given cysteamine (28 mg/100 g body wt.) by rubber stomach tube three times in a single day. All animals of the test group were injected subcutaneously either with SMS 201-995 in different doses or with 008. On the 3rd day stomach, duodenum, and adrenal glands were macroscopically examined for lesions (duodenal ulceration, gastrointestinal bleeding, adrenal hemorrhage). Our results showed a dose-dependent effect of SMS 201-995 on the mortality, incidence, and intensity of cysteamine-induced duodenal lesions in rats. The incidence and the intensity of gastrointestinal bleeding and adrenal hemorrhage were also dose-dependently reduced by SMS 201-995. There was no definite effect of 008 on the mortality, incidence, or intensity of cysteamine-induced duodenal ulceration. PMID:2882057

Palitzsch, K D; Schuler, H; Schwedes, U; Usadel, K H

1986-01-01

110

Review of Duodenal and Gastric Ulcer.  

National Technical Information Service (NTIS)

Duodenal and gastric ulcer are chronic often recurring conditions that in the past were grouped together as peptic ulcer. Many diverse environmental and genetic factors, which create an imbalance between secretion of acid and pepsin by by the stomach and ...

F. C. Garland E. D. Gorham

1985-01-01

111

[Chronic intermittent duodenal obstruction in childhood].  

PubMed

Chronic intermittent duodenal obstruction caused by stenosis of the distal duodenum is a rare disease. Tight fixation of the ligament of Treitz, compression due to mesenteric lymphomatas or abnormal attachment of the mesocolon can cause intermittent impairment of intestinal passage. It will be necessary to differentiate this against genuine arterio-mesenteric duodenal obstruction as well as nerve motility disorders. History in the appropriate cases reports on postprandial episodes of regurgitation, sensation of fullness, nausea, vomiting and paroxysmal upper abdominal colicky pain. Radiograms always reveal gastroptosis and a varying degree of duodenal obstruction, usually with retroperistalsis. The passage is markedly delayed, with an impairment sometimes at the site of the duodenojejunal flexure. Therapy is always surgical. 8 own cases were cured by leftsided duodenal mobilisation according to Clairmont with additional caudad positioning and fixation of the duodenojejunal flexure. PMID:2291339

Brandesky, G; Messner, H

1990-12-01

112

Traumatic duodenal rupture in a soccer player.  

PubMed

Traumatic duodenal rupture resulting from blunt trauma during soccer is an extremely rare occurrence. A case report of this unusual condition is presented together with a review of the literature. PMID:10854026

Houshian, S

2000-06-01

113

Abnormalities in the duodenal transit and motility in duodenal ulcer patients: studies with a new isotopic technique.  

PubMed Central

Abnormalities of duodenal motility have been described in patients with duodenal ulcer and in experimental ulcers in rats and it has been postulated that they could be pathogenic in peptic ulcer disease. We have investigated with an isotopic technique whether duodenal bulb clearance or duodenal transit are abnormal in duodenal ulcer. Six patients with inactive and six with active duodenal ulcers, all men, and six healthy male controls were studied. Motility of the duodenum was simultaneously monitored. A bolus of 99mTcDTPA was injected into the duodenum while water or acid were perfused on different occasions. Duodenal bulb clearance and transit to the ligament of Treitz were calculated. Duodenal transit in duodenal ulcer patients 108.8 (23) sec was faster than in controls, 194.9 (5.1) sec (p less than 0.05) during the quiescent period of the motility cycle. The frequency of duodenal bulb contractions during acid perfusion was higher in duodenal ulcer patients 1.7 (0.4) cont/min, than in controls 0.8 (0.1) cont/min (p less than 0.05). No other significant differences were observed between ulcer patients and controls. These data suggest that patients with duodenal ulcers do not have major abnormalities of duodenal bulb clearance, nor of duodenal transit and that duodenal motility does not play a primary role in the pathogenesis of the ulcer. Images Fig. 2 Fig. 3 Fig. 4

Quon, M G; Mena, I; Valenzuela, J E

1989-01-01

114

Duodenal ulcer disease: a fresh appraisal.  

PubMed

There have been remarkable recent advances in knowledge about duodenal ulcer, a disease which may be spontaneously disappearing. Multiple physiologic defects have been found including increased numbers of parietal cells and their increased sensitivity to gastrin, excessive gastrin release after food intake, decreased inhibition of gastrin release by low antral pH, more rapid gastric emptying, and, possibly, impaired duodenal mucosal resistance to acid. Antacid and diet therapies have been subjected to scientific scrutiny and their respective roles in the therapy of the duodenal ulcer are now better defined. New drugs have been developed which strongly inhibit gastric acid secretion in man--the recently marketed histamine H2-receptor antagonist, cimetidine, as well as chemically modified prostaglandins. Clinical trials have shown cimetidine to be effective in healing duodenal ulcers and free of significant side effects with short-term usage. Its role in the prevention of ulcer recurrence is presently being evaluated. A new operation for duodenal ulcer has been introduced which shows great promise following pilot studies and some randomized trials. Only the parietal cell containing portion of the stomach is denervated. Basal and stimulated gastric acid secretion are markedly inhibited while gastric motility is unimpaired. This operation thus eliminates the need for a drainage procedure or distal antral resection and decreases the incidence and severity of undesirable side effects associated with earlier operations for duodenal ulcer. PMID:645191

Halloran, L G; Nisman, R M; Vlahcevic, Z R

1978-04-01

115

Iatrogenic dural arteriovenous fistula and aneurysmal subarachnoid hemorrhage.  

PubMed

The authors present the case of a patient who presented acutely with aneurysmal subarachnoid hemorrhage (SAH) and a contralateral iatrogenic dural arteriovenous fistula (DAVF). Diagnostic angiography was performed, revealing a right-sided middle cerebral artery (MCA) aneurysm and a left-sided DAVF immediately adjacent to the entry of the ventriculostomy and bur hole site. A craniotomy was performed for clipping of the ruptured MCA aneurysm, and the patient subsequently underwent endovascular obliteration of the DAVF 3 days later. The authors present their treatment of an iatrogenic DAVF in a patient with an aneurysmal SAH, considerations in management options, and a literature review on the development of iatrogenic DAVFs. PMID:22537118

Vadivelu, Sudhakar; Xin, Xin; Loven, Tina; Restrepo, Guillermo; Chalif, David J; Setton, Avi

2012-05-01

116

Case report: duodenal stromal tumor.  

PubMed

Tumors of the small intestine are rare lesions, but they should be kept in mind as possible causes of gastrointestinal symptoms. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. A 78 year-old woman complaining of abdominal pain, nausea and vomiting after meal and weight loss for three months was admitted to our clinic. On physical examination, there was only epigastric tenderness. No mass was palpated. She was anemic and total protein and albumin levels were low. Other laboratory tests were normal. A 9.0 x 7.5 cm heterogeneous mass was detected on the abdominal computerized tomography scan. Endoscopy confirmed a polypoid and vegetative mass in the second part of the duodenum. Histopathological diagnosis of endoscopic biopsy was gastrointestinal stromal tumor. Pancreaticoduodenectomy was performed. On the 11th postoperative day, relaparotomy was performed due to biliary leakage from the subhepatic drain. Biliary leakage was from the choledochojejunostomy. Choledochojejunostomy and pancreaticojejunostomy were revised. She was discharged on the postoperative 25th day. Histopathological examination of the resection specimen revealed duodenal stromal tumor. Although stromal tumors are relatively rare in the duodenum, in the case of upper gastrointestinal obstruction and anemia, this type of tumors should be considered in differential diagnosis. PMID:15832594

Akkus, M A; Kismet, K; Erel, S; Adibelli, M A; Pulat, H

117

Analysis and evaluation of perforating and perforation cleanup methods  

Microsoft Academic Search

Fifty-two completions made in the Gulf of Mexico between June, 1978, and May, 1982, have been analyzed to evaluate three commonly used techniques for perforating and cleaning up the perforations prior to gravel packing. Since detailed flowing bottom hole pressure information was not available in all cases, a method was developed to evaluate the completion efficiencies using an in-house computer

J. N. Bonomo; W. S. Young

1983-01-01

118

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

Microsoft Academic Search

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula\\u000a using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Fay L. Barley; David Kessel; Tony Nicholson; Iain Robertson

2006-01-01

119

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

SciTech Connect

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Barley, Fay L.; Kessel, David, E-mail: david.kessel@leedsth.nhs.uk; Nicholson, Tony [St. James University Hospital, Department of Radiology (United Kingdom); Robertson, Iain [Gartnaval Hospital, Department of Radiology (United Kingdom)

2006-12-15

120

Brachial plexus compression by an iatrogenic arteriovenous fistula  

Microsoft Academic Search

Summary  A case of left brachial plexus compression by an iatrogenic arteriovenous fistula was treated by detachable balloon technique\\u000a with immediate relief of pain. Good results on paresia were obtained in a few weeks.

J. G. Tebib; J. Bascoulergue; Ch. Dumontet; A. Paupert-Ravault; B. Prallet; F. Colson; M. Bouvier

1987-01-01

121

Selective Embolization of Large Symptomatic Iatrogenic Renal Transplant Arteriovenous Fistula  

Microsoft Academic Search

We report on the successful treatment of hypertension by occlusion of a large iatrogenic renal transplant arteriovenous fistula using detachable embolization coils with concomitant flow reduction by occlusion balloon in two patients.

Fay L. Barley; David Kessel; Tony Nicholson; Iain Robertson

2006-01-01

122

Iatrogenic peritoneopericardial hernia following coronary artery bypass surgery.  

PubMed

Intrapericardial diaphragmatic herniation of the stomach is reported in a patient who had undergone coronary artery bypass surgery 6 years earlier. The peritoneopericardial defect was iatrogenic and emphasizes the danger of inadvertent diaphragmatic injury during cardiac surgery. PMID:1567630

Waller, D A; Satur, C M; Mitchell, I M; Sivanathan, U M

1992-01-01

123

[Laparoscopy in iatrogenic lesions of the colon during operative endoscopy].  

PubMed

Colonscopy is a standard diagnostic and therapeutic procedure that has its own morbidity. Colonic perforation is the dangerous complication of this procedure. Successful management of perforation by conservative or surgical treatment remains controversial. We report two cases, recently observed, of patients with colonic perforation occurring during therapeutic colonscopy treated with minimally invasive technique. PMID:9646549

Di Marco, L; Occhionorelli, S; Schettino, A M; Carcoforo, P; Navarra, G; Pollinzi, V

124

Surgical treatment of complicated duodenal ulcers: controlled trials.  

PubMed

Indications for surgery of duodenal ulcer (DU) have changed radically because of the efficacy of H(2)-antagonists, endoscopic procedures, and eradication of Helicobacter pylorus. The aim of this study was to analyze the current literature to determine if definitive surgery is still relevant for complicated DU (bleeding, perforation, gastric outlet obstruction). Two studies have compared early to late surgery in terms of bleeding. One recommended early surgery (significant reduction in mortality) in the elderly, but no statistically significant difference was found when analyzed with "intention to treat." In the other, mortality with early surgery was five times higher than with expectant therapy (when it was possible). Two studies comparing different surgical techniques for bleeding favored the radical procedure. Of at least 15 studies comparing endoscopic treatments, however, none has compared endoscopic therapy to surgical intervention for bleeding DU. One trial, comparing nonoperative to surgical treatment for perforation, found similar rates of morbidity, intraabdominal abscess, and mortality; but the hospital stay was longer (p < 0.001). Nonoperative treatment failed more often (p < 0.05) in patients over age 70. In three trials, postoperative morbidity (excepting wound sepsis in one) was not significantly increased by definitive surgery, with less ulcer recurrence (p < 0.05) compared with simple closure. Laparoscopy (versus laparotomy) was shown to take longer (p < 0.001) but required less postoperative analgesics (p < 0.03); there were no statistically significant differences as concerns the duration of nasogastric aspiration, intravenous drips, hospital stay, time to resume normal diet, Visual Analogous Scale pain scores for the first 24 hours after surgery, morbidity, reoperation rate, or mortality. Of 48 laparoscopic patients, 11 (23%) underwent conversion to open surgery. Three surgical techniques [highly selective vagotomy (HSU) + gastrojejunostomy (group 1), HSV + Jaboulay gastroduodenostomy (group 2), or selective vagotomy (group 3) + antrectomy) for gastric outlet obstruction (GOO)] showed that although postoperative results were similar (except wound sepsis in one trial), long-term Visick scores were significantly (p < 0.01) better in group 1 than in group 2, but not in group 3. Further studies are needed to determine the exact prevalence of Helicobacter pylori in complicated DU and to compare (1) definitive to minimal surgery (stop the bleeding or close the perforation) combined with antisecretory drugs and eradication of H. pylori; (2) surgery to endoscopic treatment combined with eradication of H. pylori; and (3) for GOO, surgery to balloon dilatation combined with eradication of H. pylori. PMID:10658064

Millat, B; Fingerhut, A; Borie, F

2000-03-01

125

Iatrogenic left main artery dissection: A catastrophic complication  

PubMed Central

Iatrogenic left main artery (LM) dissection is a catastrophic complication of coronary angiography and angioplasty that requires prompt management using stenting. Although LM dissection can be prevented, it cannot always be avoided and has a reported incidence rate of 0.02%. In the present report, a case of iatrogenic LM dissection that was successfully treated with multiple stents is presented and followed by a brief review of the literature.

Namazi, Mohammad Hassan; Rostami, Reza Tajik; Mohammadi, Afsaneh; Amini, Abdol Latifi; Safi, Morteza; Saadat, Habibollah; Vakili, Hosein; Motamedi, Mohammad Reza; Movahed, Mohammad Reza

2012-01-01

126

When is a peri-procedural death iatrogenic in nature?  

Microsoft Academic Search

In almost any instance of suspected iatrogenic fatality, the attending forensic pathologist faces the challenging and often\\u000a daunting task in ascertaining the cause of death, determining if an iatrogenic injury had indeed occurred and if so, its contribution\\u000a to the causation of death. The Forensic Medicine Division of the Health Sciences Authority in Singapore embarked on a 6 year\\u000a study of

Marian Wang; Gilbert Lau

127

Endourologic Management of Duodenal Calculi in Pancreas-Kidney Transplantation  

Microsoft Academic Search

Duodenal stones formed during pancreas-kidney transplantation are usually associated with nonabsorbable sutures or staples. We report on the delayed formation of a struvite duodenal stone not attributed to foreign material, managed successfully with intracorporeal electrohydraulic lithotripsy.

Koon H. Rha; Ioannis M. Varkarakis; Albert M. Ong; Peter A. Pinto; Ernesto P. Molmenti; Thomas W. Jarrett

2005-01-01

128

Esophageal perforations masked by steroids  

Microsoft Academic Search

Esophageal perforation is usually an acute, life-threatening event, and its diagnosis can be established on the basis of obvious clinical and radiographic findings. This article describes two cases whereby symptoms of esophageal perforations were masked by concomitant administration of steroids, thus causing marked delay in diagnosis and treatment. Esophageal rupture should be considered when patients receiving steroids develop unexplained fever

Linas M. Klygis; Rome Jutabha; Michael B. McCrohan; Arvydas D. Vanagunas

1993-01-01

129

Development of highly perforated bricks.  

National Technical Information Service (NTIS)

Perforated bricks have been produced in the UK and in other countries for many years. About 2,000 million bricks were made in 1988 in the UK by the wire-cut process, nearly all of which were perforated to some extent. The British Standard Specification fo...

1992-01-01

130

Perforated midgut diverticulitis: Revisited  

PubMed Central

AIM: To study and provide data on the evolution of medical procedures and outcomes of patients suffering from perforated midgut diverticulitis. METHODS: Three data sources were used: the Medline and Google search engines were searched for case reports on one or more patients treated for perforated midgut diverticulitis (Meckel’s diverticulitis excluded) that were published after 1995. The inclusion criterion was sufficient individual patient data in the article. Both indexed and non-indexed journals were used. Patients treated for perforated midgut diverticulitis at Vestfold Hospital were included in this group. Data on symptoms, laboratory and radiology results, treatment modalities, surgical access, procedures, complications and outcomes were collected. The Norwegian patient registry was searched to find patients operated upon for midgut diverticulitis from 1999 to 2007. The data collected were age, sex, mode of access, surgical procedure performed and number of patients per year. Historical controls were retrieved from an article published in 1995 containing pertinent individual patient data. Statistical analysis was done with SPSS software. RESULTS: Group?I: 106 patients (48 men) were found. Mean age was 72.2 ± 13.1 years (mean ± SD). Age or sex had no impact on outcomes (P = 0.057 and P = 0.771, respectively). Preoperative assessment was plain radiography in 53.3% or computed tomography (CT) in 76.1%. Correct diagnosis was made in 77.1% with CT, 5.6% without (P = 0.001). Duration of symptoms before hospitalization was 3.6 d (range: 1-35 d), but longer duration was not associated with poor outcome (P = 0.748). Eighty-six point eight percent of patients underwent surgery, 92.4% of these through open access where 90.1% had bowel resection. Complications occurred in 19.2% of patients and 16.3% underwent reoperation. Distance from perforation to Treitz ligament was 41.7 ± 28.1 cm. At surgery, no peritonitis was found in 29.7% of patients, local peritonitis in 47.5%, and diffuse peritonitis in 22.8%. Peritonitis grade correlated with the reoperation rate (r = 0.43). Conservatively treated patients had similar hospital length of stay as operated patients (10.6 ± 8.3 d vs 10.7 ± 7.9 d, respectively). Age correlated with hospital stay (r = 0.46). No difference in outcomes for operated or nonoperated patients was found (P = 0.814). Group II: 113 patients (57 men). Mean age 67.6 ± 16.4 years (range: 21-96 years). Mean age for men was 61.3 ± 16.2 years, and 74.7 ± 12.5 years for women (P = 0.001). Number of procedures per year was 11.2 ± 0.9, and bowel resection was performed in 82.3% of patients. Group III: 47 patients (21 men). Patient age was 65.4 ± 14.4 years. Mean age for men was 61.5 ± 17.3 years and 65.3 ± 14.4 years for women. Duration of symptoms before hospitalization was 6.9 d (range: 1-180 d). No patients had a preoperative diagnosis, 97.9% of patients underwent surgery, and 78.3% had multiple diverticula. Bowel resection was performed in 67.4% of patients, and suture closure in 32.6%. Mortality was 23.4%. There was no difference in length of history or its impact on survival between Groups?I?and III (P = 0.241 and P = 0.198, respectively). Resection was more often performed in Group?I?(P = 0.01). Mortality was higher in Group III (P = 0.002). CONCLUSION: In cases with contained perforation, conservative treatment gives satisfactory results, laparoscopy with lavage and drainage can be attempted and continued with a conservative course.

Spasojevic, Milan; Naesgaard, Jens Marius; Ignjatovic, Dejan

2012-01-01

131

Subfascial endoscopic perforator vein surgery.  

PubMed

Chronic venous insufficiency is a tremendous health care problem in western societies. Venous disease can affect any combination of the superficial, deep, and perforator venous systems of the lower extremities. Generally the superficial venous deficits are addressed through sclerotherapy, enovenous ablation, stab phlebectomy, and or stripping. Patients with advanced clinical sequelae (lipodermatosclerosis or ulceration) of CVI should also be evaluated for the presence of incompetent perforating veins. Open surgical approached to the calf perforating veins (ie. Linton procedure) were complicated by significant wound complications and have largely been replaced by the less invasive Subfascial Endoscopic Perforator Surgery (SEPS). The use of SEPS in patients with ulceration has been shown to be safe and to reduce the time that patients will have ulcers during follow-up. This chapter will review the pathophysiology, diagnosis, and treatment of incompetent perforating veins of the legs with particular attention to surgical issues. PMID:16387265

Iafrati, Mark D

2005-12-01

132

[Study of genetic markers of duodenal ulcer].  

PubMed

The results of determination of various hereditary predisposition markers in peptic ulcer are given: in the population, in patients with duodenal ulcer and in their siblings (risk group). Of importance for revealing subjects with hereditary predisposition to duodenal ulcer are the clinico-genealogical analysis, determination of the blood group, especially in simultaneous determination of a "secretory status" ("status of non-secretion" of the ABH blood system agglutinogen in the saliva), increase in the mass of parietal cells and, to some extent, of the distinguishing features of dermatoglyphics (in combination with the above markers). Determination of taste sensitivity to phenylthiocarbamide is non-informative. PMID:2770215

Tsimmerman, Ia S; Onosova, E A; Tsimmerman, I Ia

1989-05-01

133

Use of temporary oesophageal stent in the management of oesophageal perforation after laparoscopic redo-Nissen Fundoplication in a paediatric case  

PubMed Central

Iatrogenic perforation of the oesophagus is life threatening, usually managed surgically. A 4 year-old boy sustained an intra-operative oesophageal perforation while undergoing laparoscopic redo-Nissen Fundoplication for gastrooesophgeal reflux symptoms. After several failed attempts to manage the patients surgically and conservatively, he was successfully treated by deployment of a temporary covered stent. Although commonly employed as an alternative management option in adults, the use of temporary covered stents in the paediatric population is rare especially for nonmalignant disease. This technique can potentially reduce morbidity and surgical intervention.

Radford, Anna; Horton, David; Besarovic, Sanja; Razack, Abdul

2013-01-01

134

[Bowel perforation because of ingestion of a blister-wrapped tablet after post-interventional coronary perforation].  

PubMed

History and admission findings: A 70-year-old woman was admitted to hospital with progressive chest pain. Coronary angiography demonstrated a significant stenosis of the left descending artery (LAD), which was treated by percutaneous coronary intervention (PCI) and stent implantation. During this intervention, a coronary perforation occurred which was remedied immediately. Five days after the intervention, the patient complained about severe atypical chest and abdominal pain with nausea and vomitting, but no fever. Physical examination revealed an acute abdomen of uncertain origin.Investigations: Laboratory tests revealed leukocytosis and elevated levels of C-reactive protein while cardiac enzymes were in normal range. The electrocardiogram showed no signs of acute myocardial ischemia. Abdominal x-ray was performed without any pathological findings. Further diagnostic tests, especially computed tomography of the abdomen, revealed an ingestion of a blister-wrapped tablet which had caused small bowel perforation and peritonitis.Diagnosis, treatment and course: An acute abdomen due to ingestion of a foreign body was diagnosed and an emergency laparotomy was performed immediately. The blister pack was removed by ileostomy. The further course was uneventful.Conclusion: The clinical presentation of abdominal pain is a frequent medical condition in hospital. Determining the cause requires precise assessment and examination and implicates a variety of differential diagnosis including non-cardiac and cardiac pain. Iatrogenic causes must be considered in differential diagnosis. PMID:23225187

Sasko, B; Butz, T; Winnekendonk, G; Plehn, G; Prull, M; Liermann, D; Trappe, H-J

2012-12-05

135

Iatrogenic Intradural Lumbosacral Cyst Following Epiduroscopy  

PubMed Central

We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.

Ryu, Kyeong-Sik; Rathi, Nitesh Kumar; Kim, Geol

2012-01-01

136

Iatrogenic causes of salivary gland dysfunction  

SciTech Connect

Saliva is important for maintaining oral health and function. There are instances when medical therapy is intended to decrease salivary flow, such as during general anesthesia, but most instances of iatrogenic salivary gland dysfunction represent untoward or unavoidable side-effects. The clinical expression of the salivary dysfunction can range from very minor transient alteration in saliva flow to a total loss of salivary function. The most common forms of therapy that interfere with salivation are drug therapies, cancer therapies (radiation or chemotherapy), and surgical therapy. These therapies can affect salivation by a number of different mechanisms that include: disruption of autonomic nerve function related to salivation, interference with acinar or ductal cell functions related to salivation, cytotoxicity, indirect effects (vasoconstriction/dilation, fluid and electrolyte balance, etc.), and physical trauma to salivary glands and nerves. A wide variety of drugs is capable of increasing or decreasing salivary flow by mimicking autonomic nervous system actions or by directly acting on cellular processes necessary for salivation: drugs can also indirectly affect salivation by altering fluid and electrolyte balance or by affecting blood flow to the glands. Ionizing radiation can cause permanent damage to salivary glands, damage that is manifest as acinar cell destruction with subsequent atrophy and fibrosis of the glands. Cancer chemotherapy can cause changes in salivation, but the changes are usually much less severe and only transient. Finally, surgical and traumatic injuries interfere with salivation because of either disruption of gland innervation or gross physical damage (or removal) of glandular tissue (including ducts).

Schubert, M.M.; Izutsu, K.T.

1987-02-01

137

Perforation cleaning tools  

SciTech Connect

A well tool is described for use in cleaning a perforation that communicates a well bore with a formation, said well tool having an elongated tubular body that is adapted to be lowered into a well on a running-in string, comprising: fluidic oscillator means in said body having first and second outlets, said oscillator means being responsive to the flow of fluids in said running-in string for creating alternating pressure pulses at said first and second outlets; first and second cavity means in said body in communication respectively with said first and second outlets; passage means for communicating each of said cavity means with the annular well bore region externally of said body and said cavity means; and filter means mounted adjacent the respective upper and lower ends of said body for substantially confining said pressure variations to said annular region and for substantially isolating the well bore above and below said filter means from said pressure pulses.

Facteau, D.M.; Cobb, T.A.; Hyman, M.D.

1993-07-20

138

Perforation cleaning tool  

SciTech Connect

This patent describes a well tool for use in cleaning a perforation that extends from a well bore into a formation, the well tool having an elongated tubular body with upper and lower chambers therein, fluidic oscillator means in the upper chamber having first and second outlets, the oscillator means being responsive to the flow of fluids in the running string for creating alternating pressure pulses at the first and second outlets; means communicating the first outlet with the lower chamber; means communicating the second outlet with the annular well bore region externally of the body and the lower chamber. This patent describes improvement in cylindrical filter means mounted adjacent the respective upper and lower ends of the body for concentrating the pressure variations in the annular region and for substantially isolating the well bore above and below the filter means from the pressure pulses.

Facteau, D.M.; Cobb, T.A.; Hyman, M.D.

1992-08-04

139

Rett syndrome and gastric perforation.  

PubMed

Rett Syndrome is associated with decreased peristaltic esophageal waves and gastric dysmotility, resulting in swallowing difficulties and gastric dilation. Rarely, gastric necrosis and perforation occur. Our case represents the third reported case of gastric necrosis and perforation associated with Rett Syndrome. A 31-year-old female after 11 hours of intermittent emesis and constant, sharp abdominal pain presented with evidence of multiorgan system failure including hypovolemic shock, metabolic acidosis, coagulopathy, and hepatorenal failure. A chest radiograph revealed intra-abdominal free air necessitating emergent laparotomy. During exploration, a severely dilated, thin-walled stomach with an area of necrosis and gross perforation was noted. Wedge resection of the necrotic tissue and primary closure were performed. Despite aggressive perioperative resuscitation and ventilation support, the patient died 3 hours postoperatively secondary to refractory shock and hypoxemia. Severe gastric dilation can occur with Rett Syndrome and may cause gastric necrosis and perforation. Prolonged elevated gastric pressures can decrease perfusion and may contribute to perforation. Timely decompression via percutaneous endoscopic or surgical gastrostomy could decrease the risk of perforation particularly when significant gastric distention is present. Consideration of gastric necrosis and perforation in patients with Rett Syndrome may lead to earlier intervention and decreased mortality. PMID:18453295

Shah, Malay B; Bittner, James G; Edwards, Michael A

2008-04-01

140

Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar.  

PubMed

Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely. PMID:23082068

Kim, Ji Hun; Chang, Jae Hyuck; Nam, Sung Min; Lee, Mi Jeong; Maeng, Il Ho; Park, Jin Young; Im, Yun Sun; Kim, Tae Ho; Park, Il Young; Han, Sok Won

2012-10-14

141

Duodenal obstruction following acute pancreatitis caused by a large duodenal diverticular bezoar  

PubMed Central

Bezoars are concretions of indigestible materials in the gastrointestinal tract. It generally develops in patients with previous gastric surgery or patients with delayed gastric emptying. Cases of periampullary duodenal divericular bezoar are rare. Clinical manifestations by a bezoar vary from no symptom to acute abdominal syndrome depending on the location of the bezoar. Biliary obstruction or acute pancreatitis caused by a bezoar has been rarely reported. Small bowel obstruction by a bezoar is also rare, but it is a complication that requires surgery. This is a case of acute pancreatitis and subsequent duodenal obstruction caused by a large duodenal bezoar migrating from a periampullary diverticulum to the duodenal lumen, which mimicked pancreatic abscess or microperforation on abdominal computerized tomography. The patient underwent surgical removal of the bezoar and recovered completely.

Kim, Ji Hun; Chang, Jae Hyuck; Nam, Sung Min; Lee, Mi Jeong; Maeng, Il Ho; Park, Jin Young; Im, Yun Sun; Kim, Tae Ho; Park, Il Young; Han, Sok Won

2012-01-01

142

Rare Case of Ileal Perforation  

PubMed Central

Ileitis, or inflammation of the ileum, is often caused by Crohn’s disease. However, ileitis may be caused by a wide variety of other diseases. These include infectious diseases, spondyloarthropathies, vasculitides, ischemia, neoplasms, medication-induced, eosinophilic enteritis, and others. Eosinophilic enteritis can present as abdominal pain, protein loosing enteropathy, ulcers, intestinal obstruction, intussusception and perforation.Bowel perforation is an uncommon presentation of eosinophilic enteritis. We report a rare case of ileal perforation due to eosinophilic enteritis in a 57 years old female.

Kumar B, Vinod; Martis, John Joseph S; Mathias, Sheldon G; Kamath, Priyatham; Shetty, Vivek

2013-01-01

143

Analysis and evaluation of perforating and perforation cleanup methods  

Microsoft Academic Search

Fifty-two completions made in the Gulf of Mexico between June, 1978 and May, 1982 have been analyzed to evaluate 3 commonly used techniques for perforating and cleaning up the perforations prior to gravel packing. Since detailed flowing bottom-hole pressure information was not available in all cases, a method was developed to evaluate the completion efficiencies using an in-house computer program.

J. M. Bonomo; W. S. Young

1983-01-01

144

Perforated Neonatal Appendicitis with Pneumoperitoneum  

PubMed Central

Acute appendicitis is a rare condition in neonates, with a high mortality. If perforated, it seldom presents with radiologically significant pneumoperitoneum. An 11-day-old newborn presented with abdominal distension and reluctance to feeds. X-ray abdomen revealed significant pneumoperitoneum. After optimization of his condition, exploratory laparotomy was performed. Perforated appendix was found and appendicectomy done. Post operative course was stormy that lead to demise of the baby.

Zia, Kanwal; Saddal, Nasir Salim

2013-01-01

145

Impact perforation of steel plates  

Microsoft Academic Search

The perforation of mild steel, stainless steel and high-strength steel plates subjected to impacts characterised as low-velocity (up to about 20 m\\/s) and moderate-velocity (20–300 m\\/s, approximately) are examined in this paper, wherein recent experimental data and some empirical equations have been compared. The threshold velocity for the normal perforation of metal plates focuses on cylindrical projectiles with various shaped impact faces,

Norman Jones; Jeom Kee Paik

2012-01-01

146

Duodenal perforation because of swallowed ballpoint pen and its laparoscopic management: report of a case  

Microsoft Academic Search

Accidental ingestion of foreign objects by teenagers or young adults without mental impairment is a rare event. We present a case of a patient who unintentionally swallowed a ballpoint pen several days before seeking medical attention. She concealed the event until abdominal radiographs revealed the foreign object. Because swallowed foreign objects can be potentially harmful, they should be removed endoscopically

Claudio Golffier; Francia Holguin; Akihiko Kobayashi

2009-01-01

147

Iatrogenic botulism after botulinum toxin type A injections.  

PubMed

Therapeutic use of botulinum toxin type A (BT/A) is well known, effective, and safe. Iatrogenic botulism that presents with generalized weakness, dysphagia, and respiratory distress is a rare but significant complication in BT/A treatment. In this study, we report 4 patients who developed iatrogenic botulism after receiving therapeutic doses of BT/A for spasticity and blepharospasm. One patient was placed in intensive care unit, but consequently, every patient recovered fully. The cause of BT/A as an adverse effect is most likely hematological spread of the toxin. PMID:20150804

Coban, Arzu; Matur, Zeliha; Hanagasi, Hasmet A; Parman, Yesim

2010-05-01

148

Iatrogenic choroidal neovascularization after krypton red laser photocoagulation.  

PubMed

A major cause for failure of krypton red laser photocoagulation in patients with exudative age-related macular degeneration has been the development of recurrent choroidal neovascularization adjacent to the previously treated areas. After reviewing the possible causes of recurrences, it is apparent that a certain number are iatrogenic, ie, induced by krypton red laser causing disruption and damage to the pigment epithelium-Bruch's membrane-choroidal complex. We describe three separate episodes in two patients of iatrogenic recurrent choroidal neovascularization after krypton red laser photocoagulation. PMID:2471948

Orth, D H; Flood, T P; Packo, K H

1989-04-01

149

Role of Meteorological Factors in Duodenal Ulcer Seasonality  

PubMed Central

BACKGROUND Understanding disease seasonality can provide guidance for future biomedical research. OBJECTIVE To examine whether meteorological factors and calendar months impact duodenal ulcer (DU) exacerbations. DESIGN We conducted a retrospective time series analysis of population-based claims data. PARTICIPANTS DU inpatients (1997–2003; all endoscopy confirmed) from Taiwan, a small island nation, n?=?160,510. Inpatient admission was used as a proxy for exacerbation because 98.5% of cases had hemorrhage or perforation or both. MEASUREMENTS We used multivariate autoregressive integrated moving average (ARIMA) modeling to examine if DU admissions/100,000 was associated with calendar month, ambient temperature, relative humidity, rainfall, atmospheric pressure, and sunshine hours, controlling for available DU-relevant comorbidities. RESULTS DU admissions increased with age. ARIMA modeling showed a February (Chinese New Year-related) trough in all age groups (all p?

Xirasagar, Sudha; Chen, Chin-Shyan

2007-01-01

150

Colonic Perforation: Can We Manage It Endoscopically?  

PubMed Central

Colonic perforation occurs in a variety of clinical scenarios and colonoscopy-associated perforation is one of the important reasons for colonic perforation. Colonoscopy-associated perforation may be diagnosed during colonoscopy procedure by the visualization of evident colonic wall defect or, after the completion of colonoscopy, by the visualization of leaked air in the peritoneal or retroperitoneal space. Recently, the incidence of colonoscopy-associated perforation increased because of the introduction of colorectal endoscopic submucosal dissection. Traditionally, colonoscopy-associated perforation was managed surgically. However, medical management has been introduced widely and endoscopic clipping is the most important component for the medical management of colonoscopy-associated perforation. Timely administration of antibiotics is also important. Large perforations, diagnostic colonoscopy-associated perforations, large amount of pneumoperitoneum, and severe abdominal pain have been reported to be predictive of the necessity of surgery after endoscopic clipping. Surgery should be performed if patients show clinical deterioration even after the initiation of medical management.

2013-01-01

151

[Wide esophageal wall rupture as iatrogenic complication of anterior cervical spine surgery].  

PubMed

The case of 19-year old men with iatrogenic esophageal wall perforation is presented. The patient underwent anterior cervical stabilization using plate and screw for fracture of the C4 and C5 vertebra followed by an abscess of prevertebral space with discharging pus and food from the wound. The general condition was poor. Symptoms included: pneumonia, pleuritis with effusion, septicemia with mediastinitis, fever up to 40 and quadriplegia on neurological examination. During surgical procedure the implant loose but was still fixed into the esophagus causing a large defect in the posterior wall of the hypopharynx and cervical part of esophagus was found. The patient undergone three step surgery with wide drainage of prevertebral abscess, removing of osteosynthetic plate removal and formation of pedicle flap with sterno-cleido-mastoideus muscule. The finnal fourth procedure with using of pediculed infrahyoid flap gave an excellent result. During 160 days hospitalization the pus culture showed growth of the 11 bacterials species (like Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis) and 2 species of fungus. He was treated 13 types of antybiotics. This special case we present because of live threatening complication (mediastinitis) and complicated clinical course as well as because of unique technique of the defect closure, i.e. the infrahyoid flap occurred to be successful. PMID:16521458

Wierzbicka, Ma?gorzata; Pabiszczak, Maciej; Smuszkiewicz, Piotr; Szyfter, Witold

2005-01-01

152

Unexpected endoscopic full-thickness resection of a duodenal neuroendocrine tumor.  

PubMed

A 57-year-old man underwent endoscopy for investigation of a duodenal polyp. Endoscopy revealed a hemispheric submucosal tumor, about 5 mm in diameter, in the anterior wall of the duodenal bulb. Endoscopic biopsy disclosed a neuroendocrine tumor histologically, therefore endoscopic mucosal resection was conducted. The tumor was effectively and evenly elevated after injection of a mixture of 0.2% hyaluronic acid and glycerol at a ratio of 1:1 into the submucosal layer. A small amount of indigo-carmine dye was also added for coloration of injection fluid. The lesion was completely resected en bloc with a snare after submucosal fluid injection. Immediately, muscle-fiber-like tissues were identified in the marginal area of the resected defect above the blue-colored layer, which suggested perforation. The defect was completely closed with a total of 9 endoclips, and no symptoms associated with peritonitis appeared thereafter. Histologically, the horizontal and vertical margins of the resected specimen were free of tumor and muscularis propria was also seen in the resected specimen. Generally, endoscopic mucosal resection is considered to be theoretically successful if the mucosal defect is colored blue. The blue layer in this case, however, had been created by unplanned injection into the subserosal rather than the submucosal layer. PMID:23864794

Hatogai, Ken; Oono, Yasuhiro; Fu, Kuang-I; Odagaki, Tomoyuki; Ikematsu, Hiroaki; Kojima, Takashi; Yano, Tomonori; Kaneko, Kazuhiro

2013-07-14

153

Microleakage of CEM Cement and ProRoot MTA as Furcal Perforation Repair Materials in Primary Teeth  

PubMed Central

Introduction: Iatrogenic furcal perforation is a procedural accident in endodontic treatments of primary/permanent teeth; prognosis may be favorable if a complete seal with biomaterial is immediately established. The purpose of this in vitro study was to evaluate microleakage of calcium enriched mixture (CEM) cement and ProRoot mineral trioxide aggregate (MTA) for sealing primary molar furcal perforations. Materials and Methods This study was conducted on 38 extracted human primary molars. Furcation perforations were created in the pulp chamber floor. The teeth were divided randomly in two experimental groups (n=17) and two positive and negative controls (n=2). Perforations were then repaired with biomaterials. After 72 h, the teeth were submerged in 2% fuchsin dye solution for 24h. The samples were sectioned longitudinally and evaluated for dye leakage. Data analyzed statistically using ANOVA test. Results: The negative and positive controls behaved as expected. Dye microleakage was observed in all experimental samples; however, there was no statistically significant difference between the microleakage of MTA (4.411±2.042 mm) and CEM (3.647±1.040 mm) groups (P>0.05). Conclusion: Based on the findings of this in vitro study, CEM and tooth-colored ProRoot MTA have similar sealing ability for furcal perforation repair of primary molar teeth.

Haghgoo, Roza; Arfa, Sara; Asgary, Saeed

2013-01-01

154

Duodenal segment complications in vascularized pancreas transplantation  

Microsoft Academic Search

Bladder drainage by the duodenal segment (DS) technique is currently the preferred method of pancreas transplantation (PTX)\\u000a but is associated with unique complications. Over a 7-year period, 191 diabetic patients underwent 201 whole-organ PTXs with\\u000a bladder drainage using a 6 to 8 cm length of DS as an exocrine conduit. A retrospective chart review was performed to document\\u000a all DS

Robert J. Stratta; Rakesh Sindhi; Debra Sudan; John T. Jerius; Stanley J. Radio

1997-01-01

155

Perforated Appendicitis: Is Laparoscopy Safe?  

PubMed Central

Objective: The purpose of this study was to demonstrate the safety and efficacy of laparoscopy in children with perforated appendicitis. Methods: This is a retrospective review of consecutive patients under the age of 18, operated on for perforated appendicitis between September 1997 and December 1999. Results: Sixty-nine patients were operated on for perforated appendicitis. Eleven appendectomies were performed laparoscopically. Fifty-four patients underwent an open appendectomy. Four laparoscopic appendectomies were converted to an open procedure. The mean operative time was 79 minutes for the laparoscopic group, and 87 minutes for the open group. The mean length of hospital stay was 5.4 days versus 7.6 days for the laparoscopic and open groups, respectively. Neither of these differences was statistically significant. Conclusions: The above data support the use of laparoscopy in the management of perforated appendicitis in children. In conclusion, laparoscopy is as safe as open appendectomy. Laparoscopy is an effective alternative with a shorter length of hospital stay compared with that for an open appendectomy for perforated appendicitis in children.

Tirabassi, Michael V.; Tashjian, David B.; Konefal, Stanley H.; Courtney, Richard A.; Sachs, Barry F.

2004-01-01

156

Clinical and ultrastructural studies in duodenal pseudomelanosis.  

PubMed Central

Nine patients with duodenal pseudomelanosis are described: seven had endstage renal failure while one other patient had undergone renal transplantation. Eight of the nine had been on oral iron supplements. The pigment stained positively with Perls' stain for iron in five patients, positively with the Masson-Fontana method normally used to identify melanin in one, and positively with both methods in three. Electron probe x-ray analysis of the pigment on samples from six patients showed iron to be present in all six, while sulphur was present in five. Varying sulphur content of the pigment in different patients could account for differences in histochemical characteristics. Iron was also shown in the duodenal biopsies of 34 of 48 uraemic patients on oral iron supplements, but was present in only 22 of 120 patients endoscoped for miscellaneous conditions (p less than 0.001). We postulate that the pigment of duodenal pseudomelanosis is derived from iron absorbed from the lumen. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4

Kang, J Y; Wu, A Y; Chia, J L; Wee, A; Sutherland, I H; Hori, R

1987-01-01

157

Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation  

Microsoft Academic Search

Objectives: To assess the relationship between the time period before hyperbaric oxygenation therapy (HBO) and clinical outcome in patients with iatrogenic cerebral air embolism. Design and setting: Retrospective study in a hyperbaric chamber and medical intensive care unit of a university hospital. Patients: All patients with air embolism from 1980 to 1999. Interventions: We retrieved the cases of 86 patients

P. Blanc; A. Boussuges; K. Henriette; J. Sainty; M. Deleflie

2002-01-01

158

Iatrogenic tooth abrasion comparisons among composite materials and finishing techniques  

Microsoft Academic Search

Statement of Problem. Many different rotary instruments are available for shaping composite restorations. Whether use of these instruments causes undesirable iatrogenic abrasion of either the tooth surface or the composite restorative material is unknown. Assuming that damage occurs, which technique is least damaging is unknown. Purpose. This in vitro study quantified the loss of surface enamel and dentin surrounding Class

Christina A. Mitchell; Maria R. Pintado; William H. Douglas

2002-01-01

159

Iatrogenic complications in the neonatal intensive care unit  

Microsoft Academic Search

With the introduction of novel technologies and approaches in neonatal care and the lack of appropriately designed and well-executed randomized clinical trials to investigate the impact of these interventions, iatrogenic complications have been increasingly seen in the neonatal intensive care unit. In addition, increased awareness and the introduction of more appropriate quality control measures have resulted in higher levels of

K C Sekar

2010-01-01

160

Forensische Bewertung klinischer Todesfälle unter dem Verdacht iatrogener Hyperkaliämie  

Microsoft Academic Search

Zusammenfassung Die forensische Post-mortem-Diagnostik bei Verdacht auf letale Kaliumintoxikationen ist ein ungelöstes Problem, da der Kaliumspiegel bekanntlich in nahezu allen Flüssigkeitskompartimenten nach dem Tod rasch ansteigt. Einerseits ist der Nachweis von Kaliumvergiftungen als vorsätzliches Tötungsmittel zu beurteilen, andererseits kennt die forensische Praxis iatrogene Behandlungsfehler und akzidentelle Fehlinfusionen im Zusammenhang mit der Todesursache Hyperkaliämie. Es werden forensische Aspekte aus 3 klinischen

B. Mahfoud; A. Heinemann; J. Matschke; A. Gehl; F. Schulz; K. Püschel

2003-01-01

161

Epidemiology of iatrogenic facial nerve injury: A decade of experience.  

PubMed

OBJECTIVES/HYPOTHESIS: To determine the procedure-specific incidence, risk factors, and injury patterns in patients with iatrogenic facial nerve injury as seen at a tertiary care facial nerve center. STUDY DESIGN: Retrospective chart review. METHODS: Facial Nerve Center patient records from 2002 to 2012 were reviewed for cases of iatrogenic facial nerve injury. These were analyzed by type of inciting procedure, injury location, patient demographics, and referral pattern. RESULTS: Out of 1,810 patient records, 102 were identified that involved iatrogenic facial nerve injury. Oral and maxillofacial surgical procedures accounted for 40% of injuries, resections of head and neck lesions 25%, otologic procedures 17%, cosmetic procedures 11%, and other procedures 7%. The most common operation resulting in facial nerve injury was temporomandibular joint replacement. The most frequent pattern of injury was total hemifacial weakness. CONCLUSIONS: Iatrogenic facial nerve injury occurs most commonly in temporomandibular joint replacement, mastoidectomy, and parotidectomy. Direct visualization of the nerve may decrease the incidence of injury, and early referral for facial nerve exploration may result in improved outcomes. LEVEL OF EVIDENCE: 2b. Laryngoscope, 2013. PMID:23606475

Hohman, Marc H; Bhama, Prabhat K; Hadlock, Tessa A

2013-04-18

162

Radionuclide detection of iatrogenic arteriovenous fistulas of the genitourinary system  

Microsoft Academic Search

Radionuclide angiography is a valuable screening test for arteriovenous (AV) fistulas. Seven iatrogenic AV communications of the genitourinary system were initially diagnosed by radionuclide imaging, and untreated patients are being followed up by yearly nuclear examinations. Contrast arteriography is reserved for patients requiring interventional therapy and for symptomatic patients with a negative radionuclide study.

R. Lisbona; M. J. Palayew; R. Satin; B. B. Hyams

1980-01-01

163

Iatrogenic Arteriovenous Fistula After Revascularization of the Hand  

Microsoft Academic Search

This is the first report of an iatrogenic arteriovenous fistula complicating revascularization of an incomplete amputation of the hand, due to inadvertent anastomosis of the proximal radial artery to the distal cephalic vein. This resulted in a severely painful, massively swollen hand, which was initially diagnosed as an infection or poor venous outflow and eventually required a below-elbow amputation. This

Neil F. Jones; Erin E. Brown; Kayvan T. Khiabani

2005-01-01

164

Iatrogenic peritoneopericardial hernia following coronary artery bypass surgery  

Microsoft Academic Search

Intrapericardial diaphragmatic herniation of the stomach is reported in a patient who had undergone coronary artery bypass surgery 6 years earlier. The peritoneopericardial defect was iatrogenic and emphasizes the danger of inadvertent diaphragmatic injury during cardiac surgery. (Eur J Cardio-thorac Surg (1992) 6:156-1571

D. A. Waller; C. M. R. Satur; I. M. Mitchell; U. M. Sivanathan

1992-01-01

165

Successful Treatment of Duodenal Variceal Bleeding by Endoscopic Clipping  

PubMed Central

Duodenal varix bleeding is an uncommon cause of gastrointestinal bleeding in patients with portal hypertension but can cause severe and potentially fatal bleeding. However, the incidence is low and a good treatment method has not been well established yet. Duodenal variceal bleeding can be treated surgically or nonsurgically. We have successfully treated a patient with duodenal variceal bleeding secondary to liver cirrhosis using hemoclips to control the bleeding.

Park, Su Bin; Kim, Jin Hee; Lee, Hyun Jung; Jang, Sung Pil; Lee, Jae Nam; Hwang, Jong Ho

2013-01-01

166

Ipilimumab-induced Perforating Colitis.  

PubMed

Recently, a monoclonal antibody to cytotoxic T-lymphocyte-associated antigen 4, ipilimumab, was approved for the treatment of metastatic melanoma. One of the most common side effects associated with this therapy is diarrhea and colitis. We report 3 cases of perforating colitis induced by ipilimumab requiring colectomy. The histologic findings of mucosal biopsies have been previously described. Herein, we describe novel associated histologic findings (pseudopolyp formation, fissuring ulcers, dilated crypts, and lack of intraepithelial lymphocytosis and epithelial apoptosis) of segmental resections in patients who required subtotal colectomy after perforation due to the severity of their ipilimumab-induced colitis. Although steroid therapy is the standard treatment for ipilimumab-induced colitis, surgery may be necessary. In the setting of progressive or worsening diarrhea after steroid therapy in patients with colitis, bowel perforation should be considered. PMID:23632354

Mitchell, Kisha A; Kluger, Harriet; Sznol, Mario; Hartman, Douglas J

2013-10-01

167

Well perforating apparatus and method  

SciTech Connect

A method and apparatus for perforating a well casing and surrounding formation are disclosed. The perforating apparatus includes a laser source for projecting a high intensity laser beam transversely through the well bore and surrounding formation and a nozzle assembly for injecting exothermically reactive gas along the path of the laser beam. The gas stream shields the output lens of the laser while accelerating the rate of laser beam penetration. The laser beam is actuated as the exothermic gas is discharged through the nozzle during a penetrating cycle, and the laser beam is interrupted while the exothermic gas is discharged during a melt ejection cycle following the penetrating cycle. When the laser tool is used for perforating materials such as concrete, stone and sand which do not react exothermically with the gas, a fluxing agent is discharged into the flow path of the nozzle and is entrained by the exothermically reactive gas during the penetrating cycle.

Price, E.H.

1980-10-14

168

On demand cross web perforation  

US Patent & Trademark Office Database

A moving web is either perforated or cut using a knife cylinder having at least one blade, and an anvil cylinder having at least one raised anvil surface, and preferably a plurality (e.g. about 22) of alternating substantially uniform raised surfaces and depressions. The knife cylinder is substantially continuously rotated, and the anvil cylinder is substantially continuously rotated by a servo motor, which also positively controls the position of the anvil cylinder with respect to the knife cylinder to selectively either effect perforation or cutting of the web, or no perforation or cutting. Position controlling is typically accomplished by substantially constantly and instantly indexing the anvil cylinder in a reverse direction. Sensors may be utilized for sensing the locations of the knife and anvil cylinders and providing that information to a computer controller to facilitate indexing.

Harrod; Jimmie A. (Grand Island, NY); Bernard; Dennis R. (Amherst, NY)

1998-08-25

169

Spontaneous oesophageal perforations in a competitive swimmer  

PubMed Central

Oesophageal perforation is a rare but potentially life-threatening condition. We report a case of a young male athlete who presented to our unit with two separate areas of spontaneous oesophageal perforation.

Harries, R; Khan, A; Whiteley, G

2012-01-01

170

Duodenal pH in health and duodenal ulcer disease: effect of a meal, Coca-Cola, smoking, and cimetidine  

Microsoft Academic Search

Intraluminal duodenal pH was recorded using a combined miniature electrode and logged digitally every 10 or 20 seconds for five hours (basal\\/meal\\/drink) in eight control subjects and 11 patients with duodenal ulcer (five on and off treatment with cimetidine). Over the whole test there were no significant differences in duodenal mean pH or log mean hydrogen ion activity (LMHa) between

R F McCloy; G R Greenberg; J H Baron

1984-01-01

171

Appendix perforation by an intrauterine contraceptive device  

Microsoft Academic Search

Perforation of the uterus by an intrauterine contraceptive device (IUD) is a rare, and serious complication, occurring in 1\\/350 to 1\\/2500 insertions. Perforation by IUDs can involve several neighboring organs such as the bladder and rectosigmoid. We report two cases of IUD perforations involving the appendix, both inserted during lactation. The first case is an asymptomatic patient in early pregnancy

Eric Ohana; Eyal Sheiner; Elad Leron; Moshe Mazor

2000-01-01

172

A perforated diverticulum in Cushing's disease  

PubMed Central

We report a case of perforated colonic diverticulum in Cushing's disease. Although perforated diverticuli have been described in patients with Cushing's syndrome secondary to exogenous glucocorticoids, this complication has not been described in patients with Cushing's disease. Patients with hypercortisolism, from either exogenous or endogenous sources, should be monitored for diverticular perforation.

de Havenon, Adam; Ehrenkranz, Joel

2011-01-01

173

Perforation of honeycomb sandwich plates by projectiles  

Microsoft Academic Search

An analytical solution for the ballistic limit of a honeycomb plate subjected to normal impact by blunt and spherical projectiles is presented. The solution involves a three-stage, perforation process that results in complete perforation of the sandwich. Stages 1–3 describe perforation of the top facesheet, honeycomb core, and bottom facesheet, respectively. Residual velocities in Stages 1 and 2 are found

M. S. Hoo Fatt; K. S. Park

2000-01-01

174

Duodenal gastric heterotopia: further evidence of an association with fundic gland polyps.  

PubMed

Duodenal gastric heterotopia (DGH) is a common incidental finding at endoscopy, generally assumed to be congenital in origin. A recent study has suggested a possible association with gastric fundal gland polyps (FGPs). In this review of 37 patients with histologically confirmed DGH, the background to our present understanding of the DGH lesion is reviewed, the clinical and pathological associations of the condition in our cohort are identified, and the histological and immunohistochemical features of the DGH lesion are described. An association with the presence of FGPs is again demonstrated, whereas an inverse relationship with Helicobacter pylori is also shown. Immunohistochemical staining demonstrates that the fundic-type glands of DGH express the proton pump antigen (H(+)K(+)ATPase), whereas the overlying surface mucosa expresses the mucin profile of normal gastric-type mucosa (mucin-5AC positive, mucin-2 negative). DGH may represent a further component of the iatrogenic hypergastrinemia-related hypothesis for FGP development, although further study is required to confirm this. PMID:23063504

Conlon, Niamh; Logan, Elaine; Veerappan, Sundaram; McKiernan, Susan; O'Briain, Sean

2012-10-11

175

Gasdynamics of Perforated Muzzle Brakes.  

National Technical Information Service (NTIS)

In a study of perforated muzzle brakes, Nagamatsu, Choi, Duffy, and Carofano calculated the three-dimensional steady flow of a perfect gas through one vent hole and used the results to predict overall brake performance. The importance of the gas covolume ...

G. C. Carofano

1988-01-01

176

Tubal perforation by ESSURE microinsert  

Microsoft Academic Search

Female tubal sterilization remains the most widely used method of permanent contraception worldwide. Recent studies have shown the new sterilization technique by ESSURE microinsert to be an effective method with decided advantages for the patient in terms of morbidity associated to a quick recovery.We discuss the possible hysteroscopic signs of tubal perforation and the right measures to take if a

Véronique Thoma; Irene Chua; Olivier Garbin; Michel Hummel; Arnaud Wattiez

2006-01-01

177

BUBBLING FROM PERFORATED PLATES (thesis)  

Microsoft Academic Search

A 6-inch-square column was used to investigate certain operating ; characteristics of perforated plates. The amplitude and frequency of the ; pressure fluctuations in the chamber under the plates were studied. The ; timeaverage pressure drop across a plate and dumping rate of liquid through the ; holes were also investigated. Various gas-liquid systems were used to study the ;

1958-01-01

178

Perforated diverticulitis: a surgical dilemma.  

PubMed

Thirty-eight patients, 18 males and 20 females (mean age 61 years) have been operated on for perforated diverticulitis, over the past 14 years. We assigned the patients into stage A (n = 12) when the inflammation was confined to the mesosigmoid folds, stage B (n = 16) when an intraabdominal abscess was walled off and stage C (n = 10) when a generalized peritonitis had developed. Resection of the perforated sigmoid was carried out in 24 patients either as Hartmann's procedure (n = 18) or with primary anastomosis (n = 6). The mortality rate in this setting was 0.0% and 16.6% respectively. In 14 patients, no resection was carried out in 24 patients either drainage and colostomy (n = 10) or only drainage (n = 4) with corresponding mortality rate 30% and 25%. Mortality rate in relation to the stage was: Stage A 16.16%, Stage B 12.5% and Stage C 10%. The higher mortality rate in stage A and B was due to the fact that less radical operations were carried out. Four of our five deaths in all stages occurred in patients in whom the perforated sigmoid was not resected. In conclusion resection of the perforated sigmoid with or without primary anastomosis regardless of the stage of the disease is recommended. PMID:1577579

Smirniotis, V; Tsoutsos, D; Fotopoulos, A; Pissiotis, A C

179

Antro-pyloro-duodenal motor responses to gastric and duodenal nutrient in critically ill patients  

PubMed Central

Background: Gastric emptying is frequently delayed in critical illness which compromises the success of nasogastric nutrition. The underlying motor dysfunctions are poorly defined. Aims: To characterise antro-pyloro-duodenal motility during fasting, and in response to gastric and duodenal nutrient, as well as to evaluate the relationship between gastric emptying and motility, in the critically ill. Subjects: Fifteen mechanically ventilated patients from a mixed intensive care unit; 10 healthy volunteers. Methods: Antro-pyloro-duodenal pressures were recorded during fasting, after intragastric administration (100 ml; 100 kcal), and during small intestinal infusion of liquid nutrient (6 hours; 1 kcal/min). Gastric emptying was measured using a 13C octanoate breath test. Results: In healthy subjects, neither gastric nor small intestinal nutrient affected antro-pyloro-duodenal pressures. In patients, duodenal nutrient infusion reduced antral activity compared with both fasting and healthy subjects (0.03 (0–2.47) waves/min v 0.14 (0–2.2) fasting (p?=?0.016); and v 0.33 (0–2.57)/min in healthy subjects (p?=?0.005)). Basal pyloric pressure and the frequency of phasic pyloric pressure waves were increased in patients during duodenal nutrient infusion (3.12 (1.06) mm Hg; 0.98 (0.13)/min) compared with healthy subjects (?0.44 (1.25) mm Hg; p<0.02 after 120 minutes; 0.29 (0.15)/min; p?=?0.0002) and with fasting (?0.06 (1.05) mm Hg; p<0.03 after 160 minutes; 0.49 (0.13)/min; (p?=?0.0001). Gastric emptying was delayed in patients (gastric emptying coefficient 2.99 (0.2) v 3.47 (0.1); p?=?0.015) and inversely related to the number of pyloric pressure waves (r?=??0.563, p?=?0.029). Conclusions: Stimulation of pyloric and suppression of antral pressures by duodenal nutrient are enhanced in the critically ill and related to decreased gastric emptying.

Chapman, M; Fraser, R; Vozzo, R; Bryant, L; Tam, W; Nguyen, N; Zacharakis, B; Butler, R; Davidson, G; Horowitz, M

2005-01-01

180

Management of Biliary and Duodenal Complications of Chronic Pancreatitis  

Microsoft Academic Search

Biliary stricture and duodenal obstruction have been increasingly recognized as complications of chronic pancreatitis. The anatomical relationship of the distal common bile duct and the duodenum with the head of the pancreas is the main factor for their involvement in chronic pancreatitis. In hospitalized patients with pancreatitis, the incidence of biliary stricture and duodenal obstruction is reported to be about

Joseph D. Vijungco; Richard A. Prinz

2003-01-01

181

An unusual case of cystic dystrophy of the duodenal wall  

Microsoft Academic Search

Cystic dystrophy of the duodenal wall (CDDW) is an infrequent disease characterized by a chronic inflammation of the aberrant pancreatic tissue in the duodenal wall. A 60-year-old woman was admitted with several months of upper right abdominal discomfort, vomiting after meals and a 15kg weight loss. The diagnosis of a CDDW was initially suspected in an abdominal US examination, which

Vjacheslav I. Egorov; Grigory G. Karmazanovsky; Alexandr I. Schegolev; Julia A. Stepanova; Nina I. Yashina; Elena N. Solodinina

2007-01-01

182

Outcomes After Gastric Bypass and Duodenal Switch Surgery  

MedlinePLUS

... assigned by chance (“randomly assigned”) to undergo either gastric bypass surgery or duodenal switch surgery. Both procedures were done ... expect to see signi?cant weight loss with either gastric bypass or duodenal switch surgery. The decision about which procedure to use needs ...

183

Reflux of duodenal contents into the pancreatic duct of dogs.  

PubMed

Previously we demonstrated that postprandial duodenal pressure transiently exceeds pancreatic duct pressure in the dog. To determine whether this presure gradient causes reflux from the duodenum into the pancreatic duct, we provided each of five dogs with a permanent pancreatodochal catheter and three indwelling duodenal cutaneous catheters. 14C-PEG was infused through the proximal duodenal catheter; intraluminal pressures were monitored through the middle catheter at the level of the pancreatic duct orifice; and 15 cm abroad, duodenal contents were recovered from the third catheter. Fifteen-minute pooled samples were collected 1 hr preprandially and 2 hr postprandially from the pancreatic duct and duodenum and were analyzed for volume, lipase activity, and marker concentration. Reflux of duodenal contents occurred only in 10.8% of fasting periods but was observed in 38% of postprandial periods (p < 0.05). The total volume of duodenal content refluxed per 15 min approximated 0.1 ml and represented between 0.5% and 1% of total pancreatic volume flow and between 0.05% and 0.07% of total duodenal volume flow. Thus we have provided evidence that small amounts of duodenal contents may reflux into the pancreatic duct of dogs in our experimental model. This finding may be relevant to the pathogenesis of pancreatitis and pancreatic cancer. PMID:7419970

Hendricks, J C; DiMagno, E P; Go, V L; Dozois, R R

1980-11-01

184

Glycosaminoglycans from Ateroid ® and bovine duodenal mucosa and pancreas  

Microsoft Academic Search

Summary Glycosaminoglycans (GG) were isolated from commercial Ateroid® and compared with those from bovine duodenal mucosa and pancreas. The major GG in Ateroid® is heparin. Heparan sulfate (HS) and dermatan sulfate were also found. HS, chondroitin sulfates, and heparin were isolated from duodenal mucosa after papain digestion, but a residue, non-digestible, was mostly heparin. Pancreas contains very little GG, and

Parakkat Seethanathan; Edward Dalferes; B. S. Bhandaru Radhakrishnamurthy; Ronald Victor; Gerald S. Berenson

1975-01-01

185

Effect of fasting on rat duodenal and jejunal microvilli  

Microsoft Academic Search

Duodenal and jejunal ultrastructural morphology and total serum alkaline phosphatase (ALP) activity were investigated in Wistar rats submitted to normal feeding, a 24 h fasting without or with access to sawdust or expanded polystyrene, and a 22 h fasting followed by a 2 h refeeding. Ultrastructural observation of duodenal and jejunal villous tips showed the occurrence of degenerating epithelial cells

M. J. MARTINS; C. HIPÓLITO-REIS; I. AZEVEDO

2001-01-01

186

Isolated duodenal rupture due to blunt abdominal trauma  

Microsoft Academic Search

Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis

Atilla Celik; Ediz Altinli; Ender Onur; Aziz Sumer; Neset Koksal

187

A case of a duodenal duplication cyst presenting as melena  

PubMed Central

Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population, but seldom in adults. Symptoms depend on the type and location and can present as abdominal pain, distension, dysphagia or dyspepsia. They have been reported to be responsible for duodenal obstruction, pancreatitis and, in rare cases, gastrointestinal bleeding. We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena. Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus. However, the patient began passing melena after 3 d, with an acute decrease in hemoglobin levels. Subsequent studies revealed a duplication cyst in the second portion of the duodenum which was surgically resected. Histology revealed a duodenal duplication cyst consisting of intestinal mucosa. There was no further bleeding and the patient recovered completely. In rare cases, duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis.

Ko, Seung Yeon; Ko, Sun Hye; Ha, Sungeun; Kim, Mi Sung; Shin, Hyang Mi; Baeg, Myong Ki

2013-01-01

188

Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs  

PubMed Central

Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing’s syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP.

2012-01-01

189

Iatrogenic Cushing's syndrome with inhaled steroid plus antidepressant drugs.  

PubMed

Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing's syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP. PMID:22958272

Celik, Ozlem; Niyazoglu, Mutlu; Soylu, Hikmet; Kadioglu, Pinar

2012-08-29

190

Extensive Bilateral Intracranial Calcifications: A Case of Iatrogenic Hypoparathyroidism  

PubMed Central

This is a case of a 69-year-old male patient with long-standing iatrogenic hypoparathyroidism after total thyroidectomy. The clinical evaluation revealed mild neurological symptoms and excessive brain calcinosis. Intracranial calcification that affects structures other than the basal ganglia and the cerebellum is a rare manifestation of postoperative hypoparathyroidism. Detection of brain calcinosis in patients who had total thyroidectomy can motivate clinicians in further investigation of possible hypoparathyroidism with measurement of calcium and phosphorus serum levels.

Siatouni, Anna; Tsoukalos, Grigorios; Tavernarakis, Antonios; Gatzonis, Stylianos

2013-01-01

191

Iatrogenic intrapericardial diaphragmatic hernia diagnosed by cardiovascular magnetic resonance  

PubMed Central

Intrapericardial diaphragmatic hernias are very uncommon and are most typically caused by high-force blunt trauma. Other iatrogenic causes such as prior surgical formation of a pericardial window have been described, but are exceedingly rare. We present a case of an intrapericardial diaphragmatic hernia in a patient with a prior pericardial window in which the diagnosis was unclear using conventional imaging modalities, but was established using cardiovascular magnetic resonance.

2010-01-01

192

Human Thrombin Injection for the Percutaneous Treatment of Iatrogenic Pseudoaneurysms  

SciTech Connect

Purpose: Thrombin injection is becoming well established for the percutaneous management of iatrogenic pseudoaneurysms. All the published series to date use bovine thrombin,and there have been reports of adverse immunologic effects following its use. Our study aimed to assess the efficacy of human thrombin injection for pseudoaneurysm occlusion. Methods:Fourteen patients with iatrogenic pseudoaneurysms underwent a color Doppler ultrasound examination to assess their suitability for percutaneous human thrombin injection. Human thrombin 1000 IU was then injected into the pseudoaneurysm sac under sterile conditions and with ultrasound guidance. A further color Doppler ultrasound examination was performed 24 hr later to confirm occlusion. Results: All 14 pseudoaneurysms were successfully occluded by human thrombin injection. In two cases a second injection of thrombin was required,but there were no other complications, and all pseudoaneurysms remained occluded at 24 hr. Conclusion: Ultrasound-guided human thrombin injection is simple to perform, effective and safe. We recommend that human thrombin becomes the agent of choice for percutaneous injection into iatrogenic pseudoaneurysms.

Elford, Julian [Department of Radiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom); Burrell, Christopher [Department of Cardiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom); Freeman, Simon; Roobottom, Carl [Department of Radiology, DerrifordHospital, Plymouth PL6 8DH (United Kingdom)

2002-03-15

193

The role of gastric and duodenal pH in the cysteamine-induced duodenal ulcer in the rat.  

PubMed

Many secretory studies reported an increase in gastric acid secretion by the duodenal ulcerogen cysteamine. A detailed analysis of these experiments, especially the results from rats with chronic gastric fistula suggest that direct stimulation of gastric acid secretion may not be the primary mechanism of the duodenal ulcerogenic action of cysteamine. We used a different approach and measured the pH at the site of ulceration in the proximal duodenum. A duodenal ulcerogenic dose of cysteamine did not change the pH at the anterior or posterior wall of the duodenum during 4 hr. In the same dose and by the same route of administration, cysteamine nevertheless induced duodenal ulcers in 24 hr. These experiments demonstrate that in addition to the effect on gastric acid secretion, other factors are needed to the effect on gastric acid secretion, other factors are needed to explain the early duodenal ulcerogenic action of cysteamine. PMID:2596314

Kusterer, K; Rohr, G; Herrmann, W; Piplack, C; Schwedes, U; Usadel, K H; Szabo, S

1989-01-01

194

[Rectovaginal perforation in a child].  

PubMed

Rectal injuries are not frequent in children. The authors present the case of an 11-year-old girl with a perforation of the rectum and vagina after falling on the steel rod of a bicycle pedal. Perineal incision with the widening of the vaginal entrance enabled good surgical access and careful reconstruction of the perforations without having to perform a colostomy. The injury healed without infectious complications, rectovaginal fistula or incontinence. Current opinions on the treatment of rectal injuries with individual access are discussed. Primary repair without faecal diversion can be considered in selected stabilized patients fewer than 6-8 hours from the time of injury without serious contamination, tissue devastation and associated injuries. PMID:21755905

Tomcovcík, E; Rosocha, L; Morochovic, R; Burda, R; Kitka, M

2011-05-01

195

Aetiology of perforating eye injury.  

PubMed Central

This study addresses the aetiology of perforating ocular injury in childhood and possible preventive measures. Data have been collected from the case notes of 143 patients presenting over a 10 year period to a single ophthalmic unit. Injuries occurred most often in a domestic setting (34%) or with a child at play (19%) and showed an overall four to one ratio of boys to girls. Sports injuries accounted for 15% and assault for 8% of all injuries. A changing pattern of ocular injury is evident: road traffic accidents constituted 6% of injuries, compared with 31% in a similar study published in 1976. The role of litigation is discussed, particularly with regard to firearms, which accounted for 8% of injuries. It is concluded that the most important factor in the prevention of perforating ocular trauma is parental awareness, 53% of injuries occurring with the child in a domestic setting or at play.

Luff, A J; Hodgkins, P R; Baxter, R J; Morrell, A J; Calder, I

1993-01-01

196

Perforated Peptic Ulcer: new insights  

Microsoft Academic Search

Much has been written on perforated peptic ulcer (PPU) during the last hundred years.\\u000aIn 1500, when necropsies were first allowed, often a small hole was found in the\\u000aanterior wall of the stomach, giving an explanation for symptoms of acute abdominal\\u000apain, nausea, vomiting which often led to death within a few hours or days.\\u000aLaparoscopic surgery, also called

M. J. O. E. Bertloff

2011-01-01

197

Colonic perforation in Behcet's syndrome.  

PubMed

A 17-year-old gentleman was admitted to our hospital for headache, the differential diagnosis of which included Behcet's syndrome (BS). He developed an acute abdomen and was found to have air under the diaphragm on erect chest X-ray. Subsequent laparotomy revealed multiple perforations throughout the colon. This report describes an unusual complication of Behcets syndrome occurring at the time of presentation and a review of the current literature of reported cases. PMID:19030217

Dowling, Catherine-M; Hill, Arnold-Dk; Malone, Carmel; Sheehan, John-J; Tormey, Shona; Sheahan, Kieran; McDermott, Enda; O'Higgins, Niall-J

2008-11-14

198

Perforated plant vessel for epiphytes  

US Patent & Trademark Office Database

A perforated plant vessel that can be assembled by using plastic components including at least one base plate with insertion openings, apertures and lateral wall segments with insertion projections adapted to the insertion openings. The individual parts are well-suited to plants, visually attractive, can be stored easily and can be assembled in various shapes so as to form vessels of different sizes. The plant vessel is particularly suitable for epiphytes in living areas.

1990-10-16

199

Acute Duodenal Obstruction After Percutaneous Placement of Metallic Biliary Stents: Peroral Treatment with Enteral Stents  

SciTech Connect

Three patients with malignant biliary obstruction were treated with placement of metallic biliary stents. Two patients had known partial duodenal stenosis but had no symptoms of gastrointestinal obstruction. The patients developed symptomatic duodenal obstruction early after biliary metallic stent placement. The symptomatic duodenal obstructions were successfully treated with peroral placement of duodenal stents, which obviated the need for surgical intervention.

Lopera, Jorge E. [Louisiana State University, 1542 Tulane Avenue, New Orleans, LA 70112, Department of Radiology (United States)], E-mail: jloper@lsuhsc.edu; Alvarez, Oscar A. [Hospital Universitario San Vicente de Paul, Universidad de Antioquia, Medellin, Department of Gastroenterology (Colombia); Perdigao, Joseph; Castaneda-Zuniga, Wilfrido [Louisiana State University, 1542 Tulane Avenue, New Orleans, LA 70112, Department of Radiology (United States)

2003-09-15

200

Regulation of Duodenal Bicarbonate Secretion during Stress by Corticotropin-Releasing Factor and beta -endorphin  

Microsoft Academic Search

Proximal duodenal mucosal bicarbonate secretion is an important factor in the pathogenesis of duodenal ulcer disease. To examine the central nervous system regulation of duodenal bicarbonate secretion, an animal model was developed that allowed cerebroventricular and intravenous injections as well as collection of duodenal perfusates in awake, freely moving rats. The hypothalamic peptide corticotropinreleasing factor (CRF) and stress (physical restraint)

H. Jurgen Lenz

1989-01-01

201

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study  

PubMed Central

Introduction The objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis. Methods Data was collected prospectively for all peritonitis cases admitted in single surgical unit from January 2005 to December 2009. Parameters for calculating POSSUM were also retrieved; in these patients, O:E (Observed vs. Expected) ratio of mortality and morbidity were estimated after calculating predicted mortality and morbidity by exponential regression equations. Results 887 patients with peritonitis were admitted and treated in this unit during the 5 years of study period. Duodenal (n=431; 48%) followed by ileal (n=380; 42.8%) perforations were the commonest. Mean age of the patients was 34 years and 86% were males. Mean delay in presentation was 78.5 hrs. Mean duration of hospital and ICU stay was 13 and 7.2 days. Postoperative complications were seen in 481 (54%) patients, and 90 (10%) patients died. POSSUM scores and predicted mortality/morbidity were calculated in 380 patients of ileal perforation peritonitis; O:E ratio of mortality and morbidity were 0.47 and 0.85 in these patients. Conclusion POSSUM and P-POSSUM are accurate tools for predicting morbidity and mortality respectively in EP patients. Though they may sometime over or under predict morbidity as well as mortality.

Kumar, Sunil; Gupta, Amit; Chaudhary, Sujata; Agrawal, Neeraj

2011-01-01

202

A case of duodenal intramural metastasis from gastric cancer  

PubMed Central

INTRODUCTION Here, we report a case of duodenal intramural metastasis from gastric cancer, which is extremely rare. PRESENTATION OF CASE A 72-year-old man was admitted to our hospital with a chief complaint of lack of appetite in 2010. An endoscopic evaluation detected a Borrmann type 2 tumor occupying the lesser curvature of the gastric body and antrum, and pyloric stenosis. The patient underwent total gastrectomy. In an examination of the resected specimen, a type 2 tumor was identified in the middle gastric body and antrum, and a submucosal tumor was detected in the duodenal bulb. A histopathological examination demonstrated that the gastric tumor was not contiguous with the duodenal submucosal tumor. A microscopic examination demonstrated that the gastric tumor was a moderately to poorly differentiated adenocarcinoma and displayed lymphatic permeation. The duodenal submucosal tumor was also found to be an adenocarcinoma and was similar to the gastric tumor; therefore, we diagnosed the duodenal tumor as an intramural metastasis from gastric cancer. DISCUSSION The most common route of metastasis from gastric cancer involves hematogenous metastasis, lymph node metastasis, and peritoneal metastasis. Intramural metastasis from gastric cancer is rare and has been reported to be a variant of lymphogenic metastasis. The clinicopathological features of patients with duodenal intramural metastasis from gastric cancer are unclear because only one case of the condition has been reported. CONCLUSION Duodenal intramural metastasis from gastric cancer is an advanced form of cancer, and we suggest that it should be treated with surgical resection followed by adjuvant therapy.

Ito, Tomoaki; Sato, Koichi; Maekawa, Hiroshi; Sakurada, Mutsumi; Orita, Hajime; Kushida, Tomoyuki; Komatsu, Yoshihiro; Wada, Ryo

2013-01-01

203

Symptomatic duodenal Crohn's disease: Is strictureplasty the right choice?  

PubMed

Primary duodenal localization of Crohn's disease (CD) is rare. Medical therapy can control symptoms, but surgery is required when progressive obstructive symptoms occur. Surgical options include bypass, resection, or strictureplasty, but it is still not clear which should be the treatment of choice. Reviewing the medical records of 1253 patients undergoing surgery for CD between January 1986 and December 2011 at the Digestive Surgery Unit of the Department of Clinical Physiopathology of the University of Florence, 10 patients (6 males and 4 females) underwent operations for duodenal CD. Four patients had only a duodenal localization, 6 patients had synchronous involvement of other intestinal tracts. Strictures were distributed in all the duodenal portions: in 7 patients there were single lesions, in 3 patients there were multiple lesions. Eight patients were treated with strictureplasty: 5 with the Heineke-Mikulicz technique, 2 with Jaboulay, and 1 with a pedunculated jejunal patch. Two patients were treated with resection: one with a B2 gastro-duodenal resection, and 1 with a duodenal-jejunal resection and an end to side duodeno-jejunal anastomosis. Follow up of the patients was from 2 to 18years. No recurrence of duodenal CD was observed in the 2 patients treated with resection, while 2 of the 8 patients treated with strictureplasty had a recurrence. In our experience, strictureplasty is indicated when less than 2 strictures are present in the 2nd or 3rd duodenal portion. In cases with multiple strictures localized in the 1st or the distal duodenal portion, resection is preferable. PMID:23165121

Tonelli, Francesco; Alemanno, Giovanni; Bellucci, Francesco; Focardi, Adriana; Sturiale, Alessandro; Giudici, Francesco

2012-11-17

204

Duodenal Bleeding from Metastatic Renal Cell Carcinoma  

PubMed Central

Massive upper gastrointestinal bleeding due to malignancy is relatively uncommon and the duodenum is the least frequently involved site. Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. We report a case of intractable upper gastrointestinal bleeding from metastatic RCC to the duodenum. The patient presented with melena and anemia, 13 years after nephrectomy for RCC. On esophagogastroduodenoscopy, a submucosal mass was noted in the duodenum, biopsies of which revealed metastatic RCC. In conclusion, metastasis from RCC should be considered in nephrectomized patients presenting with gastrointestinal symptoms and a complete evaluation, especially endoscopic examination followed by biopsy, is suggested.

Rustagi, Tarun; Rangasamy, Priya; Versland, Mark

2011-01-01

205

Incidence of glove perforation during caesarean section.  

PubMed

A survey of glove perforation in 200 consecutive Caesarean sections (100 elective and 100 emergency) was undertaken. A total of 1276 gloves were tested for punctures after the end of the operation. Evidence of perforation of one or more gloves was found following 39 elective (234 gloves, 37.2%) and 43 emergency sections (290 gloves, 44.8%) (total 82, 41%). Only in 17 of these cases (20.7%) was it realised that a perforation had actually occurred. The surgeons were found to be significantly more at risk of perforation than the other members of the operating team. PMID:1814261

Arena, B; Maffulli, N; Vocaturo, I; Scognamiglio, G

1991-01-01

206

Spontaneous free perforation and perforated abscess in 30 patients with Crohn's disease.  

PubMed Central

Spontaneous free perforation is an uncommon event in the natural history of Crohn's disease. It occurred in 21 of 1415 patients (1.5%) admitted with Crohn's disease to The Mount Sinai Hospital between 1960 and 1983. The mean duration from onset of Crohn's disease to occurrence of perforation was 3.3 years. Ten patients had small bowel perforation, ten patients had large bowel perforation, and one patient had simultaneous perforation of both ileum and cecum. The incidence of perforation in disease segments of small bowel was 1.0% (jejunum 6.0%, ileum 0.7%), and in the colon, 1.3%. Besides the 21 patients with spontaneous free perforation, an additional nine patients had spontaneous free rupture of an abscess into the peritoneal cavity. The mean duration from onset of Crohn's disease to rupture of abscess was 8.5 years. All 30 patients had surgery within 24 hours of perforation or rupture. All 21 patients with spontaneous free perforations survived, as did all but one of the nine patients with perforated abscess. The cornerstone of the treatment of ileocolonic lesions perforating into the general peritoneal cavity is proximal diversion with delayed reconstruction of intestinal continuity whenever possible. With perforation of the small bowel, primary reanastomosis is possible in selected patients.

Greenstein, A J; Sachar, D B; Mann, D; Lachman, P; Heimann, T; Aufses, A H

1987-01-01

207

[Indirect forms of iatrogenic violence in clinical psychiatry].  

PubMed

The paper tries to describe often neglected forms of iatrogenic violence in clinical psychiatry. These examples are different from those forms of violent treatment in psychiatry, which are commonly known and discussed (medication, fixation, isolation). One aim of the paper is to emphasize determinants and modalities of emotional and verbal violence used without being noticed in clinical routine work. The idea is supported that the patient may voluntarily estimate his/her closeness to the therapist, who, on the other hand, should try to abandon therapeutic overactivity. An atmosphere should be established which allows the patient to refuse therapeutic offers without fear of revenge. PMID:3186857

Hinrichs, R

1988-09-01

208

An Iatrogenically Unmasked Life Threatening Disease: Brugada Syndrome  

PubMed Central

Brugada syndrome is a life threatening disease that is usually overlooked during emergency service admissions. It is characterized by typical electrocardiography resembling right bundle branch block, static or dynamic ST-segment elevation in leads V 1-3. There is familial tendency in some cases. A majority of patients have a structurally normal heart and are likely to remain asymptomatic, however they may present to emergency departments with syncope and various serious arrhythmias. Therefore it is crucially important for emergency medicine physicians not to omit this potential diagnosis. Herein we report a case with Brugada syndrome which was iatrogenically unmasked after propafenone administration for atrial fibrillation.

Oylumlu, Muhammed; Altunbas, Gokhan; Davutoglu, Vedat

2013-01-01

209

Iatrogenic injury from vascular access and endovascular procedures.  

PubMed

Endovascular procedures inevitably result in iatrogenic injury in a small percentage of patients. Appropriate choice of access site, careful technique, and selective use of closure devices may reduce the incidence of these complications. The vascular interventionalist should be able to recognize and manage various access site complications, such as pseudoaneurysm, arteriovenous fistula, and retroperitoneal hematoma. Procedural complications such as arterial dissection can often be repaired with endovascular techniques. Newer techniques such as totally percutaneous endovascular aneurysm repair have special considerations to minimize the risk of hemorrhage or limb ischemia. The purpose of this review is to define the more common endovascular complications, their diagnosis, and management. PMID:21986688

Tonnessen, Britt H

2011-06-01

210

Iatrogenic arteriovenous fistula of the superficial temporal artery  

Microsoft Academic Search

Introduction  The temporal artery courses superficially over the temporal bone and thus can be vulnerable to trauma. Although traumatic\\u000a lacerations of this vessel are indeed common, trauma-induced arteriovenous fistulae involving the temporal artery are relatively\\u000a rare. Arteriovenous fistulae caused by iatrogenic injury to the temporal artery are rarer still.\\u000a \\u000a \\u000a \\u000a Discussion and conclusion  We report a case of an ateriovenous fistula involving the

Grzegorz Miekisiak; Maciej Mis; Adam Sandler; Adam Druszcz

2008-01-01

211

Hypercalcemia in a dog with resolution of iatrogenic Cushing's syndrome.  

PubMed

A six-year-old spayed Pug was presented with crust formation and ulcer on the skin. The patient had received long-term glucocorticoid therapy for treatment of tentatively diagnosed panniculitis. Severe calcification and pyoderma was observed and the patient was diagnosed with iatrogenic Cushing's syndrome and predonisolone was gradually withdrawn. After the withdrawal, the patient developed marked hypercalcemia (15.3 mg/dl) and finally died from renal failure. It is postulated that the eluted calcium from the calcified lesions may have contributed to the high serum calcium level as the underlying disease was not identified on necropsy. PMID:15107569

Nakamura, Momoko; Kawamura, Yuko; Minegishi, Michiyo; Momoi, Yasuyuki; Iwasaki, Toshiroh

2004-03-01

212

Iatrogenic choroidal neovascularization following idiopathic epiretinal membrane peel  

PubMed Central

Summary Choroidal neovascularization is an uncommon complication of macular surgery. The functional outcome is poor despite various treatment options, including laser photocoagulation, photodynamic therapy, and a variety of surgical procedures. We report a case of iatrogenic choroidal neovascularization in a 69-year-old woman at the site of inadvertent retinal trauma 5 weeks after an epiretinal membrane peel. Visual acuity was 6/15 at the time of diagnosis. Four intravitreal bevacizumab injections were administered over a period of 6 months; treatment was discontinued when a disciform scar was noted. At last follow-up, 21 months after surgery, the patient’s visual acuity was counting fingers.

Goh, Yi Wei; Ehrlich,, Rita; Welch, Sarah

2013-01-01

213

Gene expression and gene therapy in experimental duodenal ulceration  

Microsoft Academic Search

Gastroduodenal ulceration is still poorly understood and changes in gene expression may provide new mechanistic insights. Previously, we demonstrated that angiogenic growth factors are potent ulcer healing agents, and the synthesis of bFGF, PDGF and VEGF is enhanced early in duodenal ulcer healing. The initial molecular event in duodenal ulceration seems to be the organ-specific early release of ET-1 in

Sandor Szabo; Xiaoming Deng; Tetyana Khomenko; Masashi Yoshida; Martin R Jadus; Zsuzsa Sandor; Zoltan Gombos; Hiroko Matsumoto

2001-01-01

214

Relief of duodenal ulcer sysmptons by oral metiamide.  

PubMed Central

Thirty patients with symptoms of duodenal ulceration were treated for five to eight weeks in a double-blind trial with either metiamide 1 g daily by mouth or a placebo. In the 15 patients receiving metiamide there were significant reductions in nocturnal pain and antacid consumption. Daytime pain was diminished. The results suggest that histamine H2-receptor antagonists are likely to be useful in the medical management of the symptoms of duodenal ulceration.

Pounder, R E; Williams, J G; Milton-Thompson, G J; Misiewicz, J J

1975-01-01

215

Iatrogenic hyperadrenocorticism in a cat following a short therapeutic course of methylprednisolone acetate  

Microsoft Academic Search

Iatrogenic hyperadrenocorticism (or iatrogenic Cushing's syndrome) is an adrenal disorder that may result from long-term administration of glucocorticoids for therapeutic purposes, most often given to treat allergic or immune-mediated disorders. Prolonged treatment with synthetic glucocorticoids can suppress hypothalamic corticotrophin releasing hormone and plasma adrenocorticotrophic hormone (ACTH), thus causing a functional inactivity of the adrenal cortex. The result is a clinical

L Ferasin

2001-01-01

216

Effect of the hexapeptide dalargin on ornithine decarboxylase activity in the duodenal mucosa of rats with experimental duodenal ulcer  

SciTech Connect

The authors study the effect of dalargin on ornithine decarboxylase in homogenates of the duodenal ulcer from rats with experimental duodenal ulcer induced by cysteamine. Activity of the enzyme was expressed in pmoles /sup 14/CO/sub 2//mg protein/h. Protein was determined by Lowry's method. The findings indicate that stimulation of ornithine decarboxylase and the antiulcerative effect of dalargin may be due to direct interaction of the peptide with cells of the intestinal mucosa and with enterocytes.

Yarygin, K.N.; Shitin, A.G.; Polonskii, V.M.; Vinogradov, V.A.

1987-08-01

217

A hypervelocity projectile launcher for well perforation  

Microsoft Academic Search

Current oil well perforation techniques use low- to medium-velocity gun launchers for completing wells in soft rock. Shaped-charge jets are normally used in harder, more competent rock. A launcher for a hypervelocity projectile to be used in well perforation applications has been designed. This launcher will provide an alternative technique to be used when the conventional devices do not yield

L. E. Fugelso; J. N. Albright; G. C. Langner; K. L. Burns

1989-01-01

218

Analysis and evaluation of perforating cleanup methods  

Microsoft Academic Search

Fifty-two completions made in the Gulf of Mexico between June 1978 and May 1982 have been analyzed to evaluate three commonly used techniques for perforating and cleaning up perforations before gravel packing. Since detailed flowing bottomhole pressure (BHP) information was not available in all cases, a method was developed to evaluate the completion efficiencies by using an inhouse computer program.

J. M. Bonomo; W. S. Young

1985-01-01

219

The incidence and the risk factors for iatrogenic retinal breaks during pars plana vitrectomy  

PubMed Central

Purpose To establish the frequency and the risk factors for iatrogenic retinal breaks during three-port pars plana vitrectomy (PPV). Methods A total of 2471 PPV operations were included in the study. The study period was between 2001 and 2010, all the data were entered in an electronic patient record database. All 270 consecutive eyes of 270 patients developing iatrogenic retinal breaks during primary PPV were matched to 270 controls. Univariate and multivariate analysis were performed to establish the risk factors. Results The median age of the patients with iatrogenic breaks was 60.06 years; male to female ratio was 140/130. The overall frequency of iatrogenic retinal breaks was 10.09%. The frequency of iatrogenic retinal breaks for eyes undergoing PPV for tractional retinal detachment (TRD) was 32.45%. The lens status was phakic in 79.6% of the eyes, with iatrogenic breaks compared with 34.4% of the eyes in control group (P<0.001). Posterior vitreous was attached in 58.9% of the eyes with iatrogenic breaks compared with 50.4% of the eyes in control group (P=0.04). Internal limiting, epiretinal, proliferative, or fibrovascular membrane removing manoeuvers were performed in 71.1% of the eyes with iatrogenic breaks compared with 61.9% of the eyes in control group (P=0.052). Conclusion Eyes undergoing PPV for TRD had significantly higher frequency of iatrogenic retinal breaks compared with other subgroups (P=0.0001). Phakia and absence of PVD were found to be risk factors for iatrogenic retinal breaks.

Dogramaci, M; Lee, E J K; Williamson, T H

2012-01-01

220

Induction of iatrogenic electrocardiographic patterns during electrophysiologic studies.  

PubMed

Indwelling cardiac catheters by producing local mechanical stimulation or trauma can induce electrocardiographic (ECG) patterns which simulate known electrophysiologic phenomena. Catheter-induced ECG patterns were analyzed in 447 consecutive patients undergoing electrophysiologic studies. Iatrogenic nature of these patterns was suggested by 1) absence prior to placement of catheter; 2) sudden appearance with catheter placement and disappearance with catheter repositioning; 3) reoccurrence with remanipulation of catheters; and 4) simulation (in some cases) by programmed electrical stimulation from the catheter. Common catheter-induced patterns were 1) right bundle branch block (RBBB) lasting less than 24 hours occurred in 19 patients; 2) transient third degree atrioventricular block in His-Purkinje system developed in 3/13 patients with pre-existing left BBB; 3) catheter-induced ventricular pre-excitation which simulated ECG patterns of type B Wolff-Parkinson-White syndrome; 4) fortuitous synchronization of right ventricular excitation from the catheter, and left ventricular excitation from sinus beat resulted in normalization of the QRS complexes in 5/68 patients with pre-existing RBBB; 5) premature beats from the atria, right ventricle, and His bundle, which were common, resulted in complex ECG patterns. These iatrogenic ECG patterns must be identified in order to avoid errors in interpretation. PMID:862172

Akhtar, M; Danato, A N; Gilbert-Leeds, C J; Batsford, W P; Reddy, C P; Gomes, J A; Calon, A H; Dhatt, M S

1977-07-01

221

[Iatrogenic laryngotracheal stenosis. Our therapeutic experience apropos of 25 cases].  

PubMed

The authors report 25 cases of iatrogenous laryngotracheal stenosis seen at the university hospital IBN Rochd of Casablanca these stenosis are frequent as well as in infant as (12 cases) as in males (10 cases) they are the consequence of prolonged intubation in cases of coma (12 cases) of traumatic intubation (10 cases) but also after laryngeal irradiation (2 cases) or partial laryngeal surgery (1 case). The seat of stenosis is laryngeal (56%) laryngotracheal (36%) and tracheal (8%). The treatment of these stenosis is difficult; our patients are usually tracheotomised (63.6%) with extensive stenosis. The treatment has used this rilling with laser (12 cases) an endoscopic microsurgery (4 cases) and open surgery 2 times. The dilatation by mean of Montgomery tube or by Traissac tube is often irispensable to avoid relapses. The results are favorable in spite of the length of the treatment (10 days to 30 months) with 15 succesS and 7 partial failures. The authors underline the stenagenous risk of intubations and tracheotomies and on the rules to prevent these iatrogenous laryngo-tracheal stenosis. PMID:2055987

Touhami, M; Moumen, M

1991-04-01

222

Endovascular Management of Iatrogenic Native Renal Arterial Pseudoaneurysms  

SciTech Connect

Purpose: Our purpose was to evaluate iatrogenic renal pseudoaneurysms, endovascular treatment, and outcomes. Methods: This retrospective study (2003-2011) reported the technical and clinical outcomes of endovascular therapy for renal pseudoaneurysms in eight patients (mean age, 46 (range 24-68) years). Renal parenchymal loss evaluation was based on digital subtraction angiography and computed tomography. Results: We identified eight iatrogenic renal pseudoaneurysm patients with symptoms of hematuria, pain, and hematoma after renal biopsy (n = 3), surgery (n = 3), percutaneous nephrolithotomy (n = 1), and endoscopic shock-wave lithotripsy (n = 1). In six patients, the pseudoaneurysms were small-sized (<20 mm) and peripherally located and were treated solely with coil embolization (n = 5). In one patient, coil embolization was preceded by embolization with 500-700 micron embospheres to control active bleeding. The remaining two patients had large-sized ({>=}50 mm), centrally located renal pseudoaneurysms treated with thrombin {+-} coils. Technical success with immediate bleeding cessation was achieved in all patients. There were no procedure-related deaths or complications (mean follow-up, 23.5 (range, 1-67) months). Conclusions: Treatment of renal pseudoaneurysms using endovascular approach is a relatively safe and viable option regardless of location (central or peripheral) and size of the lesions with minimal renal parenchymal sacrifice.

Sildiroglu, Onur; Saad, Wael E.; Hagspiel, Klaus D.; Matsumoto, Alan H.; Turba, Ulku Cenk, E-mail: Turba@me.com [University of Virginia Health System, Department of Radiology (United States)

2012-12-15

223

Evaluation of nasal mucociliary activity in iatrogenic hypothyroidism.  

PubMed

Our aim was to evaluate the effects of iatrogenic, acute and deep hypothyroidism on nasal mucociliary clearance. A total of 46 patients undergoing total or near total thyroidectomy for differentiated thyroid cancer between March and June 2012, and scheduled to undergo radioactive iodine (I-131) ablation therapy followed with an induced hypothyroidism for routine screening were included in the study. Mucociliary clearance test was made during hypothyroid and euthyroid periods in all the patients included in the study. Of the 46 patients included in the study, 37 (%80.4) were females, 9 (%19.6) were males, and the average mucociliary clearance times were 16.78 and 9.58 min during hypothyroid and euthyroid periods, respectively. When the results were compared statistically, mucociliary clearance time measured during hypothyroidism period was found to be significantly longer than the one measured during euthyroid period. Mucociliary clearance time was found to be long during iatrogenic acute and deep hypothyroid periods. During these periods, patients should be followed closely for lower and upper respiratory tract infections. PMID:23519683

Uysal, Ismail Onder; Gökak?n, Ali Ka?an; Karaku?, Canan Filiz; Deveci, Köksal; Hasbek, Zekiye; Sancakdar, Enver

2013-03-22

224

Extreme overbalance perforating improves well performance  

SciTech Connect

The application of extreme overbalance perforating, by Oryx Energy Co., is consistently outperforming the unpredictable, tubing-conveyed, underbalance perforating method which is generally accepted as the industry standard. Successful results reported from more than 60 Oryx Energy wells, applying this technology, support this claim. Oryx began this project in 1990 to address the less-than-predictable performance of underbalanced perforating. The goal was to improve the initial completion efficiency, translating it into higher profits resulting from earlier product sales. This article presents the concept, mechanics, procedures, potential applications and results of perforating using overpressured well bores. The procedure can also be used in wells with existing perforations if an overpressured surge is used. This article highlights some of the case histories that have used these techniques.

Dees, J.M.; Handren, P.J. [Oryx Energy Co., Dallas, TX (United States)

1994-01-01

225

Method of opening cased well perforation  

SciTech Connect

This patent describes a method of opening perforations in a cased well flow, the cased well having a maximum safe wellhead, using a treating fluid and perforation sealers. It comprises determining the number of perforations in the casing which have already been opened by injection of treating fluid into the well but have not yet been and establishing a treating fluid flow rate such that the treating fluid flows through the already opened perforations which have not yet been sealed at a velocity which is at least as high as the minimum effective sealing velocity but the maximum safe well head pressure will not be exceeded when the next of the already opened perforations which have not yet been sealed is sealed.

McMechan, D.E.

1992-05-19

226

Cryo perforator surgery with a diamond dust-coated cryoprobe.  

PubMed

This study was conducted to determine the efficacy of cryoperforator surgery in the treatment of incompetent perforating veins with a diamond dust coated cryoprobe. Eleven patients with clinical severity class C2-C4 were enrolled in this study. Under local anesthesia, incompetent perforating veins were duplex guided treated with a diamond dust coated cryoprobe. Duplex scan was performed 4 weeks after treatment. Eleven patients with 15 incompetent perforating veins were treated with cryoperforator surgery. Distribution of incompetent perforating veins was as follows: thigh perforator, 6; leg perforators, 9. Median diameter was 4mm (range = 2.0-6.2 mm). Follow-up showed successful treatment of 3 incompetent perforating veins (20%). Distribution of perforating veins in successful treatment: thigh perforator, 1; leg perforator, 2. This study showed that cryoperforator surgery is not feasible for treatment of incompetent perforating veins. The procedure is difficult and painful with a disturbing success rate and it should be considered obsolete. PMID:20538731

Klem, Taco Marius Adrianus Leonardus; van der Ham, Arie; van Brussel, Jerome; Wittens, Cees

2010-06-10

227

Surface studies of duodenal lesions induced by thoracic irradiation  

SciTech Connect

Acute duodenal ulcers are produced in mice as a remote (abscopal) effect of irradiation to the lower mediastinum. Such lesions have been examined with scanning electron microscopy at 5, 8 and 28 days after irradiation with 18 Gy of X-rays. All the ulcers occur within the first 1 cm long segment of the duodenum which is endowed with Brunner's glands. The single lesions vary in size, shape and position. The damaged area often includes much of the duodenal circumference and is distinguished by conical or rudimentary villi, or even by the complete absence of villi. In contrast, around the periphery of the ulcer the villi are mostly vertical. Although the floor of these lesions appears to be covered with a continuous epithelial layer, during the first 4 weeks after irradiation the severity of the focal duodenal damage seems to increase gradually with time. The lesions have been compared with specimens from unirradiated mice and also with samples taken 3 days after partial thoracic irradiation when little damage is seen. The pattern of fully developed duodenal lesions differs greatly from that seen after direct irradiation where damage has not included localised ulceration in the samples of jejunum so far examined. The lesions induced by partial thoracic irradiation may be related to radiation injury to vascular or autonomic nerve targets in the lower mediastinum. Such injury could result in malfunction of the pyloric sphincter or could alter the secretion by Brunner's glands and thus lead to duodenal ulceration.

Carr, K.E.; Ellis, S.; Michalowski, A.

1986-01-01

228

Chemical process for backsurging fluid through well casing perforations  

Microsoft Academic Search

A chemical process for initiating a backsurging of fluid through well casing perforations and perforation tunnels that interconnect a wellbore with a subterranean reservoir are described. A chemically delayed gas-generating aqueous liquid solution is injected through the well conduits, perforations and perforation tunnels and into the reservoir. The injected solution contains the following: 1) at least one compound which has

E. A. Richardson; R. F. Sheuerman; D. C. Berkshire

1980-01-01

229

Syndrome d’Ehlers-Danlos révélé par une perforation sigmoïdienne  

Microsoft Academic Search

We report a case of colonic perforation revealing Ehlers –Danlos syndrom type IV in a male adult. This syndrom is a heritable disorder of collagen synthesis. Its prognosis is severe resulting in vascular rupture or bowel perforation. In his surgical strategy, the surgeon has to cope with the recurrent feature of the colonic perforation. In order to prevent other perforations,

S. Bedda; A. Radovanovic; A. Fajardy; N. Bataille; T. Montariol

2005-01-01

230

"Murder!" she said: a case of iatrogenic delirium.  

PubMed

This case study discusses the psychotherapy of an elderly woman who presented with anxiety and depression manifest by psychosomatic symptoms. At the termination of what had appeared to be a successfully completed therapy, the patient revealed a longheld secret. An iatrogenic delirium resulted in the patient's having "witnessed a murder." Unaddressed and unresolved feelings of anger, shame, and guilt led to years of anguish. This study illustrates the destructive potential of secrecy in both personal and professional relationships. It emphasizes the importance of the nurse's role in acquiring and applying knowledge of pharmacology, especially as it applies to the elderly; the need to discuss delirious episodes without delay; the wisdom of listening to a person's story as a lived experience; the value of applying the nursing process toward problem resolution; and the benefit of providing holistic nursing care. PMID:7706061

Edmands, M S

231

Assessment and management of pediatric iatrogenic medical trauma.  

PubMed

Medically ill children are often exposed to traumatizing situations within the medical setting. Approximately 25-30 % of medically ill children develop posttraumatic stress symptoms and 10-20 % of them meet criteria for posttraumatic stress disorder. Parents of medically ill children are at even higher risk for posttraumatic stress symptoms. Most children and parents will experience resolution of mild trauma symptoms without formal psychological or psychiatric treatment. Posttraumatic stress symptoms are associated with medical nonadherence, psychiatric co-morbidities, and poorer health status. Therefore, evidenced-based trauma-focused treatment is indicated for those who remain highly distressed or impaired. This paper reviews approaches to the assessment and management of pediatric iatrogenic medical trauma within a family-based framework. PMID:23307562

Forgey, Marcy; Bursch, Brenda

2013-02-01

232

Iatrogenic vertebral artery pseudoaneurysm due to central venous catheterization  

PubMed Central

Central venous lines have become an integral part of patient care, but they are not without complications. Vertebral artery pseudoaneurysm formation is one of the rarer complications of central line placement. Presented is a rare case of two pseudoaneurysms of the vertebral and subclavian artery after an attempted internal jugular vein catheterization. These were successfully treated with open surgical repair and bypass. Open surgical repair remains the gold standard of treatment. Endovascular repair of vertebral artery pseudoaneurysms has been described with promising outcomes, but long-term results are lacking. Ultimately, the best treatment of these iatrogenic injuries should start with prevention. Well-documented techniques to minimize mechanical complications, including inadvertent arterial puncture, should be practiced and taught in training programs to avoid the potentially devastating consequences.

Vasquez, Jay

2011-01-01

233

Complexity of non-iatrogenic ureteral injuries in children: single-center experience  

Microsoft Academic Search

Purpose  Non-iatrogenic ureteral injuries in children are rare. Only sparse literature reports are available regarding management and\\u000a outcome. We reviewed our experience in diagnosis and treatment of complex non-iatrogenic ureteral injuries in children.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  From 2000 to 2010, children who were treated for non-iatrogenic ureteral injuries were reviewed. Patients’ characteristics,\\u000a mechanism of trauma, affected ureteral segment, time of recognition, associated

Tamer E. Helmy; Osama M. Sarhan; Ahmed M. Harraz; Mohamed Dawaba

2011-01-01

234

Effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer  

Microsoft Academic Search

AIM: To investigate the effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer. METHODS: Sprague-Dawley rats were randomly divided into four groups: sham operation without ginkgo, sham operation with ginkgo, duodenal ulcer without ginkgo, and duodenal ulcer with ginkgo. Rats with duodenal ulcer were induced by 500 mL\\/L acetic acid. Rats with ginkgo were intravenously injected

Jane C.-J. Chao; Huei-Chen Hung; Sheng-Hsuan Chen; Chia-Lang Fang

2004-01-01

235

Duodenal varices successfully treated with cyanoacrylate injection therapy  

PubMed Central

Duodenal varices are a rare complication of portal hypertension secondary to liver cirrhosis. Compared to oesophageal varices, they bleed less often but are also more difficult to diagnose and treat. There is no established treatment for bleeding duodenal varices and different treatment strategies have been employed with variable results. The authors present a case of 52-year-old male who was admitted with melaena. Upper gastrointestinal endoscopy was performed which identified bleeding varices in the second part of duodenum. The varices were injected with cyanoacrylate and the outcome was favourable. Subsequent endoscopies showed complete resolution of the varices. The authors conclude that cyanoacrylate injection is an effective first-line treatment for bleeding duodenal varices.

Malik, Ahsan; Junglee, Naushad; Khan, Anwar; Sutton, Jonathon; Gasem, Jaber; Ahmed, Waqar

2011-01-01

236

A Rare Cause of Acute Pancreatitis: Intramural Duodenal Hematoma  

PubMed Central

We describe an interesting case of intramural duodenal hematoma in an otherwise healthy male who presented to emergency room with gradually progressive abdominal pain, nausea, and vomiting. This condition was missed on initial evaluation and patient was discharged from emergency room with diagnosis of acute gastritis. After 3 days, patient came back to emergency room and abdominal imaging studies were conducted which showed that patient had intramural duodenal hematoma associated with gastric outlet obstruction and pancreatitis. Hematoma was the cause of acute pancreatitis as pancreatic enzymes levels were normal at the time of first presentation, but later as the hematoma grew in size, it caused compression of pancreas and subsequent elevation of pancreatic enzymes. We experienced a case of pancreatitis which was caused by intramural duodenal hematoma. This case was missed on initial evaluation. We suggest that physicians should be more vigilant about this condition.

Goyal, Hemant; Singla, Umesh; Agrawal, Roli R.

2012-01-01

237

Experimental Study of Perforated Muzzle Brakes.  

National Technical Information Service (NTIS)

A firing test was conducted to examine the recoil efficiency and blast characteristics of perforated muzzle brakes fitted to a 20-mm cannon. Recoil impulse blast overpressures, muzzle velocity, sequential spark shadowgraphs, and photographs of the muzzle ...

R. E. Dillon H. T. Nagamatsu

1984-01-01

238

Tuberculous perforation of the small bowel.  

PubMed Central

Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended.

Aston, N. O.; de Costa, A. M.

1985-01-01

239

Fracture strength in randomly perforated plates  

NASA Astrophysics Data System (ADS)

We have measured the forces that need to be applied quasistatically to randomly perforated rectangular aluminum plates to tear them apart. Concomitantly, for identical geometrical structures, we have carried out numerical simulations of the tearing process. The two results agree quite reasonably, and especially so for perforated area densities (P) that are rather less than the critical percolation densities. A given value of P can be achieved through various different realizations (patterns of perforations), each with a somewhat different fracture (or failure) strength F. Our results predict empirically an ``expected F'' [F(P)] and an expected standard deviation [root variance, S(P)] as functions of P. This enables the risk analysis of failures in plates under tensile stress, which is needed in, e.g., the estimation of the flying safety of a spacecraft subject to multiple perforations.

Yanay, Y.; Goldsmith, A.; Siman, M.; Englman, R.; Jaeger, Z.

2007-05-01

240

[Perforated diverticulitis of the sigmoid. Our experience].  

PubMed

The authors report their experience on sigma acute perforated diverticulitis. They affirm that best results are obtained with a surgical treatment "case for case" depending to anatomopathologic pattern, patient age and his general conditions. PMID:1484981

Degli Albizi, S; Terzi, G; Durzi, S; Pillitu, A; Menghini, L; Carletti, N

241

Evidence for acid-induced loss of Cdx2 expression in duodenal gastric metaplasia  

Microsoft Academic Search

Gastric metaplasia in the duodenum (GMD) is characterized by transdifferentiation of intestinal epithelial cells into gastric foveolar cells within the duodenal mucosa. GMD is often associated with duodenal ulceration. Higher duodenal acidity due to increased gastric acid output into the duodenum has been implicated in the development of GMD. Intestinal development and homeostasis are controlled by the homeobox transcription factor

Gerhard Faller; Arno Dimmler; Tilman Rau; Simone Spaderna; Falk Hlubek; Andreas Jung; Thomas Kirchner; Thomas Brabletz

2004-01-01

242

Duodenal Acid Clearance in Humans: Observations Made with Intraluminal Impedance Recording  

Microsoft Academic Search

Duodenal acid clearance appears to be involved not only in the pathogenesis of duodenal ulcer disease but also in functional dyspepsia. Duodenal contractile activity can help to maintain neutral pH in the duodenum by mixing acid with bicarbonate or by aborally transporting the acid load. Intraluminal impedance recording, allowing the detection of nonacid liquid boluses, can be carried out concomitantly

Guillaume Savoye; Jac Oors; ANDR ´ E SMOUT

2005-01-01

243

A parametric study of perforated muzzle brakes  

NASA Astrophysics Data System (ADS)

A firing test was conducted to study the parameters influencing the recoil efficiency and the blast characteristics of perforated muzzle brakes. Several scaled (20 mm) devices were tested as candidates for the 105 mm Armored Gun System (AGS). Recoil impulse, blast overpressures, muzzle velocity, sequential spark shadowgraphs, and photographs of the muzzle flash were obtained. A total of nine different perforated brakes were tested as well as a scaled M 198 double muzzle brake.

Dillon, Robert E., Jr.; Nagamatsu, H. T.

1993-07-01

244

Impact perforation of sandwich panels with Coremat®  

Microsoft Academic Search

Analytical solutions for the quasi-static and low-velocity perforation of sandwich panels with woven roving E-glass\\/vinyl ester facesheets and Coremat were derived. A multi-stage perforation process involving delamination, debonding, core shear fracture and facesheet fracture was used to predict the quasi-static failure load and ballistic resistance of the panel. The high core-crushing resistance and damping of the Coremat resulted in rupture

Michelle S. Hoo Fatt; Dushyanth Sirivolu

2009-01-01

245

Flexural properties of grooved perforation sandwich composites  

Microsoft Academic Search

Selecting H-60 PVC foam, four-axis E-glass non-woven fabric and vinyl resin, a type of innovative reinforced sandwich composite\\u000a as grooved perforation sandwich (GPS) were fabricated by VIMP. The interfacial structure between the face and core of the\\u000a sandwich is innovative because of the acuminate grooves in both sides of foam core and the holes perforated along core’s height.\\u000a The fabrication

Hai Fang; Weiqing Liu; Weidong Lu; Li Wan

2010-01-01

246

Right-sided sigmoid diverticular perforation.  

PubMed

Diverticulosis is a common disorder among geriatric patients, of whom 10% to 25% go on to develop diverticulitis. Known complications of diverticulitis include formation of phlegmon, fistula, bowel obstruction, bleeding, perforation, and colonic abscess. A less common complication is perforation with formation of an extra-abdominal necrotizing abscess. This case is a report of an 83-year-old female who presented to the emergency department with a necrotizing abdominal wall abscess secondary to right-sided diverticular microperforation. PMID:22461936

Little, Andrew; Culver, Andy

2012-02-01

247

Right-Sided Sigmoid Diverticular Perforation  

PubMed Central

Diverticulosis is a common disorder among geriatric patients, of whom 10% to 25% go on to develop diverticulitis. Known complications of diverticulitis include formation of phlegmon, fistula, bowel obstruction, bleeding, perforation, and colonic abscess. A less common complication is perforation with formation of an extra-abdominal necrotizing abscess. This case is a report of an 83-year-old female who presented to the emergency department with a necrotizing abdominal wall abscess secondary to right-sided diverticular microperforation.

Little, Andrew; Culver, Andy

2012-01-01

248

Perforating techniques for maximizing well productivity  

SciTech Connect

This paper describes the various combinations of perforating guns and techniques that are in common use, with the advantage and disadvntages of each. The four basic performance parameters, i.e., shot density, perforation diameter, penetration depth, and gun phasing, are ranked in order of relative importance for natural, sand-control, and stimulated completions. Where justified, the author makes recommendations and draws conclusions as to appropriate action. 11 refs.

Bell, W.T.

1982-01-01

249

Ileal perforation due to cytomegalovirus infection.  

PubMed Central

This article reports a case of cytomegalovirus (CMV) ileitis with perforation in a woman with transfusion-acquired human immunodeficiency virus (HIV) infection. The clinical problem of small bowel perforation due to CMV disease in association with HIV infection is emphasized. Typically, a patient with a history of chronic diarrhea, fever, and abdominal pain develops the superimposed picture of an acute abdomen and has pneumoperitonium on radiograph. The prognosis is poor.

Meza, A. D.; Bin-Sagheer, S.; Zuckerman, M. J.; Morales, C. A.; Verghese, A.

1994-01-01

250

Duodenal rupture secondary to blunt trauma from a football  

PubMed Central

Duodenal rupture secondary to blunt trauma is a relatively uncommon event and is usually a result of a road traffic accident. As the duodenum is a retroperitoneal organ, delays in diagnosis can occur, as the patient may present with vague abdominal symptoms and other non-specific signs. Computed tomographic scanning is therefore a useful tool in the diagnosis of this condition. We present a 19-year-old girl who was hit in the abdomen with a football and subsequently had a duodenal rupture.

Luther, Alison; Mann, Christopher; Hart, Colin; Khalil, Khalil

2013-01-01

251

[A case of groove pancreatitis associated with duodenal ulcer].  

PubMed

We describe a 69-year-old man with a history of multiple gastroduodenal ulcers, presenting with the onset of obstructive jaundice. Abdominal CT, MRI and EUS demonstrated a sheet-like mass in the pancreaticoduodenal groove. EUS-FNA did not reveal malignancy. Conservative treatment did not improve his clinical condition and repeated acute pancreatitis occurred during his treatment. Thus, pancreaticoduodenectomy was performed. Histopathological findings showed a duodenal ulcer penetrating the pancreas and infiltration of inflammatory cells and fibrosis in the pancreaticoduodenal groove. The spread of inflammation associated with the duodenal ulcer may have been one of the causes of groove pancreatitis. PMID:23303234

Iemoto, Takao; Shiomi, Hideyuki; Masuda, Atsuhiro; Sanuki, Tsuyoshi; Kutsumi, Hiromu; Hayakumo, Takanobu; Shinzeki, Makoto; Matsumoto, Ippei; Ku, Yonson; Kanzawa, Maki; Hara, Shigeo; Azuma, Takeshi

2013-01-01

252

Histiocytic sarcoma with fatal duodenal ulcers.  

PubMed

Histiocytic sarcoma is an uncommon neoplasm of mature histiocytes with very poor outcome. We report an autopsy case of a true histiocytic sarcoma with characteristic symptoms of so-called "malignant histiocytosis of the intestine". The liver and spleen were enlarged, with remarkable tumor cell infiltration in the hepatic sinusoids and splenic sinuses. Tumor cells aggregated to form sporadic nodular lesions in the liver, which often showed coagulative necrosis. Infarcted lesions also occurred at the splenic subcapsular area. In addition, tumor cell infiltration was noted in the sinuses of bone marrow and lymph node. Tumor cells often demonstrated moderate pleomorphism with multinucleated giant cells. They were positive for CD68 and negative for T- and B-cell lineage markers, megakaryocytic markers, and CD30. Various examinations were done to rule out infection-associated hemophagocytic syndrome, and the absence of infectious diseases was revealed. Thus, the diagnosis of histiocytic sarcoma was made. Apart from these lesions, multiple ulcerations, some with fatal perforation, were found in the esophagus and duodenum. They showed only non-specific inflammatory changes without tumor cell involvement. The ulcers probably derived from ischemic condition through an embolic process caused by tumor cell infiltration elsewhere in the blood vessels at the periphery of the ulcers. PMID:15310151

Akishima, Yuri; Akasaka, Yoshikiyo; Yih-Chang, Ger; Ito, Kinji; Ishikawa, Yukio; Lijun, Zhang; Kiguchi, Hideko; Lipscomb, Gary; Strong, Jack P; Ishii, Toshiharu

2004-01-01

253

Analyses and applications of pressure, flow rate, and temperature measurements during a perforating run. [Measurement while perforating  

Microsoft Academic Search

Perforating technology has undergone significant advances during the last decade. Tubing-conveyed perforating, underbalanced perforating, high-shot-density guns, better shaped charges, and improved gun systems have contributed to safer operations and improved productivity of the perforated completions. A recent development described in this paper is a perforating tool that makes real-time downhole measurements (including pressure, flow rate, temperature, gamma ray, casing-collar locator

S. M. Tariq; L. C. Ayestaran

1991-01-01

254

Iatrogenic Ureteric Injuries: Incidence, Aetiological Factors and the Effect of Early Management on Subsequent Outcome  

Microsoft Academic Search

Objective: To investigate the changing pattern in incidence, aetiological factors and the effect of early diagnosis and surgical treatment on the outcome of iatrogenic ureteric injuries in our Urology Unit over a 5 year period. Patients\\/Methods: All patients with ureteric injuries caused as a result of any surgical procedures (iatrogenic ureteric injuries) were studied during a 5 year period (1998–2002). Data collected

Khaleel Al-Awadi; Elijah O. Kehinde; Adel Al-Hunayan; Ahmed Al-Khayat

2005-01-01

255

Treatment with Epidural Blood Patch for Iatrogenic Intracranial Hypotension after Spine Surgery  

PubMed Central

Intracranial hypotension syndrome typically occurs spontaneously or iatrogenically. It can be associated with headache, drowsy mentality and intracranial heamorrhage. Iatrogenic intracranial hypotension can occur due to dural pucture, trauma and spine surgery. Treatment may include conservative therapy and operation. We report a case of a 54-year-old man who was successfully treated with epidural blood patches for intracranial hypotension due to cerebrospinal fluid (CSF) leakage into the lumbosacral area after spine surgery.

Kim, Jaekook; Lee, Sunyeul; Lee, Wonhyung

2012-01-01

256

Iatrogenic left internal mammary artery to great cardiac vein anastomosis treated with coil embolization.  

PubMed

Inadvertent left internal mammary artery (LIMA)-great cardiac vein (GCV) anastomosis is a rare complication of coronary artery bypass graft surgery. Patients with iatrogenic aortocoronary fistula (ACF) were usually treated surgical repair, percutaneous embolic occlusion with coil or balloon. We report a case of iatrogenic LIMA to GCV anastomosis successfully treated with coil embolization and protected left main coronary intervention through the percutaneous transfemoral approach. PMID:21430997

Jung, Il Soon; Jeong, Jin-Ok; Kim, Song Soo; Shin, Byung Seok; Shin, Sung Kyun; Park, Yong Kyu; Jin, Seon-Ah; Ahn, Kye Taek; Seong, In-Whan

2011-02-28

257

Iatrogenic arteriovenous fistula of distal greater palatine artery by gingival suture  

Microsoft Academic Search

Iatrogenic arteriovenous fistula (AVF) is rarely seen in the oral cavity, especially located on the distal greater palatine artery, which has not ever been reported before. We present a case of a 13-year-old girl who had received one simple suture over the left upper gingiva in a dental clinic which 4 days later resulted in an iatrogenic AVF with life-threatening

Chi-Hsin Shao; Yeh-Lin Kuo; Jui-Pin Lai; Ruey-Fen Hsu

258

Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study  

Microsoft Academic Search

Background\\/Objectives:Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies.Subjects\\/Methods:Standards of nutritional care were assessed on the basis of (1) adherence to study

E Cereda; L Lucchin; C Pedrolli; A D'Amicis; M G Gentile; N C Battistini; M A Fusco; A Palmo; M Muscaritoli

2010-01-01

259

Laparoscopic Repair for Perforated Peptic Ulcer  

PubMed Central

Objective To compare the results of open versus laparoscopic repair for perforated peptic ulcers. Summary Background Data Omental patch repair with peritoneal lavage is the mainstay of treatment for perforated peptic ulcers in many institutions. Laparoscopic repair has been used to treat perforated peptic ulcers since 1990, but few randomized studies have been carried out to compare open versus laparoscopic procedures. Methods From January 1994 to June 1997, 130 patients with a clinical diagnosis of perforated peptic ulcer were randomly assigned to undergo either open or laparoscopic omental patch repair. Patients were excluded for a history of upper abdominal surgery, concomitant evidence of bleeding from the ulcer, or gastric outlet obstruction. Patients with clinically sealed-off perforations without signs of peritonitis or sepsis were treated without surgery. Laparoscopic repair would be converted to an open procedure for technical difficulties, nonjuxtapyloric gastric ulcers, or perforations larger than 10 mm. A Gast- rografin meal was performed 48 to 72 hours after surgery to document sealing of the perforation. The primary end-point was perioperative parenteral analgesic requirement. Secondary endpoints were operative time, postoperative pain score, length of postoperative hospital stay, complications and deaths, and the date of return to normal daily activities. Results Nine patients with a surgical diagnosis other than perforated peptic ulcer were excluded; 121 patients entered the final analysis. There were 98 male and 23 female patients recruited, ages 16 to 89 years. The two groups were comparable in age, sex, site and size of perforations, and American Society of Anesthesiology classification. There were nine conversions in the laparoscopic group. After surgery, patients in the laparoscopic group required significantly less parenteral analgesics than those who underwent open repair, and the visual analog pain scores in days 1 and 3 after surgery were significantly lower in the laparoscopic group as well. Laparoscopic repair required significantly less time to complete than open repair. The median postoperative stay was 6 days in the laparoscopic group versus 7 days in the open group. There were fewer chest infections in the laparoscopic group. There were two intraabdominal collections in the laparoscopic group. One patient in the laparoscopic group and three patients in the open group died after surgery. Conclusions Laparoscopic repair of perforated peptic ulcer is a safe and reliable procedure. It was associated with a shorter operating time, less postoperative pain, reduced chest complications, a shorter postoperative hospital stay, and earlier return to normal daily activities than the conventional open repair.

Siu, Wing T.; Leong, Heng T.; Law, Bonita K. B.; Chau, Chun H.; Li, Anthony C. N.; Fung, Kai H.; Tai, Yuk P.; Li, Michael K. W.

2002-01-01

260

Iatrogenic hyperadrenocorticism in a cat following a short therapeutic course of methylprednisolone acetate.  

PubMed

Iatrogenic hyperadrenocorticism (or iatrogenic Cushing's syndrome) is an adrenal disorder that may result from long-term administration of glucocorticoids for therapeutic purposes, most often given to treat allergic or immune-mediated disorders. Prolonged treatment with synthetic glucocorticoids can suppress hypothalamic corticotrophin releasing hormone and plasma adrenocorticotrophic hormone (ACTH), thus causing a functional inactivity of the adrenal cortex. The result is a clinical syndrome of hyperadrenocorticism but with basal and ACTH-stimulated plasma cortisol concentrations that are consistent with spontaneous hypoadrenocorticism (Addison's disease). Whilst iatrogenic hyperadrenocorticism is relatively frequent in dogs, the diagnosis of iatrogenic hyperadrenocorticism in cats is very uncommon because this species has been found to be remarkably resistant to prolonged administration of glucocorticoids. To the author's knowledge, there are only two published clinical cases of feline iatrogenic Cushing's syndrome. This report describes a case of iatrogenic hyperadrenocorticism in a cat, and shows how normalisation of the adrenal function was achieved with supportive treatment and withdrawal of glucocorticoid administration. PMID:11876622

Ferasin, L

2001-06-01

261

Coronary Perforation and Covered Stents: An Update and Review  

PubMed Central

Coronary perforation is a rare complication of percutaneous coronary intervention. We present two different types of coronary intervention, but both ending with coronary perforation. However, these perforations were tackled successfully by covered stents. This article reviews the incidence, causes, presentation, and management of coronary perforation in the present era of aggressive interventional cardiology. Coronary perforations are classified as type I (extraluminal crater), II (myocardial or pericardial blushing), and III (contrast streaming or cavity spilling). Types I and II coronary perforations are caused by stiff or hydrophilic guidewires. Type I has a benign prognosis, whereas type II coronary perforations have the potential to progress to tamponade. Type III coronary perforations are caused by balloons, stents, or other intracoronary devices and commonly lead to cardiac tamponade necessitating pericardial drainage. However, type III perforations can be managed with covered stents without need for surgical intervention.

Al-Mukhaini, Mohammed; Panduranga, Prashanth; Sulaiman, Kadhim; Riyami, Abdulla Amour; Deeb, Mohammed; Riyami, Mohamed Barkat

2011-01-01

262

Pellagra revealing a congenital duodenal diaphragm in an adult.  

PubMed

Pellagra is a nutritional disease caused by the deficiency of niacin. It is a clinical syndrome characterized by four "D's": diarrhea, dermatitis, dementia and ultimately death. We describe a case of pellagra as the initial presentation of congenital duodenal diaphragm. PMID:23168227

Khouloud, Bouslama; Haykel, Bedioui; Ahmed, Saidani; Houcine, Maghrebi; Yacine, Ben Safta; Farah, Jokho; Zoubeir, Ben Safta

2012-11-15

263

Acid infusion enhances duodenal mechanosensitivity in healthy subjects.  

PubMed

Duodenal acid has been suggested to be of importance for dyspeptic symptoms. We investigated the effects of acid on duodenal mechanosensitivity and antroduodenal motility in 10 healthy subjects before and during duodenal infusion of acid (0.1 N HCl) or water by using a combined barostat-manometry assembly. During acid infusion, increased sensitivity to balloon distension was seen, with reduced perception (P = 0.04) and discomfort thresholds (P = 0.06) and higher intensity of discomfort (P = 0.02) compared with water. Higher balloon volumes were seen during acid infusion, indicating decreased tone (P = 0.05). Large volume waves were more prevalent during acid than water infusion (P = 0.009). The acid infusion suppressed antral contractions (P = 0.04) and increased the number of contractions in the proximal duodenum (P = 0.02) compared with before the infusion. In conclusion, duodenal acid enhances mechanical sensitivity in the duodenum, affects gastroduodenal motor function, and might be of importance for dyspeptic symptoms. PMID:12686509

Simrén, Magnus; Vos, Rita; Janssens, Jozef; Tack, Jan

2003-04-09

264

DUODENAL CYTOCHROME B: A NOVEL FERRIREDUCTASE IN AIRWAY EPITHELIAL CELLS  

EPA Science Inventory

Catalytically active iron in the lung causes oxidative stress and promotes microbial growth that can be limited by intracellular sequestration of iron within ferritin. Because cellular iron uptake requires membrane ferrireductase activity that in the gut can be provided by duoden...

265

Long-term outcomes in patients with duodenal adenocarcinoma.  

PubMed

BACKGROUND: Because of the rarity of duodenal adenocarcinoma, little is known regarding its natural history or prognostic factors for survival. We therefore evaluated surgical treatment, and prognostic factors for survival in patients with duodenal adenocarcinoma. METHODS: We retrospectively reviewed the medical records of patients who were diagnosed with duodenal adenocarcinoma at Asan Medical Center between December 1999 and December 2009. RESULTS: Of the 76 patients, 47 (61%) underwent surgery with curative intent and 29 (39%) underwent palliative operation. Of the former, 25 underwent pancreaticoduodenectomy (PD), 19 underwent pylorus-preserving PD, 2 underwent segmental duodenectomy and 1 underwent transduodenal excision. The median survival of the 41 patients who achieved R0 resection was 25.1 months (range 4-134 months), with overall 1-, 3- and 5-year survival rates of 80.4%, 63.4% and 60.9%, respectively. Median survival was significantly longer in patients who underwent curative resection than in those who underwent palliative surgery (28.2 versus 6.6 months, P < 0.001). Univariate analysis showed that transfusion and lymph node metastasis were related to survival, and multivariate analysis revealed that lymph node metastasis was independently associated with survival (P = 0.036). Survival differences were observed between stages of the seventh edition of the American Joint Committee on Cancer staging system. CONCLUSION: In the absence of distant metastasis, curative resection enhances the long-term survival of patients with duodenal adenocarcinoma. Lymph node metastasis is prognostic factor of overall survival. PMID:23656271

Lee, Sang Yeup; Lee, Jae Hoon; Hwang, Dae Wook; Kim, Song Cheol; Park, Kwang-Min; Lee, Young-Joo

2013-05-01

266

Effect of sucralfate on gastric emptying in duodenal ulcer patients  

Microsoft Academic Search

Duodenal ulcer (DU) patients may have accelerated gastric emptying (GE) suggesting that there is an increase in unbuffered gastric acid reaching the duodenum contributing to DU disease. Aluminum-containing antacids were shown to delay GE. The authors' aim was to investigate whether another aluminum-containing compound, Sucralfate, affects GE in normal and DU patients. Nine normal volunteers and 10 patients with documented

J. M. Petersen; V. J. Caride; E. K. Prokop; F. Troncale; R. W. McCallum

1985-01-01

267

Plasma neurotransmitters and cortisol in duodenal ulcer patients  

Microsoft Academic Search

Levels of noradrenaline, adrenaline, dopamine, free serotonin, platelet serotonin, and cortisol were measured in the plasma of duodenal ulcer patients and controls. All subjects received antacids, and these substances were also measured. During relapse, all patients showed raised noradrenaline, adrenaline, dopamine, free serotonin, and cortisol values. In contrast, platelet serotonin showed very low values, which correlated negatively with all the

Fuad Lechin; Bertha van der Dijs; Isaìs Rada; Hector Jara; Alex E. Lechin; Alejandra Cabrera; Marcel E. Lechin; Vladimir Jimènez; Francisco Gòmez; Simòn Villa; Emilio Acosta; Luis Arocha

1990-01-01

268

Antacid maintenance therapy in the prevention of duodenal ulcer relapse  

Microsoft Academic Search

The effectiveness of antacid maintenance therapy in preventing duodenal ulcer (DU) relapse was investigated. Two hundred and fifty one asymptomatic patients with healed DU were stratified into smokers and non-smokers and randomised to receive for one year either placebo, or Maalox TC three tablets (81 mmol) at bedtime (hs), or Maalox TC three tablets in the morning plus three tablets

K D Bardhan; J O Hunter; J P Miller; A B Thomson; D Y Graham; R I Russell; S Sontag; C Hines; T Martin; L Gaussen

1988-01-01

269

Duodenal atresia in association with situs inversus abdominus.  

PubMed

We report a rare association of duodenal atresia with situs inversus abdominus in a newborn. The infantogram revealed "reverse double-bubble sign" without dextrocardia. The sonography and echocardiography confirmed the diagnosis of situs inversus abdominus with multiple cardiac anomalies. Laparotomy and a duodenoduodenostomy were carried out. PMID:22529552

Shankar, Raghu; Rao, Sadashiva P; Shetty, Kishan B

2012-04-01

270

Does Down syndrome affect the outcome of congenital duodenal obstruction?  

Microsoft Academic Search

Congenital duodenal obstruction (DO) has a well-known association with Down syndrome (DS) and other congenital malformations. Previously reported series on DO have not examined the influence of DS on associated congenital malformations and postoperative morbidity and mortality. We report on a retrospective study of all children born with DO over an 11-year period to investigate this. A total of 79

M. V. A. Singh; C. Richards; J. C. Bowen

2004-01-01

271

Case Report: Delayed Perforation after Definitive Treatment of Focal Intestinal Perforation with a Peritoneal Drain  

PubMed Central

Focal intestinal perforation (FIP) has long been described in the pediatric literature. Peritoneal drainage (PD) is widely used as treatment for focal intestinal perforation. Here we report a premature infant that underwent PD on day of life 9 for a FIP. The infant recovered well from this episode and was discharged home without known sequelae. Subsequently, the same patient presented 16 months later with peritonitis. A perforation was discovered at laparotomy without evidence of surrounding necrosis. Given this finding, we believe this second episode of perforation was at the same site as the initial episode of FIP. The finding of FIP has been described without findings of surrounding necrosis. However, we believe this to be the first report of delayed perforation greater than 1 year from initial presentation after FIP treated definitively with peritoneal drain.

Dalton, Brian G. A.; Walters, Kenneth C.; Dassinger, Melvin S.

2012-01-01

272

Treating bilio-duodenal obstruction: Combining new endoscopic technique with 6 Fr stent introducer  

PubMed Central

Periampullary cancer may cause not only biliary but also duodenal obstructions. In patients with concomitant duodenal obstructions, endoscopic biliary stenting remains technically difficult and may often require percutaneous transhepatic biliary drainage. We describe a method of metal stent placement via a thin forward-viewing endoscope in patients with simultaneous biliary and duodenal obstruction. In two consecutive patients with biliary and duodenal obstruction due to pancreatic cancer, a new biliary metal stent mounted in a slim delivery catheter was placed via a thin forward viewing endoscope after passage across the duodenal stenosis without balloon dilation. In both patients, with our new placement technique, metallic stents were successfully placed in a short time without adverse events. After biliary stenting, one patient received curative resection and the other received duodenal stenting for palliation. Metallic stent placement with a forward-viewing thin endoscope is a beneficial technique, which can avoid percutaneous drainage in patients with bilio-duodenal obstructions due to periampullary cancer.

Maetani, Iruru; Nambu, Tomoko; Omuta, Shigefumi; Ukita, Takeo; Shigoka, Hiroaki

2010-01-01

273

Esophago-gastroduodenal ulceration complicated by duodenal perforation in a three year old Thoroughbred colt: a case report  

Microsoft Academic Search

A three year old Thoroughbred colt was admitted to our clinic because of chronic inapetence, weight loss and exercise intolerance. Clinical examination, blood examination and endoscopy were carried out. The endoscopic appearance of the distal esophagus was characterized by extensive and severe ulceration. Gastroscopy revealed severe diffuse ulceration of the entire nonglandular mucosa. A diagnosis of esophago-gastric ulceration and delayed

B. Bezdekova

274

Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing's syndrome: cohort study  

PubMed Central

Objective To investigate whether there is an increased risk of cardiovascular events in people who exhibit iatrogenic Cushing’s syndrome during treatment with glucocorticoids. Design Cohort study. Setting 424 UK general practices contributing to The Health Improvement Network database. Participants People prescribed systemic glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome (n=547) and two comparison groups: those prescribed glucocorticoids and with no diagnosis of iatrogenic Cushing’s syndrome (n=3231) and those not prescribed systemic glucocorticoids (n=3282). Main outcome measures Incidence of cardiovascular events within a year after diagnosis of iatrogenic Cushing’s syndrome or after a randomly selected date, and association between iatrogenic Cushing’s syndrome and risk of cardiovascular events. Results 417 cardiovascular events occurred in 341 patients. Taking into account only the first event by patient (coronary heart disease n=177, heart failure n=101, ischaemic stroke n=63), the incidence rates of cardiovascular events per 100 person years at risk were 15.1 (95% confidence interval 11.8 to 18.4) in those prescribed glucocorticoids and with a diagnosis of iatrogenic Cushing’s syndrome, 6.4 (5.5 to 7.3) in those prescribed glucocorticoids without a diagnosis of iatrogenic Cushing’s syndrome, and 4.1 (3.4 to 4.8) in those not prescribed glucocorticoids. In multivariate analyses adjusted for sex, age, intensity of glucocorticoid use, underlying disease, smoking status, and use of aspirin, diabetes drugs, antihypertensive drugs, lipid lowering drugs, or oral anticoagulant drugs, the relation between iatrogenic Cushing’s syndrome and cardiovascular events was strong (adjusted hazard ratios 2.27 (95% confidence interval 1.48 to 3.47) for coronary heart disease, 3.77 (2.41 to 5.90) for heart failure, and 2.23 (0.96 to 5.17) for ischaemic cerebrovascular events). The adjusted hazard ratio for any cardiovascular event was 4.16 (2.98 to 5.82) when the group prescribed glucocorticoids and with iatrogenic Cushing’s syndrome was compared with the group not prescribed glucocorticoids. Conclusion People who use glucocorticoids and exhibit iatrogenic Cushing’s syndrome should be aggressively targeted for early screening and management of cardiovascular risk factors.

2012-01-01

275

[Acute duodenal obstruction due to incomplete duodenal diaphragm and foreign bodies in a two-year old child (author's transl)].  

PubMed

A case of congenital incomplete duodenal diaphragm associated to foreign bodies, in a 28 months child with Down's syndrom is reported. This case had an acute beginning of the symptoms and a severe clinical picture. We discuss the clinical features diagnostic and therapeutic aspects. PMID:145197

Ruiz Jiménez, J I; Gualda Cantón, J; Sánchez, E B

1977-03-01

276

CANULACIÓN DUODENAL E ILEAL PARA ESTUDIOS DE DIGESTIÓN EN CERDOS DUODENAL AND ILEAL CANNULATION FOR DIGESTION STUDIES IN PIGS  

Microsoft Academic Search

The quality evaluation of protein sources for pigs includes the de- termination of amino acid digestibility as well as the secretion and activity of pancreatic proteases, which require to obtain duodenal and ileal digesta samples. In this report, a procedure for cannulat- ing growing pigs (35 kg average liveweight) at proximal duode- num and terminal ileum is described. The recovery

Miguel Cervantes-Ramírez; Víctor González-Vizcarra; Salvador Rodríguez-Rubí; Julio S. González-Monreal; Leopoldo Flores-Aguirre; Julián Carrillo

277

First do no harm: iatrogenic maintaining factors in anorexia nervosa.  

PubMed

The aim of this paper is to reflect on the way that we as clinicians may play an inadvertent role in perpetuating eating disordered behaviour. This is considered within the theoretical framework of Schmidt and Treasures' maintenance model of anorexia nervosa (AN). The model includes four main domains; interpersonal factors, pro-AN beliefs, emotional style and thinking style. Interpersonal reactions are of particular relevance as clinicians (as with family members) may react with high expressed emotion and unknowingly encourage eating disorder behaviours to continue. Hostility in the form of coercive refeeding in either a hospital or outpatient setting may strengthen conditioned food avoidance and pessimism may hamper motivation to change. Negative schema common to eating disorders, for example low self-esteem, perfectionism and striving for social value may augment existing or initiate new eating disorder behaviour. Services can become a reinforcing influence by providing an overly protective, palliating environment which ensures safety, security and acceptance whilst reducing loneliness and isolation. This stifles the need for an individual to develop their own sense of responsibility, autonomy and independence allowing avoidance to dominate. Furthermore, the highly structured environment of inpatient care supports the rigid attention to detail and inflexibility that is characteristic of people with eating disorders, and allows these negative behaviours to thrive. Careful planning of service provision, reflective practice, supervision and regular team feedback is essential to prevent iatrogenic harm. PMID:21714039

Treasure, Janet; Crane, Anna; McKnight, Rebecca; Buchanan, Emmakate; Wolfe, Melissa

2011-01-03

278

Evaluation of recovery in iatrogenic evoked acute mediatinitis.  

PubMed

This study attempts to find a prediction method of death risk in patients with acute mediastinitis (AM). There is no such tool described in available literature for this serious disease. The study comprised 37 consecutive cases of iatrogenic AM. General anamnesis and biochemical data were included. Factor analysis was used to extract the risk characteristic for the patients. The most valuable results were obtained for eight parameters, which were selected for further statistical analysis (all collected during a few hours after admission). Three factors reached eigenvalue?>?1. Clinical explanations for these combined statistical factors are as follows: Factor 1-proteinic status (serum total protein, albumin, and hemoglobin level), Factor 2-inflammatory status (white blood cells, C-reactive protein, and procalcitonin), and Factor 3-general risk (age and number of coexisting diseases). Threshold values of prediction factors were estimated using statistical analysis (factor analysis, Statgraphics Centurion XVI). The final prediction result for the patients is constructed as simultaneous evaluation of all factor scores. High probability of death should be predicted if factor 1 value decreases with simultaneous increase of factors 2 and 3. The diagnostic power of the proposed method was revealed to be high [sensitivity?=?100 %, specificity?=?69.2 %]: Factor 1 [SNC?=?95.8 %, SPC?=?76.9 %]; Factor 2 [SNC?=?100 %, SPC?=?53.8 %]; and Factor 3 [SNC?=?75 %, SPC?=?76.9 %]. The described method may turn out to be a valuable prognostic tool for patients with AM. PMID:23619916

Jab?o?ski, S?awomir; Kozakiewicz, Marcin

2013-10-01

279

Perforated peptic ulcer in an infant.  

PubMed

We describe a case of perforated peptic ulcer (PPU) in a 9-month-old boy. Abdominal distension was the first clinical sign of PPU. Before he developed abdominal distension, the patient had suffered from an upper respiratory tract infection with fever for about 2 weeks, which was treated intermittently with ibuprofen. A plain abdominal radiograph revealed pneumoperitoneum with a football sign. At laparotomy, a 0.8-cm perforated hole was found over the prepyloric area. Simple closure with omental patching was performed after debridement of the perforation. Pathologic examination showed chronic peptic ulcer with Helicobacter pylori infection. The postoperative course and outcome were satisfactory. The stress of underlying disease, use of ibuprofen, blood type (A), and H. pylori infection might have contributed to the development of PPU in this patient. PPU in infancy is rare and has a high mortality rate; early recognition and prompt surgical intervention are key to successful management. PMID:11393101

Feng, C Y; Hsu, W M; Chen, Y

2001-02-01

280

Free perforation of the small intestine.  

PubMed

Surgeons operating on patients with an obscure peritonitis should be aware of the diverse etiologies of small intestinal perforation and the general principles of management of each. A series of 16 adult patients with free perforation of the small intestine and spreading peritonitis in the absence of bowel obstruction, incarcerated hernia, or trauma is reviewed. Etiologies were as follows: Crohn's disease, four patients; foreign body ingestion, two patients; jejunal diverticulosis, one patient; lymphoma, two patients; cancer chemotherapy, one patient, amyloidosis, one patient; idiopathic, five patients. Although all patient presented with diffuse peritonitis, the findings of fever and leukocytosis were inconstant. Free air was demonstrated on radiographs in only eight of 16 patients, and the correct preoperative diagnosis was not made except in the four patients with Crohn's disease. Resection and primary anastomosis were utilized successfully in ten patients, the remainder of the patients undergoing oversewing the the perforation. Four patients (25%) died. PMID:7125743

Rajagopalan, A E; Pickleman, J

1982-11-01

281

Free perforation of the small intestine.  

PubMed Central

Surgeons operating on patients with an obscure peritonitis should be aware of the diverse etiologies of small intestinal perforation and the general principles of management of each. A series of 16 adult patients with free perforation of the small intestine and spreading peritonitis in the absence of bowel obstruction, incarcerated hernia, or trauma is reviewed. Etiologies were as follows: Crohn's disease, four patients; foreign body ingestion, two patients; jejunal diverticulosis, one patient; lymphoma, two patients; cancer chemotherapy, one patient, amyloidosis, one patient; idiopathic, five patients. Although all patient presented with diffuse peritonitis, the findings of fever and leukocytosis were inconstant. Free air was demonstrated on radiographs in only eight of 16 patients, and the correct preoperative diagnosis was not made except in the four patients with Crohn's disease. Resection and primary anastomosis were utilized successfully in ten patients, the remainder of the patients undergoing oversewing the the perforation. Four patients (25%) died.

Rajagopalan, A E; Pickleman, J

1982-01-01

282

Perforator flaps of the facial artery angiosome.  

PubMed

For small to moderate-sized defects in the head and neck region, local flaps have been the mainstay of reconstruction for years. However, in certain instances, additional flap translation is required be it advancement, transposition or rotation. In such cases, the local flap concept is combined with perforator flap know-how, allowing larger loco-regional flaps to be raised to reconstruct relatively larger defects, even in cosmetically-expensive areas. In our cohort of fifteen patients', we have utilised detailed microanatomy of the facial artery perforators to reconstruct such defects with good results. PMID:23219748

Kannan, R Y; Mathur, B S

2012-12-07

283

Plate perforation by eroding rod projectiles  

Microsoft Academic Search

The penetration and perforation of stationary, oblique steel plates by hypervelocity tungsten-alloy projectiles is examined here. Simulations have been performed for L\\/D 10 projectiles against one- and two-plate target configurations. The plate thickness-to-rod diameter ratio t\\/D varied slightly, as did the plate spacing-to-plate thickness ratio tgap\\/t. For all simulations, t\\/D?[1.2,1.6] and tgap\\/t?[0.7,1]. Normalized line-of-sight perforation is one measure of performance,

D. J. Gee

2003-01-01

284

Colon perforation in renal transplant patients.  

PubMed

Six patients with spontaneous colonic perforation after cadaveric kidney transplantation are described. Five perforations occurred in a diverticulum of the sigmoid colon, while one was at the suture line after a colotomy performed 5 months previously. Four patients died. Clinical diagnosis was difficult, but on x-ray examination free air in the abdominal cavity was found in 3 patients. Explorative laparotomy should be performed promptly when the diagnosis is suspected. All patients above the age of 4o should be screened with a barium enema prior to transplantation. PMID:775614

Hognestad, J; Flatmark, A

1976-01-01

285

Attenuation of an air shock wave by perforated baffles  

SciTech Connect

One of the ways of attenuating an air shock wave (ASW) is to use a perforated shield; the parameters of the ASW behind a perforated baffle in the form of a steel sheet with holes are determined by the amplitude of the incident ASW and the sheet perforation coefficient. The authors examine the effects of the perforated shield structure on the ASW behind it and examples are given where the results can be used in the design of test chambers.

Klapovskii, V.E.; Grigor'ev, G.S.; Logvenov, A.Y.; Mineev, V.N.; Vershinin, V.Y.

1984-03-01

286

Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy  

PubMed Central

When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.

Blouhos, Konstantinos; Boulas, Konstantinos A.; Konstantinidou, Anna; Salpigktidis, Ilias I.; Katsaouni, Stavroula P.; Ioannidis, Konstantinos; Hatzigeorgiadis, Anestis

2013-01-01

287

Iatrogenic QT Abnormalities and Fatal Arrhythmias: Mechanisms and Clinical Significance  

PubMed Central

Severe and occasionally fatal arrhythmias, commonly presenting as Torsade de Pointes [TdP] have been reported with Class III-antiarrhythmics, but also with non-antiarrhythmic drugs. Most cases result from an action on K+ channels encoded by the HERG gene responsible for the IKr repolarizing current, leading to a long QT and repolarization abnormalities. The hydrophobic central cavity of the HERG-K+ channels, allows a large number of structurally unrelated drugs to bind and cause direct channel inhibition. Some examples are dofetilide, quinidine, sotalol, erythromycin, grepafloxacin, cisapride, dolasetron, thioridazine, haloperidol, droperidol and pimozide. Other drugs achieve channel inhibition indirectly by impairing channel traffic from the endoplasmic reticulum to the cell membrane, decreasing channel membrane density (pentamidine, geldalamicin, arsenic trioxide, digoxin, and probucol). Whereas, ketoconazole, fluoxetine and norfluoxetine induce both direct channel inhibition and impaired channel trafficking. Congenital long QT syndrome, subclinical ion-channel mutations, subjects and relatives of subjects with previous history of drug-induced long QT or TdP, dual drug effects on cardiac repolarization [long QT plus increased QT dispersion], increased transmural dispersion of repolarization and T wave abnormalities, use of high doses, metabolism inhibitors and/or combinations of QT prolonging drugs, hypokalemia, structural cardiac disease, sympathomimetics, bradycardia, women and older age, have been shown to increase the risk for developing drug-induced TdP. Because most of these reactions are preventable, careful evaluation of risk factors and increased knowledge of drugs use associated with repolarization abnormalities is strongly recommended. Future genetic testing and development of practical and simple provocation tests are in route to prevent iatrogenic TdP.

Cubeddu, Luigi X

2009-01-01

288

Iatrogenic QT Abnormalities and Fatal Arrhythmias: Mechanisms and Clinical Significance.  

PubMed

Severe and occasionally fatal arrhythmias, commonly presenting as Torsade de Pointes [TdP] have been reported with Class III-antiarrhythmics, but also with non-antiarrhythmic drugs. Most cases result from an action on K(+) channels encoded by the HERG gene responsible for the IKr repolarizing current, leading to a long QT and repolarization abnormalities. The hydrophobic central cavity of the HERG-K+ channels, allows a large number of structurally unrelated drugs to bind and cause direct channel inhibition. Some examples are dofetilide, quinidine, sotalol, erythromycin, grepafloxacin, cisapride, dolasetron, thioridazine, haloperidol, droperidol and pimozide. Other drugs achieve channel inhibition indirectly by impairing channel traffic from the endoplasmic reticulum to the cell membrane, decreasing channel membrane density (pentamidine, geldalamicin, arsenic trioxide, digoxin, and probucol). Whereas, ketoconazole, fluoxetine and norfluoxetine induce both direct channel inhibition and impaired channel trafficking. Congenital long QT syndrome, subclinical ion-channel mutations, subjects and relatives of subjects with previous history of drug-induced long QT or TdP, dual drug effects on cardiac repolarization [long QT plus increased QT dispersion], increased transmural dispersion of repolarization and T wave abnormalities, use of high doses, metabolism inhibitors and/or combinations of QT prolonging drugs, hypokalemia, structural cardiac disease, sympathomimetics, bradycardia, women and older age, have been shown to increase the risk for developing drug-induced TdP. Because most of these reactions are preventable, careful evaluation of risk factors and increased knowledge of drugs use associated with repolarization abnormalities is strongly recommended. Future genetic testing and development of practical and simple provocation tests are in route to prevent iatrogenic TdP. PMID:20676275

Cubeddu, Luigi X

2009-08-01

289

Extensive Tympanic Membrane Cholesteatoma with Marginal Perforation: An Unusual Case  

PubMed Central

The migration of squamous epithelium of external ear through a tympanic membrane perforation into the middle ear forms a cholesteatoma. But it is extremely a rare condition to observe extensive cholesteatoma on the medial surface of tympanic membrane with perforation. This condition is termed tympanic membrane cholesteatoma (TMC). We herein present an exceptional case of extensive TMC with marginal perforation.

Sakalli, Erdal; Kaya, Deniz; Celikyurt, Cengiz; Erdurak, Selcuk Cem

2013-01-01

290

Right-sided perforated ascending colonic diverticulum mimicking acute appendicitis.  

PubMed

Perforation of the colonic diverticulum is a common reason for emergency laparotomy, especially in older people but is rare in the younger population. While perforation of the sigmoid diverticulum is very common, perforation of the ascending colonic diverticulum is a very rare event. For this reason, the divereticulitis is usually discovered unexpectedly at surgery for suspected appendicitis. PMID:23378699

Bilic Komarica, Edina; Zvizdic, Zlatan

2012-12-01

291

RIGHT-SIDED PERFORATED ASCENDING COLONIC DIVERTICULUM MIMICKING ACUTE APPENDICITIS  

PubMed Central

Perforation of the colonic diverticulum is a common reason for emergency laparotomy, especially in older people but is rare in the younger population. While perforation of the sigmoid diverticulum is very common, perforation of the ascending colonic diverticulum is a very rare event. For this reason, the divereticulitis is usually discovered unexpectedly at surgery for suspected appendicitis.

Bilic Komarica, Edina; Zvizdic, Zlatan

2012-01-01

292

Spontaneous sealing of a neonatal intestinal perforation by the omentum  

Microsoft Academic Search

Several recent reports have suggested that, in select premature neonates, intestinal perforation may be managed by peritoneal drainage alone. Much like a surgical Graham patch, the omentum may seal an intestinal perforation allowing healing while maintaining bowel continuity. This photograph, illustrating a classic case of spontaneous sealing of such a perforation, demonstrates why surgery may be avoided in some cases.

Diana L. Diesen; Micheal A. Skinner

2008-01-01

293

Oblique Perforation of Thick Metallic Plates by Rigid Projectiles  

Microsoft Academic Search

Oblique perforation of thick metallic plates by rigid projectiles with various nose shapes is studied in this paper. Two perforation mechanisms, i.e., the hole enlargement for a sharp projectile nose and the plugging formation for a blunt projectile nose, are considered in the proposed analytical model. It is shown that the perforation of a thick plate is dominated by several

Xiaowei Chen; Qingming Li; Saucheong Fan

2006-01-01

294

Controlled trial of hypnotherapy in relapse prevention of duodenal ulceration.  

PubMed

30 patients with rapidly relapsing duodenal ulceration were studied to assess the possible benefit of hypnotherapy in relapse prevention. After the ulcer had healed on treatment with ranitidine, the drug was continued for a further 10 weeks during which time patients received either hypnotherapy or no hypnotherapy. The two randomly selected groups were comparable in terms of age, sex, smoking habits, and alcohol consumption. Follow-up of both groups of patients was continued for 12 months after the cessation of ranitidine. After 1 year, 8 (53%) of the hypnotherapy patients and 15 (100%) of the control subjects had relapsed. The results of this study suggest that hypnotherapy may be a useful therapeutic adjunct for some patients with chronic recurrent duodenal ulceration. PMID:2897556

Colgan, S M; Faragher, E B; Whorwell, P J

1988-06-11

295

Autonomic and psychologic correlates in hypertension and duodenal ulcer  

Microsoft Academic Search

Psychophysiologic response patterns of 47 male duodenal-ulcer patients, 50 male hypertensive patients, and a control group\\u000a of 65 men were compared by recording skin resistance level and responses, finger pulse volume, and surface integrated electromyograms\\u000a during a series of verbal, acoustic, and color stimuli. Personality characteristics were examined on the basis of the Eysenck\\u000a Personality Inventory, the Lüscher Test, Juhász’

Maria S. Kopp; László Korányi

1982-01-01

296

Challenges in the management of pancreatic and duodenal injuries.  

PubMed Central

A retrospective analysis of 44 consecutive patients with pancreatic or duodenal injuries admitted to an urban trauma center over a 6-year period was undertaken. Thirty-three patients had pancreatic injuries, including eight with combined duodenal injuries. Eleven patients had duodenal injuries. The mean age was 28 years, and 93% of the patients were male. Penetrating abdominal trauma accounted for the majority of injuries. Class I pancreatic injuries were the most common (55%), followed by those with class III (21%) and class II (18%). The majority (55%) of pancreatic injuries were managed by drainage with or without suturing; distal pancreatectomy was used in 39% of patients. Duodenal injuries were managed by primary repair in 50% of cases and pyloric exclusion/diverticulization techniques were used in 20% of cases. The mean first 24 hours transfusion requirement was 6.8 packed red blood cells. Complications were common, occurring in 61% of patients surviving longer than 24 hours. Intraabdominal abscess developed in 31% of all patients, 42% of whom required relaparotomy. Pancreatic fistulas occurred in 16% of patients with pancreatic injuries. Six patients died, 83% within 8 hours of admission, all as a result of gunshot wounds. Increased mortality was seen in patients with higher blood transfusion requirements, higher penetrating abdominal trauma index, shotgun wounds, the need for pancreaticoduodenectomy, hypotension on admission, and the presence of an associated major vascular injury. We conclude that early operation and efficacious control of hemorrhage is of prime importance in decreasing the mortality rate associated with these injuries.(ABSTRACT TRUNCATED AT 250 WORDS)

Moncure, M.; Goins, W. A.

1993-01-01

297

The effect of disinfectants on perforated gloves.  

PubMed

Three types of gloves, 'Biogel', 'Regent Dispo Surgical' gloves and Ansell gammex were perforated, and contaminated with Escherichia coli or Pseudomonas aeruginosa as test organisms applied either to the hand or the glove surface. The glove surface was decontaminated with alcoholic chlorhexidine ('Hibisol'), methylated spirit, or soap and water. The experiments were performed in triplicate on three separate days. The experiments were designed to study the ability of the three disinfection methods to reduce the bacterial count of 10(6) colony forming units (cfu) ml-1 (applied to perforated gloves or hands) sufficiently to permit the re-use of such gloves for non-sterile ward procedures. The best method of disinfection was using alcoholic chlorhexidine which not only reduced glove surface carriage but also reduced transfer of bacteria to the hands through the perforation in the gloves. Soap and water was the least effective. Escherichia coli was more easily removed than P. aeruginosa. We recommend that non-sterile ward procedures may be carried out even after gloves have been perforated provided alcoholic chlorhexidine is used between each procedure to reduce cross-infection between patients. PMID:1680901

Mehtar, S; Tsakris, A; Castro, D; Mayet, F

1991-07-01

298

An experimental study of perforated muzzle brakes  

Microsoft Academic Search

A firing test was conducted to examine the recoil efficiency and blast characteristics of perforated muzzle brakes fitted to a 20 mm cannon. Recoil impulse blast overpressures, muzzle velocity, sequential spark shadowgraphs, and photographs of the muzzle flash structure were obtained. Three different nuzzle devices were used with one device equipped with pressure transducers to measure the static pressure in

R. E. Dillon Jr.; H. T. Nagamatsu

1984-01-01

299

A parametric study of perforated muzzle brakes  

Microsoft Academic Search

A firing test was conducted to study the parameters influencing the recoil efficiency and the blast characteristics of perforated muzzle brakes. Several scaled (20 mm) devices were tested as candidates for the 105 mm Armored Gun System (AGS). Recoil impulse, blast overpressures, muzzle velocity, sequential spark shadowgraphs, and photographs of the muzzle flash were obtained. A total of nine different

Robert E. Dillon Jr.; H. T. Nagamatsu

1993-01-01

300

The Effects of Droperidol in Perforating Keratoplasty  

Microsoft Academic Search

Purpose: To evaluate the intraoperative and postoperative effects of droperidol administered with general anesthesia during perforating keratoplasty. Methods: A prospective, randomized, double-masked clinical trial. Twenty-seven patients undergoing penetrating keratoplasty under general anesthesia were included. Patients were assigned randomly to two groups. Fifteen subjects received droperidol during induction of general anesthesia. Twelve control patients received general anesthesia without droperidol. Results: Droperidol

Hanna J. Garzozi; Raneen Shehadeh-Masha’our; Mostafa Somri; Larry Kagemann; Alon Harris

2006-01-01

301

Pressure enhanced penetration with shaped charge perforators  

Microsoft Academic Search

A downhole tool, adapted to retain a shaped charge surrounded by a superatmospherically pressurized light gas, is employed in a method for perforating a casing and penetrating reservoir rock around a wellbore. Penetration of a shaped charge jet can be enhanced by at least 40% by imploding a liner in the high pressure, light gas atmosphere. The gas pressure helps

Lewis A

2001-01-01

302

Forming limit diagram of perforated sheet  

Microsoft Academic Search

The proper design and manufacture of tube sheets in heat exchangers and shadow masks in color picture tubes require the characterization of the deformation behavior of perforated sheets containing a large number of holes. The limit or failure strains in sheet metal forming are best represented by a forming limit curve (FLC) which indicates the onset of necking over all

Seung Chul Baik; Kyu Hwan Oh; Dong Nyung Lee

1995-01-01

303

Caged Polymer Crystallization in Perforated Layers*  

NASA Astrophysics Data System (ADS)

Confined polymer crystallization is studied in a poly(ethylene oxide)-b-polystyrene (PEO-b-PS) diblock copolymer. The number-average molecular weights for the PEO and PS blocks are 11k g/mol and 17k g/mol, respectively. After planar oscillatory shear, a perforated layer phase is obtained. This perforated layer phase is found by two-dimensional (2D) small angle X-ray scattering (SAXS) to have two commensurate crystalline structures. One is a trigonal phase, and the other is a hexagonal phase. The crystal orientation within the confined perforated layers is studied by simultaneous SAXS and wide angle X-ray scattering. The PEO crystal orientations with respect to the layers have been found to be dependent on the crystallization temperatures (Tc). At low Tcs, the PEO crystal c-axis preferentially orients parallel to the layers. At high Tcs, the crystal c-axis orients inclined to the layers. During high temperature crystallization in the perforated layers, the PEO lamellar crystals grow specifically along the (100) planes of the hexagonal lattice within the layers. Specific crystal orientation is found in an early stage of crystallization as studied by simultaneous time-resolved 2D SAXS and WAXS.

Zhu, L.; Huang, P.; Calhoun, B. H.; Cheng, S. Z. D.; Ge, Q.; Quirk, R. P.; Thomas, E. L.; Hsiao, B. S.; Yeh, F.; Liu, L.; Lotz, B.

2001-03-01

304

Axial perforation of aluminum honeycombs by projectiles  

Microsoft Academic Search

Deformation and energy absorption characteristics of aluminum honeycomb when penetrated or perforated in the axial direction by spheres and cylinders with diameters of the order of and twice the cell size have been observed experimentally. The work of static penetration using a standard test machine was obtained from measured force histories when hard-steel spheres with three different diameters were pushed

Werner Goldsmith; Dell L. Louie

1995-01-01

305

The surface potential of perforated dielectric layers  

Microsoft Academic Search

The maximum value of the surface potential or of the related equivalent voltage of perforated dielectric sheets may be of special interest in application of materials such as electrostatic-polymeric electret filters, fabrics, non-wovens and others. Experimental investigations carried out on polymeric fabrics with application of the corona triode have shown that the surface potential is limited mainly by the back

Ryszard Kacprzyk; W. Mista

2006-01-01

306

Design formula for axially compressed perforated plates  

Microsoft Academic Search

This paper is concerned with post-buckling behaviour and the ultimate load capacity of perforated plates with different boundary conditions and subjected to uniaxial or biaxial compression. Plates were analysed using the finite element method (FEM), and extensive studies were carried out covering parameters such as plate slenderness, opening size, boundary conditions and the nature of loading. A design formula to

N. E Shanmugam; V Thevendran; Y. H Tan

1999-01-01

307

Hypervelocity Projectile Launcher for Well Perforation.  

National Technical Information Service (NTIS)

Current oil well perforation techniques use low- to medium-velocity gun launchers for completing wells in soft rock. Shaped-charge jets are normally used in harder, more competent rock. A device to create a much higher velocity projectile was designed. Th...

J. N. Albright L. E. Fugelso G. C. Lagner K. L. Burns

1989-01-01

308

A hypervelocity projectile launcher for well perforation  

Microsoft Academic Search

Current oil well perforation techniques use low- to medium-velocity gun launchers for completing wells in soft rock. Shaped-charge jets are normally used in harder, more competent rock. A device to create a much higher velocity projectile was designed. This launcher will provide an alternative technique to be used when the conventional devices do not yield the maximum well performance. It

J. N. Albright; L. E. Fugelso; G. C. Lagner; K. L. Burns

1989-01-01

309

Energy and momentum changes during ballistic perforation  

Microsoft Academic Search

The paper presents an investigation of the energy and momentum changes of a projectile during the perforation of monolithic and composite targets. Three approaches are adopted: an analytical approach, based on first principles, an analytical development of established penetration prediction equations and an experimental investigation. Experimental evidence indicates that the energy and momentum transfer to the target is greatest at

J. G. Hetherington

1996-01-01

310

Jejunal Diverticular Perforation due to Enterolith  

PubMed Central

Jejunal diverticulosis is a rare entity with variable clinical and anatomical presentations. Although there is no consensus on the management of asymptomatic jejunal diverticular disease, some complications are potentially life-threatening and require early surgical treatment. Small bowel perforation secondary to jejunal diverticulitis by enteroliths is rare. The aim of this study was to report a case of small intestinal perforation caused by a large jejunal enterolith. An 86-year-old woman was admitted with signs of diffuse peritonitis. After initial fluid recovery the patient underwent emergency laparotomy. The surgery showed that she had small bowel diverticular disease, mainly localized in the proximal jejunum. The peritonitis was due to intestinal perforation caused by an enterolith 12 cm in length, localized inside one of these diverticula. The intestinal segment containing the perforated diverticulum with the enterolith was removed and an end-to-end anastomosis was done to reconstruct the intestinal transit. The patient recovered well and was discharged from hospital on the 5th postoperative day. There were no signs of abdominal pain 1 year after the surgical procedure. Although jejunal diverticular disease with its complications, such as formation of enteroliths, is difficult to suspect in patients with peritonitis, it should be considered as a possible source of abdominal infection in the elderly patient when more common diagnoses have been excluded.

Nonose, Ronaldo; Valenciano, Juliana Santos; de Souza Lima, Jacintho Soares; Nascimento, Enzo Fabricio; Silva, Camila Morais Goncalves; Martinez, Carlos Augusto Real

2011-01-01

311

Performance characterization of perforated multilayer insulation blankets  

Microsoft Academic Search

Perforated multilayer insulation (MLI) blanket systems are targeted for large- scale cryogenic facilities. Space applications and particle accelerators are two fields concerned with thermal shielding of cryogenic devices. Because radiation heat transfer varies with T 4, heat transfer in the range of 300 K to 77 K is dominant even for devices operating at temperatures as low as 2 K.

312

Surgical complications of typhoid fever: Enteric perforation  

Microsoft Academic Search

Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical

Miguel Santillana

1991-01-01

313

Postvaginal Delivery Caecal Volvulus and Perforation  

PubMed Central

Intestinal obstruction is an uncommon complication of pregnancy and pueperium. It has different etiologies and voluvlus is one of the common causes. High index of suspicion is needed to diagnose it as initial presentation is nonspecific and that is critical to avoid adverse outcomes. We presented here one of these cases that followed vaginal delivery and ended with caecal perforation and hemicolectomy.

Abdullah Agha, M. M.

2012-01-01

314

Perforating globe injury from Taser trauma.  

PubMed

We report a case of a blinding, perforating globe injury from Taser trauma. There have been other instances involving similar circumstances, but this traumatic event resulted in the loss of all meaningful vision and eventual enucleation. Despite meticulous planning and intervention, however, Taser trauma can result in devastating ocular injury. PMID:20551855

Teymoorian, Savak; San Filippo, Ashley N; Poulose, Abraham K; Lyon, David B

315

Peripheral melatonin mediates neural stimulation of duodenal mucosal bicarbonate secretion  

PubMed Central

Melatonin is released from intestinal enterochromaffin cells and from the pineal gland, but its role in gastrointestinal function is largely unknown. Our aim was to study the involvement of intestinal and central nervous melatonin in the neurohumoral control of the duodenal mucosa-protective bicarbonate secretion. Working in anesthetized rats, we cannulated a 12-mm segment of duodenum with an intact blood supply and titrated the local bicarbonate secretion with pH-stat. Melatonin and receptor ligands were supplied to the duodenum by close intra-arterial infusion. Even at low doses, melatonin and the full agonist 2-iodo-N-butanoyl-5-methoxytryptamine increased duodenal bicarbonate secretion. Responses were inhibited by the predominantly MT2-selective antagonist luzindole but not by prazosin, acting at MT3 receptors. Also, luzindole almost abolished the marked rise in secretion induced by intracerebroventricular infusion of the adrenoceptor agonist phenylephrine. This response was also abolished by sublaryngeal ligation of all nerves around the carotid arteries. However, it was insensitive to truncal vagotomy alone or sympathectomy alone and was unaffected by removal of either the pineal gland or pituitary gland. Thus, melatonin stimulates duodenal bicarbonate secretion via action at enterocyte MT2-receptors and mediates neural stimulation of the secretion.

Sjoblom, Markus; Jedstedt, Gunilla; Flemstrom, Gunnar

2001-01-01

316

Bovine Milk Inhibits Proteolytic Degradation of Epidermal Growth Factor in Human Gastric and Duodenal Lumen  

Microsoft Academic Search

R. K. Rao, R. D. Baker and S. S. Baker. Bovine milk inhibits proteolytic degradation of epidermal growth factor in human gastric and duodenal lumen. Peptides 19(3) 495–504, 1998.—Degradation of epidermal growth factor (EGF) in human gastric and duodenal lumen was analyzed by incubating 125I-labeled or unlabeled human recombinant EGF with human gastric or duodenal luminal fluids in vitro. Degradation

R. K Rao; R. D Baker; S. S Baker

1998-01-01

317

In Vitro Model for Liposome-Mediated Adenomatous Polyposis Coli Gene Transfer in a Duodenal Model  

Microsoft Academic Search

PURPOSE: Duodenal adenomas arise in more than 90 percent of patients with familial adenomatous polyposis (FAP). Management of severe duodenal disease remains difficult and controversial. This study investigates transfer of functional wild-type adenomatous polyposis coli (APC) gene under conditions of varying pH and bile concentrations into a somatic duodenal cancer cell line (HUTU-80) as a prelude to in vivo gene

Jack Lee; Rachel Hargest; Harpreet Wasan; Robin K. S. Phillips

2004-01-01

318

Effect of cysteamine on redox-sensitive thiol-containing proteins in the duodenal mucosa  

Microsoft Academic Search

Recent studies from our laboratory demonstrated that Egr-1 is upregulated in the rat duodenal mucosa during cysteamine-induced duodenal ulceration and that antisense egr-1 oligonucleotide aggravates the duodenal ulcers. This study was aimed to determine the effects of cysteamine on redox-sensitive Egr-1 transcriptional activity and on other thiol-containing proteins such as redox factor-1 (Ref-1) and thioredoxin (Trx). Here we demonstrate for

Tetyana Khomenko; Xiaoming Deng; Martin R Jadus; Sandor Szabo

2003-01-01

319

Duodenal cytochrome B and hephaestin expression in patients with iron deficiency and hemochromatosis  

Microsoft Academic Search

Background & Aims: An increased duodenal expression of the iron transporters, divalent-metal-transporter-1, and ferroportin is observed in patients with iron deficiency or hereditary hemochromatosis. Two oxidoreductases, termed duodenal cytochrome b and hephaestin, are proposed to co-operate with divalent-metal-transporter-1 and FPN1, respectively, to transfer iron from the duodenal lumen to the circulation. Methods: In the present study, we investigated the mRNA

Heinz Zoller; Igor Theurl; Robert O. Koch; Andrew T. Mckie; Wolfgang Vogel; Gü Weiss

2003-01-01

320

Surveillance and treatment of periampullary and duodenal adenomas in familial adenomatous polyposis  

Microsoft Academic Search

Opinion statement  Patients with familial adenomatous polyposis (FAP) have a cumulative lifetime risk of over 90% for developing duodenal adenomas,\\u000a which are the precursor lesions for duodenal adenocarcinoma. Consequently, these patients have a 5% to 10% lifetime risk of\\u000a periampullary or duodenal adenocarcinoma, making this the leading cause of cancer death in FAP patients who have had prophylactic\\u000a colectomies. The increased

J. Chad Johnson; James A. DiSario; William M. Grady

2004-01-01

321

Long-term follow-up of iatrogenic atrial septal defect: after percutaneous mitral balloon valvuloplasty.  

PubMed

During percutaneous mitral balloon valvuloplasty, the Inoue method leaves patients with an iatrogenic atrial septal defect. In this study, we evaluated the factors affecting the development of iatrogenic atrial septal defect and searched for the possible influence of this defect on long-term outcomes.We reviewed the medical records of 267 patients who had undergone successful percutaneous mitral balloon valvuloplasty for symptomatic moderate or severe mitral stenosis from January 2000 through March 2004. Sixty-three of the 267 patients were enrolled in a face-to-face follow-up study. We noted their clinical and demographic characteristics. All included patients were asked for the endpoints of repeat percutaneous mitral balloon valvuloplasty or mitral valve surgery, cerebrovascular accident or transient ischemic attack, and the need of intervention for the iatrogenic atrial septal defect. They underwent standard 2-dimensional and Doppler echocardiographic examination. The presence of iatrogenic atrial septal defect was evaluated via the color-Doppler technique in the subcostal view and via contrast echocardiography.Patients were subclassified in accordance with the presence (n = 15) or absence (n = 48) of echocardiographically proven persistent iatrogenic atrial septal defect. When we compared the 2 groups, there were no significant differences in baseline demographic characteristics or in pre- and postprocedural echocardiographic data.We conclude that the presence of persistent iatrogenic atrial septal defects might not be predicted from echocardiographic or demographic data in patients undergoing percutaneous mitral balloon valvuloplasty. Fortunately, these defects are small in size and low in shunt ratio. They appear not to be associated with serious long-term outcomes. PMID:22163126

Korkmaz, Sule; Demirkan, Burcu; Guray, Yesim; Yilmaz, Mehmet Birhan; Sasmaz, Hatice

2011-01-01

322

In vitro evaluation of bacterial leakage through different perforation repair materials of teeth.  

PubMed

Purpose: This study was conducted to evaluate micro-leakage through different furcation repair dental materials which are used to repair iatrogenic perforations in teeth. Six commercially available dental materials high copper amalgam, glass ionomer cements (GIC) Fuji II and Fuji IX, intermediate restorative material (IRM), mineral trioxide aggregate (MTA) and fully injectable calcium phosphate cement (Chitra-CPC) were evaluated. Methods: Eighty extracted human molar teeth were prepared chemo-mechanically and allocated to six experimental and two control groups, each comprising of 10 teeth. Microleakage was evaluated using the Enterococcus fecalis bacterial penetration test and confirmed with a confirmatory broth. On a daily basis broth was evaluated for visual turbidity for 45 days and leakage was confirmed using Mac Conkey's medium. Results: Statistical analysis using the Chi-Square test has revealed a significant difference among the materials tested, with MTA and Chitra-CPC showing minimal leakage when compared to the other repair materials within this period. Conclusions: MTA and Chitra-CPC showed a similar micro leakage patterns and had a better sealing ability when compared to other materials in this study. PMID:20740427

Bellam, Kranti Kumari; Namburi, Suneel Kumar; Tripuraneni, Sunil Chandra

323

Structural analysis for wingspan stent in a perforator model.  

PubMed

Perforator infarction represents a critical problem after intracranial Wingspan stent. To explore the mechanism of perforator infarction, we simulated the stent-artery interaction at an atheromatous plaque with perforator. Structural deformation and biomechanical stress distribution after stenting were analyzed. High radial stress values were located along the stent struts, which surrounded the area with high circumferential stress. Stretched perforator orifice in a circumferential direction after stenting was simulated. These results show that structural deformation could play a role in the mechanism of perforator occlusion after Wingspan stenting. PMID:24070074

Fujimoto, Motoaki; Shobayashi, Yasuhiro; Takemoto, Koichiro; Tateshima, Satoshi; Viñuela, Fernando

2013-09-26

324

[Use of human fibrin glue for perforated trophic retinal ulcer.  

PubMed

A patient with a sterile trophic corneal perforation of 2 mm after cataract surgery underwent perforation closure with human fibrin glue. Whitening of the fibrin glue indicated a stable perforation closure 10 min after application. Perforation closure was successfully performed using human fibrin glue with complete epithelialization 2 weeks after surgery. Corneal perforation closure of sterile corneal ulcerations using human fibrin glue is a simple technique that may be successful in acute cases which have an increased risk of corneal transplant rejection. PMID:23760426

Röpke, A K; Plange, N

2013-06-14

325

[Analysis on characters of 220 cases of tympani membrane perforated].  

PubMed

220 cases of tympani membrane perforated were summarized retrospectively. The tympani membrane perforated of injury was different from otitis media's because they had marked or extreme marked difference in sex, age, ear distinction, shape, position, size, degree of hearing damaged, time of healing, cause of perforating and adhesive substance. This difference was relative to mechanism of tympani membrane perforated. The distinction gist of two sorts of tympani membrane perforated was expounded through comparison and analysis. It would be of great value to clinical forensic medical examination. PMID:12533889

Xu, Z

2001-02-01

326

Iatrogenic Blood-borne Viral Infections in Refugee Children from War and Transition Zones  

PubMed Central

Pediatric infectious disease clinicians in industrialized countries may encounter iatrogenically transmitted HIV, hepatitis B virus, and hepatitis C virus infections in refugee children from Central Asia, Southeast Asia, and sub-Saharan Africa. The consequences of political collapse and/or civil war—work migration, prostitution, intravenous drug use, defective public health resources, and poor access to good medical care—all contribute to the spread of blood-borne viruses. Inadequate infection control practices by medical establishments can lead to iatrogenic infection of children. Summaries of 4 cases in refugee children in Australia are a salient reminder of this problem.

2013-01-01

327

Predictive Factors of Complications After Surgical Repair of Iatrogenic Femoral Pseudoaneurysms  

Microsoft Academic Search

Background  The aim of the present study was to identify the predictive factors associated with the development of postoperative complications\\u000a in patients treated with surgical repair of iatrogenic femoral pseudoaneurysm.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  Between July 1992 and October 2009 we identified 92 cases of iatrogenic femoral pseudoaneurysm treated with conventional surgery.\\u000a Surgical repair was performed via a longitudinal groin incision. A primary

Gabriele Piffaretti; Giovanni Mariscalco; Matteo Tozzi; Nicola Rivolta; Patrizio Castelli; Andrea Sala

2011-01-01

328

Bare Stent Implantation in Iatrogenic Dissecting Pseudoaneurysm of the Superior Mesenteric Artery  

SciTech Connect

Iatrogenic arterial dissection leading to the development of dissecting pseudoaneurysms of the superior mesenteric artery (SMA) is a rare complication of angiography. Surgical and endovascular treatment options exist for this important condition. We report a case of bare stent implantation in dissecting pseudoaneurysm of the SMA that developed after angiography in a patient with acute mesenteric ischemia. Although it is rarely published, iatrogenic arterial dissection causing pseudoaneurysm can occur after diagnostic and interventional angiography. Bare stent implantation in dissecting pseudoaneurysm of the SMA could be an advantageous endovascular treatment option in selected cases due its to potential preservation of important side branches of the SMA.

Kutlu, Ramazan [Inonu University School of Medicine, Department of Radiology (Turkey)], E-mail: rkutlu@inonu.edu.tr; Ara, Cengiz [Inonu University School of Medicine, Department of General Surgery (Turkey); Sarac, Kaya [Inonu University School of Medicine, Department of Radiology (Turkey)

2007-02-15

329

DWI Findings in a Iatrogenic Lumbar Epidermoid Cyst. A Case Report.  

PubMed

Epidermoid cysts comprise less than 1% of intraspinal tumors. They can be congenital, frequently associated with other spinal malformations, or iatrogenic, resulting from the implantation of epidermal cells within the spinal canal during the execution of a variety of procedures such as spinal puncture. At MR imaging epidermoid tumors can mimic cystic lesions with fluid content such as arachnoid cysts. DWI can help obtain a correct diagnosis. We describe a case of iatrogenic lumbar epidermoid cyst with DWI findings in a young woman who had undergone epidural anesthesia for Cesarean section three years before the onset of symptoms. PMID:24007735

Manzo, G; De Gennaro, A; Cozzolino, A; Martinelli, E; Manto, A

2013-08-27

330

Iatrogenic tumor seeding after ureteral stenting in a dog with urothelial carcinoma.  

PubMed

A 5 yr old castrated male miniature dachshund presented with clinical signs attributable to carcinoma involving the bladder neck and prostate. On day 84 following diagnosis, the dog developed bilateral ureteral obstruction and ureteral stenting was attempted. The stents were inserted in a normograde fashion via percutaneous puncture of the dilated renal pelvises. Two wk later, the dog developed nodules at both sites of renocentesis. En block resection of the masses was performed, and histologic examination confirmed that the masses were urothelial carcinoma, likely caused by iatrogenic tumor seeding. Ureteral stenting is a useful technique to relieve malignant ureteral obstruction; however, risk of iatrogenic tumor seeding must be considered. PMID:23690494

Hosoya, Kenji; Takagi, Satoshi; Okumura, Masahiro

2013-05-20

331

Undetected iatrogenic lesions of the anterior femoral shaft during intramedullary nailing: a cadaveric study  

PubMed Central

Background The incidence of undetected radiographically iatrogenic longitudinal splitting in the anterior cortex during intramedullary nailing of the femur has not been well documented. Methods Cadaveric study using nine pairs of fresh-frozen femora from adult cadavers. The nine pairs of femora underwent a standardized antegrade intramedullary nailing and the detection of iatrogenic lesions, if any, was performed macroscopically and by radiographic control. Results Longitudinal splitting in the anterior cortex was revealed in 5 of 18 cadaver femora macroscopically. Anterior splitting was not detectable in radiographic control. Conclusion Longitudinal splitting in the anterior cortex during intramedullary nailing of the femur cannot be detected radiographically.

Papadakis, Stamatios A; Zalavras, Charalampos; Mirzayan, Raffy; Shepherd, Lane

2008-01-01

332

Iatrogenic arteriovenous fistula in the arm in an infant: diagnostic and therapeutic considerations.  

PubMed

Iatrogenic arteriovenous fistulas (AVF) are well described in adults; however, this complication is rarely described and reported in infants. We report the case of a 3-month-old infant with complicated gastroschisis requiring multiple venipunctures who presented with signs and symptoms suggestive of traumatic arteriovenous fistula. Ultrasound imaging confirmed the presence of a wide-necked AVF between the brachial artery and vein. The fistula was surgically repaired. This case report describes the clinical imaging and treatment options for infants with iatrogenic AVF. PMID:22102366

Kotagal, Meera; Reiss, Aya; Vo, Nghia; Feldman, Kenneth; Drugas, George; Avansino, Jeffrey R

2011-11-21

333

Balloon-assisted N-butyl-2-cyanoacrylate closure of an iatrogenic femoral arteriovenous fistula.  

PubMed

Femoral arteriovenous fistula (AVF) is an abnormal communication between femoral artery and vein, which is frequently caused by an iatrogenic or traumatic event. Surgery and endovascular approach with coil and stent graft placement are the most frequent choices of treatment. Herein, we present 2 cases of iatrogenic superficial femoral AVF, which were treated with percutaneous balloon-assisted N-butyl-2-cyanoacrylate glue (N-BCA). Both fistulae had a short tract, and 1 of the patients had previously undergone a failed coil embolization. The occlusions with N-BCA were achieved immediately, and both fistulae remained obliterated at 1 and 12 months of follow-up. PMID:23339151

Wang, Weiping; Moon, Eunice; Spain, James

2013-01-20

334

Iatrogenic blood-borne viral infections in refugee children from war and transition zones.  

PubMed

Pediatric infectious disease clinicians in industrialized countries may encounter iatrogenically transmitted HIV, hepatitis B virus, and hepatitis C virus infections in refugee children from Central Asia, Southeast Asia, and sub-Saharan Africa. The consequences of political collapse and/or civil war-work migration, prostitution, intravenous drug use, defective public health resources, and poor access to good medical care-all contribute to the spread of blood-borne viruses. Inadequate infection control practices by medical establishments can lead to iatrogenic infection of children. Summaries of 4 cases in refugee children in Australia are a salient reminder of this problem. PMID:23739597

Goldwater, Paul N

2013-06-01

335

Alpha-hemolytic streptococci: A major pathogen of iatrogenic meningitis following lumbar puncture. Case reports and a review of the literature  

Microsoft Academic Search

Summary Iatrogenic meningitis following lumbar puncture is a rare complication of myelography, spinal anesthesia, intrathecal chemotherapy, and epidural anesthesia. Sporadic cases and clusters of iatrogenic meningitis have been reported after intrathecal therapy, but most incidental cases are reported after myelography. Four cases of iatrogenic meningitis caused by viridans streptococci and a review of the literature are presented here. Observations and

P. M. Schneeberger; M. Janssen; A. Voss

1996-01-01

336

Risk factors of oesophageal perforation during pneumatic dilatation for achalasia.  

PubMed Central

BACKGROUND/AIMS: Pneumatic dilatation of the oesophagus is a well established treatment for achalasia. Oesophageal perforation is the most serious complication that occurs in 2% to 6% of cases. The aim of this retrospective survey was to identify predictive risk factors for perforation in a consecutive series of 218 patients with achalasia. METHODS: Between 1983 and 1993, 270 pneumatic dilatations were performed in 218 patients. A Witzel dilator was used in 58 cases and a Rigiflex dilator in 212. Eight oesophageal perforations occurred (3%). The clinical, radiological, endoscopic, manometric, and technical data for the eight perforated patients were compared with those of 30 patients randomly sampled among those without perforation. RESULTS: All perforations occurred during the first dilatation. Perforations were fewer during dilatations with the Rigiflex dilator than with the Witzel dilator (2.4% v 5.2%). Perforations were all located above the cardia, on the left side of the oesophagus. In a multivariate analysis, a small weight loss and a high amplitude of oesophageal contractions in the group of patients with perforations were predictive of complications (respectively, p = 0.001 and p = 0.026). A contraction amplitude higher than 70 cm H2O in the lower part of the oesophagus was observed in three of eight patients with perforations but was not seen in any of the 30 patients without perforation (p < 0.01). CONCLUSIONS: This identification of risk factors should facilitate the choice between pneumatic dilatation or a surgical approach.

Borotto, E; Gaudric, M; Danel, B; Samama, J; Quartier, G; Chaussade, S; Couturier, D

1996-01-01

337

Paramuscular Perforators in DIEAP Flap for Breast Reconstruction.  

PubMed

: One of the main steps in perforator flap surgery is to identify the dominant perforator. Using multidetector row computed tomography (MDCT) for the preoperative planning of deep inferior epigastric artery perforator (DIEAP) flap surgery, we identified a perforator with a large caliber, an excellent location in the middle abdominal region, and a totally extramuscular trajectory in a significant number of patients. We describe the frequency of this perforator and determine its characteristics. PATIENTS AND METHODS: We conducted a retrospective study of 482 patients who underwent 526 DIEAP flaps for breast reconstruction from October 2003 to October 2011. Mean age at surgery was 51.3 years old. A preoperative MDCT of abdominal vascularization was performed in all patients. RESULTS: MDCT identified a dominant perforator with a paramuscular course in 12.4% of abdominal walls. In all cases, it was located in the midline and emerged directly from the deep inferior epigastric system. Its mean caliber was 1.9 mm. The flap was harvested based on this perforator in all these patients, and mean harvest time was 51 minutes. The characteristics of this perforator made dissection easier and reduced morbidity at the donor site. There were no flap losses and the only complications were minor. CONCLUSION: We located a paramuscular perforator in 12.4% of patients undergoing breast reconstruction with abdominal perforator flaps. Its morphological features and extramuscular course make it the perforator of choice in DIEAP flap surgery. PMID:23728240

Pons, Gemma; Masia, Jaume; Sanchez-Porro, Lídia; Larrañaga, Jose; Clavero, Juan Angel

2013-05-30

338

The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation  

PubMed Central

Objective: To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Study Design: Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011. Materials and Method: This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Result: Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. Conclusion: The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation –operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation.

Surapaneni, Sushama; S, Rajkumar; Reddy A., Vijaya Bhaskar

2013-01-01

339

The Perforation-Operation time Interval; An Important Mortality Indicator in Peptic Ulcer Perforation.  

PubMed

Objective: To find out the significance of the Perforation-Operation Interval (POI) with respect to an early prognosis, in patients with peritonitis which is caused by peptic ulcer perforation. Study Design: Case series. Place and Duration of the Study: Department of General Surgery, Konaseema Institute of Medical Sciences and RF Amalapuram, Andhra Pradesh, India from 2008-2011. Materials and Method: This study included 150 patients with generalized peritonitis, who were diagnosed to have Perforated Peptic Ulcers (PPUs). The diagnosis of the PPUs was established on the basis of the history , the clinical examination and the radiological findings. The perforation-operation interval was calculated from the time of onset of the symptoms like severe abdominal pain or vomiting till the time the patient was operated. Result: Out of the 150 patients 134 were males and 16 were females, with a male : female ratio of 9:1. Their ages ranged between 25-70 years. Out of the 150 patients, 65 patients (43.3%) presented within 24 hours of the onset of severe abdominal pain (Group A), 27 patients (18%) presented between 24-48 hours of the onset of severe abdominal pain (Group B) and 58 patients (38.6%) presented after 48 hours. There was no mortality in Group A and the morbidity was more in Group B and Group C. There were 15 deaths in Group C. Conclusion: The problem of peptic ulcer perforation with its complication, can be decreased by decreasing the perforation -operation time interval, which as per our study, appeared to be the single most important mortality and morbidity indicator in peptic ulcer perforation. PMID:23814733

Surapaneni, Sushama; S, Rajkumar; Reddy A, Vijaya Bhaskar

2013-05-01

340

[Perforated peptic ulcer disease in the elderly].  

PubMed

There has been a marked decrease in elective surgery for peptic ulcer disease following introduction of medical therapies including H2-receptor antagonists (H2-RA) and proton pump inhibitors (PPI). By contrast, the incidence of emergency surgery for perforated peptic ulcer(PPU) has remained relatively unchanged, and potentially increased. Conservative treatment of PPU should be selected based on the physical condition of the patient. Open and laparoscopic repair of PPU are made with peritoneal lavage and omental patch closure of perforation. Laparoscopic repair of PPU seems better than open repair for low-risk patients. However, open repair for high-risk patients of PPU should not be delayed, and prognosis is affected primarily by concomitant medical comorbidity in the elderly. PMID:21061540

Kondoh, Yasumasa

2010-11-01

341

Pneumomediastinum caused by colonic diverticulitis perforation  

PubMed Central

A 59-year-old man presented with abdominal and left flank pain. The symptom had started 30 days before as an acute nephrolithiasis, which had worsened despite conservative management. The abdomen was slightly distended and tender over the lower abdomen, without signs of generalized peritoneal irritation. A computed tomography (CT) scan showed an abscess in left para-renal space up to the subphrenic space and an unexpected pneumomediastinum. An emergency operation was performed, which showed retroperitoneal diverticulitis perforation of the sigmoid descending junction with abscess formation. A segmental resection of the diseased colon and end-colostomy was performed (Hartmann's procedure). However, the patient's condition progressively deteriorated, and he died of sepsis and multi-organ failure on the 5th postoperative day. Although pneumomediastinum caused by colonic diverticulitis perforation is extremely rare, it could be a life-threatening condition in patients without signs of peritonitis because of delayed diagnosis.

2011-01-01

342

Overbalance perforating and stimulation method for wells  

SciTech Connect

This patent describes a method for decreasing the resistance to fluid flow in a subterranean formation around a well having unpreforated casing fixed therein, the casing extending at least partially through the formation. It comprises providing a liquid in the casing opposite the formation to be treated; placing perforating means in the casing at a depth opposite the formation to be treated; injecting gas into the well until the pressure in the liquid opposite the formation to be treated will be at least as large as the fracturing pressure of the formation when the liquid pressure is applied to the formation; activating the perforating means; and at a time before pressure in the well at the depth of the formation to be treated has substantially decreased, injecting fluid at an effective rate to fracture the formation.

Dees, J.M.; Handren, P.J.; Jupp, T.B.

1992-07-21

343

An experimental study of perforated muzzle brakes  

NASA Astrophysics Data System (ADS)

A firing test was conducted to examine the recoil efficiency and blast characteristics of perforated muzzle brakes fitted to a 20 mm cannon. Recoil impulse blast overpressures, muzzle velocity, sequential spark shadowgraphs, and photographs of the muzzle flash structure were obtained. Three different nuzzle devices were used with one device equipped with pressure transducers to measure the static pressure in the brake. Experimental results are compared with the earlier predictions of Dillon and Nagamatsu.

Dillon, R. E., Jr.; Nagamatsu, H. T.

1984-06-01

344

Colonic perforation in Beh?et's syndrome  

PubMed Central

A 17-year-old gentleman was admitted to our hospital for headache, the differential diagnosis of which included Behçet’s syndrome (BS). He developed an acute abdomen and was found to have air under the diaphragm on erect chest X-ray. Subsequent laparotomy revealed multiple perforations throughout the colon. This report describes an unusual complication of Behcets syndrome occurring at the time of presentation and a review of the current literature of reported cases.

Dowling, Catherine M; Hill, Arnold DK; Malone, Carmel; Sheehan, John J; Tormey, Shona; Sheahan, Kieran; McDermott, Enda; O'Higgins, Niall J

2008-01-01

345

Urosepsis complicated by a spontaneous bladder perforation.  

PubMed

The authors present a case of a 72-year-old diabetic male s/p pelvic irradiation for prostate carcinoma who arrived in the emergency department with complaints of shaking chills. After admission for urosepsis, he developed severe abdominal pain and examination revealed a diffusely tender abdomen. The patient was diagnosed with spontaneous urinary bladder perforation and underwent surgery. After several weeks of intravenous antibiotics, he was discharged with multiple drains in place and bilateral nephrostomy tubes. PMID:22674104

Lutwak, Nancy; Dill, Curt

2011-11-08

346

Perforation of thin unreinforced concrete slabs  

Microsoft Academic Search

This report discusses fourteen tests which were conducted to investigate the perforation of thin unreinforced concrete slabs. The 4340-steel projectile used in the test series is 50.8 mm in diameter, 355.6 mm in length, has a mass of 2.34 kg. and an ogive nose with caliber radius head of 3. The slabs, contained within steel culverts, are 1.52 m in

J. D. Cargile; M. E. Giltrud; V. K. Luk

1993-01-01

347

Projectile perforation of moving plates: experimental investigation  

Microsoft Academic Search

An experimental investigation was conducted to examine the normal impact and perforation of blunt- and 60°-conically-tipped 12.7 mm diameter hard-steel cylindrical projectiles on plates moving orthogonal to their initial trajectory with three different speeds. By means of an air or powder gun, these bullets were propelled at speeds ranging from 50 to 1000m\\/s against rotating annular disks of aluminum, steel

Xiofan Hou; Werner Goldsmith

1996-01-01

348

Tracheal perforation by an oesophageal stent.  

PubMed

In a 63 year-old female patient with oesophageal carcinoma a tracheal perforation by an oesophageal stent was diagnosed. A first attempt of tracheal stenting was not successful due to spontaneous dislocation of the stent. Therefore, a shorter stent was chosen and correctly placed in a second session. This case report on an oesophagotracheal fistula provides a summary of this complication in advanced oesophageal cancer. PMID:23055372

Knoop, H; Knoop, U; Martini, H-C-D; Heining, L; Wolf, R; Ewig, S; Hecker, E

2012-10-10

349

Endovascular embolization of iatrogenic lumbar artery pseudoaneurysm following extreme lateral interbody fusion (XLIF).  

PubMed

Iatrogenic lumbar artery pseudoaneurysm is a very rare complication of spinal surgery. To the best of our knowledge, this is the first report of a lumbar artery pseudoaneurysm after extreme lateral interbody fusion (XLIF). The lesion was diagnosed by catheter spinal angiography and was effectively treated with embolization. PMID:20675335

Santillan, Alejandro; Patsalides, Athos; Gobin, Y Pierre

2010-07-30

350

The Iatrogenic Effects of Group Intervention for Antisocial Youth: Premature Extrapolations?  

Microsoft Academic Search

Group intervention for antisocial youth has received harsh criticism in recent years. This paper reviews relevant research focused on the influence of contact with delinquent peers on the development of antisocial activity. Also reviewed are studies reporting outcomes of group intervention for antisocial youth. Although a few studies have found iatrogenic effects for group intervention with antisocial youth, the majority

Michael L. Handwerk; Clinton E. Field; Patrick C. Friman

2000-01-01

351

Iatrogenic Paresthesia in the Third Division of the Trigeminal Nerve: 12 Years of Clinical Experience  

Microsoft Academic Search

Background: Iatrogenic paresthesia in the third division of the trigeminal nerve remains a complex clinical problem with major medicolegal implications. However, most lawsuits can be prevented through better planning of procedures and by obtaining informed consent. The purpose of this article is to present the authors' clinical experience over the past 12 years, to review the principles of prevention and

René Caissie; Jacques Goulet; Michel Fortin; Domenic Morielli

2005-01-01

352

Iatrogenic Arteriovenous Fistula in a Renal Allograft: The Result of a TAD Guidewire Injury  

Microsoft Academic Search

A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis

Catherine Lee-Elliott; Kok-Tee Khaw; Anna-Maria Belli; Uday Patel

2000-01-01

353

Emergency endovascular repair of iatrogenic aortocaval fistula: a rare complication of laparoscopic surgery.  

PubMed

We present the first reported case of iatrogenic aortocaval fistula due to trochar injury after attempted laparoscopic repair of incisional hernia. It was diagnosed with an x-ray computed tomography and successfully managed with an endovascular-covered stent graft by excluding the fistula. A follow-up computed tomography scan at 3 months did not show any recurrence. PMID:22678342

Sinha, Surajit; Kember, Peter; Currie, Ian

2012-06-01

354

Occult glove perforation during ophthalmic surgery.  

PubMed Central

We examined the latex surgical gloves used by 56 primary surgeons in 454 ophthalmic surgical procedures performed over a 7-month period. Of five techniques used to detect pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.8% prevalence in postoperative study glove pairs, for a 15.0% incidence of surgically induced perforations (P = 0.000459). The lowest postoperative perforation rate was 11.4% for cataract and intraocular lens surgery, and the highest was 41.7% for oculoplastic procedures. Factors that correlated significantly with the presence of glove perforations as determined by multiple logistic regression analysis were oculoplastic and pediatric ophthalmology and strabismus surgical procedures, surgeon's status as a fellow in training, operating time, and glove size. The thumb and index finger of the nondominant hand contained the largest numbers of pinholes. These data suggest strategies for reducing the risk of cross-infection during ophthalmic surgery.

Apt, L; Miller, K M

1992-01-01

355

Perforation of thin unreinforced concrete slabs  

SciTech Connect

This report discusses fourteen tests which were conducted to investigate the perforation of thin unreinforced concrete slabs. The 4340-steel projectile used in the test series is 50.8 mm in diameter, 355.6 mm in length, has a mass of 2.34 kg. and an ogive nose with caliber radius head of 3. The slabs, contained within steel culverts, are 1.52 m in diameter and consist of concrete with a nominal unconfined compressive strength of 38.2 MPa and maxima aggregate size of 9.5 mm. Slab thicknesses are 284.4, 254.0, 215.9 and 127.0 mm. Tests were conducted at impact velocities of about 313 m/s on all slab thicknesses and about 379 and 471 m/s on the 254.0-mm-thick slab. All tests were conducted at normal incidence to the slab. All tests were conducted at normal incidence to the slab. Information obtained from the tests used to determine the loading (deceleration) on the projectile during the perforation process, the velocity-displacement of the projectile as it perforated the slab, and the projectile position as damage occurred on the backface of the slab. The test projectile behaved essentially as a rigid body for all of the tests.

Cargile, J.D. [Army Engineer Waterways Experiment Station, Vicksburg, MS (United States); Giltrud, M.E. [Defense Nuclear Agency, Washington, DC (United States); Luk, V.K. [Sandia National Labs., Albuquerque, NM (United States)

1993-10-01

356

Urinary purine derivative excretion in swamp buffaloes after duodenal purine base infusion  

Microsoft Academic Search

Four male swamp buffaloes (Bubalus bubalis) each fitted with a duodenal catheter, with an initial body weight of 244±19.8kg were used to study the recovery rate of urinary purine derivatives (PD) after duodenally infused with incremental amounts of purine bases (PB). During the experiment, the buffaloes were fed, at a maintenance energy level, a diet containing 40% oil palm frond

O Pimpa; J. B Liang; J Balcells; Z. A Jelan; N Abdullah

2003-01-01

357

Controlled therapeutic trial to determine the optimum dose of antacids in duodenal ulcer  

Microsoft Academic Search

Antacids are widely used in the management of duodenal ulcer but the optimum dose of antacid required for ulcer healing has not been determined. We therefore studied 107 patients with endoscopically diagnosed duodenal ulcer who were allotted at random to one of the following treatment groups; placebo (group P) and antacid (groups A, B and C). A liquid antacid (Aludrox

N Kumar; J C Vij; A Karol; B S Anand

1984-01-01

358

Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate  

Microsoft Academic Search

Persistence of Helicobacter pylori after duodenal ulcer healing is associated with high rates of ulcer relapse. We compared colloidal bismuth subcitrate alone with CBS combined with one of four antibiotic regimens in the treatment of duodenal ulcers. Endoscopy and antral biopsies were performed before treatment and four weeks afterwards. Biopsy specimens were examined for histological evidence of gastritis and by

T ORiordan; E Mathai; E Tobin; D McKenna; C Keane; E Sweeney; C OMorain

1990-01-01

359

Decision analysis in the management of duodenal adenomatosis in familial adenomatous polyposis  

Microsoft Academic Search

BACKGROUND: Patients with familial adenomatous polyposis are not only at high risk of developing adenomas in the colorectum but a substantial number of patients also develop polyps in the duodenum. Because treatment of duodenal polyps is extremely difficult and it is unknown how many patients ultimately develop duodenal cancer, the value of surveillance of the upper digestive tract is uncertain.

H. F. A. Vasen; S. Bulow; T. Myrhoj; L Mathus-Vliegen; G. Griffioen; E. Buskens; B. G. Taal; F. M. Nagengast; J. F. M. Slors; P. E. de Ruiter

1997-01-01

360

SUCCESSFUL THERAPY OF BLEEDING DUODENAL VARICES BY TIPS AFTER FAILURE OF SCLEROTHERAPY  

Microsoft Academic Search

Hemorrhage from duodenal varices may be severe and life threatening. We report a patient with portal hypertension and bleeding duodenal varices caused by cirrhosis of the liver. Endoscopic sclerotherapy and intravenous vasopressin failed to control bleeding in this patient. Hemorrhage was subsequently controlled by placement of a transjugular intrahepatic portosystemic shunt. We recommend that in patients with life-threatening hemorrhage from

Sreenivasa S. Jonnalagadda; Stella Quiason; Owen J. Smith

1998-01-01

361

Reevaluation of duodenal endoscopic markers in the diagnosis of celiac disease  

Microsoft Academic Search

Background: Loss or reduction of duodenal folds, scalloping of Kerkring folds and a micronodular or mosaic duodenal mucosal pattern have been described in celiac disease (CD), endoscopic findings that are considered reliable in the diagnosis of this disorder. However, most data have been obtained in patients with suspected or certain disease. We assessed the accuracy of the above markers in

Maria Teresa Bardella; Giorgio Minoli; Franco Radaelli; Maurizio Quatrini; Paolo A. Bianchi; Dario Conte

2000-01-01

362

Importance of duodenal bulb biopsies in children for diagnosis of celiac disease in clinical practice  

Microsoft Academic Search

BACKGROUND: The patchy nature of villous lesion in celiac disease is increasingly being recognized. Current guidelines recommend four endoscopic duodenal mucosal biopsies from the second or more distal part of the duodenum to confirm the diagnosis of celiac disease. The purpose of the study was to investigate the usefulness of duodenal bulb mucosal biopsies in confirming the diagnosis of celiac

Mohsin Rashid; Andrea MacDonald

2009-01-01

363

The possibility of dietary protective factors in duodenal ulcer  

PubMed Central

Rats fed on a supplement of raw cabbage, brinjal, dhal or powdered milk given in addition to a staple rice or laboratory stock diet show a high degree of protection against experimental ulceration following pyloric ligation. Wheat bran and ragi (a millet) conferred some protection, whereas rice bran and maize conferred no protection. The protection conferred by raw cabbage was destroyed by cooking. The lettuce used conferred no protection. The significance of such findings with regard to the geographical distribution of duodenal ulcer in India and Africa is discussed.

Tovey, F. I.; Jayaraj, A. Paul; Clark, C. G.

1975-01-01

364

Laparoscopic Resection of Antenataly Identified Duodenal Duplication Cyst  

PubMed Central

We report the first case of complete laparoscopic resection of a duodenal duplication cyst (DDC) in an 8-mo-old patient. The cyst was diagnosed by routine antenatal ultrasound performed at 3 mo of gestational age. Although the baby was born asymptomatic without any congenital abnormalities, the cyst had continued to increase on serial sonographic examinations. Previous reports have described treatment of DDC by surgical resection (laparotomy) or endoscopic marsupialization; we describe here, the first report of laparoscopic approach to resect DDC in a pediatric patient with a favorable outcome.

Ballehaninna, Umashankar K.; Nguyen, Tin

2013-01-01

365

Why is the coexistence of gastric cancer and duodenal ulcer rare? Examination of factors related to both gastric cancer and duodenal ulcer  

Microsoft Academic Search

The coexistence of gastric cancer with duodenal ulcer has been found empirically to be rare, but why it is rare is difficult\\u000a to explain satisfactorily. To elucidate this question, we carried out a literature review of the subject. The frequency with\\u000a which the two diseases coexist is 0.1–1.7%, and the main factor associated with both gastric cancer and duodenal ulcer

Hideyuki Ubukata; Hiroyuki Nagata; Teruhiko KasugaTakafumi Tabuchi; Satoru Konishi; Teruhiko Kasuga; Takafumi Tabuchi

2011-01-01

366

Computer simulation of flow and mixing at the duodenal stump after gastric resection  

PubMed Central

AIM: To investigate the flow and mixing at the duodenal stump after gastric resection, a computer simulation was implemented. METHODS: Using the finite element method, two different Billroth II procedure cases (A and B) were modeled. Case A was defined with a shorter and almost straight duodenal section, while case B has a much longer and curved duodenal section. Velocity, pressure and food concentration distribution were determined and the numerical results were compared with experimental observations. RESULTS: The pressure distribution obtained by numerical simulation was in the range of the recorded experimental results. Case A had a more favorable pressure distribution in comparison with case B. However, case B had better performance in terms of food transport because of more continual food distribution, as well as better emptying of the duodenal section. CONCLUSION: This study offers insight into the transport process within the duodenal stump section after surgical intervention, which can be useful for future patient-specific predictions of a surgical outcome.

Filipovic, Nenad; Cvetkovic, Aleksandar; Isailovic, Velibor; Matovic, Zoran; Rosic, Mirko; Kojic, Milos

2009-01-01

367

Effects of Solanum malacoxylon on duodenal calcium binding protein in the diabetic rat.  

PubMed

Duodenal calcium absorption and calcium binding protein (CaBP) are depressed in uncontrolled experimental (alloxan and streptozotocin) diabeties in the rat. Administration of an aqueous extract of the South American plant Solanum malacoxylon to diabetic rats restores duodenal calcium absorption to control levels. Since CaBP is thought to play a role in intestinal calcium transport, we isolated CaBP from duodenal mucosa of control, diabetic, and S. malacoxylon-treated diabetic rats. CaBP, whose concentration is about half normal in mucosal extracts from diabetic rats by treatment of diabetics with Smalacoxylon extracts. Hence these studies provide a further correlation between duodenal calcium absorption and levels of duodenal CaBP. In addition, a new purification procedure is described which produces a 17-fold increase in purity of CaBP above that attainable by our previously reported method. PMID:138586

Schneider, L E; Schedl, H P

1977-04-01

368

On deformation and perforation of ship structures under ballistic impacts  

Microsoft Academic Search

This paper investigates the characteristics of the deformation and perforation on thin-walled structures under ballistic impacts based on the DYNA3D numerical simulations. Perforation mechanisms of plates and numerical modelling techniques to simulate the response of thin-walled structures under ballistic impacts are discussed to some extent. A benchmark study on deformation and perforation of steel plates struck by a rigid projectile

J. K. Paik; S. H. Won

2007-01-01

369

Surgical treatment of perforated diverticulitis of the sigmoid colon  

Microsoft Academic Search

A retrospective review of 1353 cases of acute perforated sigmoid diverticulitis treated surgically demonstrates that those\\u000a operations that resect or exteriorize the perforated segment at the first operation are associated with a lower operative\\u000a mortality rate than procedures that fail to remove the perforated segment at the initial operation. These results are true\\u000a for both diffuse peritonitis and localized abscess.

Jon M. Greif; Gregory Fried; Charles K. McSherry

1980-01-01

370

Hypermagnesemia Accompanied with Colonic Perforation in a Hemodialysis Patient  

PubMed Central

We report a case of a chronic hemodialysis patient who developed hypermagnesemia due to an overdose of magnesium-containing laxative and paralytic ileus resulting in colonic perforation. Despite intravenous calcium infusion and daily hemodialysis, the patient developed ischemic colitis and intestinal perforation. Colonic perforation accompanied with hypermagnesemia in hemodialysis patients has rarely been reported. This case suggests that hypermagnesemia should be considered in renal failure patients as this can result in life-threatening events despite prompt treatment.

Yoon, Hye Eun; Kim, Young Wook; Ha, Kyung Sun; Sim, Eun Hui; Go, Seong Woo

2013-01-01

371

Fundic balloon distension stimulates antral and duodenal motility in man.  

PubMed

Distension of the intestine triggers the peristaltic reflex, which consists of orad contraction and aborad relaxation. Whether a similar response occurs in the human stomach is unclear. Our aim was to investigate the antral and duodenal motor response(s) to mechanical distension of the proximal stomach. In six healthy volunteers, a large compliant balloon was placed in the proximal stomach. Alongside this a water-perfused manometry probe with six sensors was placed to measure the antral and duodenal motility. Pressure activity was assessed before and during balloon distension. In five of six subjects, balloon distension triggered a salvo of antral pressure waves within 3-5 min, some of which propagated into the duodenum. The amplitude of waves was higher (P < 0.05) at the antrum than at the duodenum. The area under the curve of pressure waves was higher (P < 0.05) at the antrum than at the duodenum. In conclusion, distension of the proximal stomach, at or below the threshold for perception, evokes phasic motor activity in the antrum and duodenum. Thus, the gastric response to distension differs from that observed during the intestinal peristaltic reflex. PMID:12018896

Rao, Satish S C; Vemuri, Sreevani; Harris, Brenton; Schulze, Konrad

2002-05-01

372

Gastric outlet obstruction due to duodenal bezoar: A case report?  

PubMed Central

INTRODUCTION Gastric outlet obstruction (GOO) is a clinical syndrome characterized by abdominal pain and postprandial vomiting. Causes of GOO include both benign and malignant disease. Bezoars, concretions of undigested or partially digested material in the gastrointestinal tract, are a rare entity and GOO due to duodenal bezoar is an uncommon presentation. PRESENTATION OF CASE We report the case of a 56-year-old woman who presented to the emergency department acutely with a 3-day history of epigastric pain, weakness and postprandial nonbilious vomiting. Initially, an upper gastrointestinal endoscopy (UGE) was performed to evaluate the cause of the GOO. A solid impacted bezoar was detected in the first portion of the duodenum with complete obstruction of the pyloric canal. In spite of multiple attempts for fragmentation using different devices, the extraction attempts failed. We administered acetylcysteine and cola per os. Abdominal computerized tomography was obtained and showed a solid mass in the duodenum. UGE was performed once more however, the mass was not suitable for fragmentation and removal. Thus, surgical treatment was decided. The bezoar was extracted via gastrotomy. The postoperative period was uneventful. DISCUSSION Even if a duodenal bezoar is small, because of its location it may cause GOO with abruptly clinical features. The diagnostic approach is similar to the other causes of the GOO. However, therapeutic options differ for each patient. CONCLUSION We should remember all the therapeutic and diagnostic options for a patient with upper gastrointestinal bezoars who present at the hospital whether or not there is a predisposing risk factor.

Guner, Ali; Kahraman, Izzettin; Aktas, Adem; Kece, Can; Reis, Erhan

2012-01-01

373

Forced convective heat transfer enhancement with perforated pin fins  

NASA Astrophysics Data System (ADS)

Increasing miniaturization of high speed multi-functional electronics demands ever more stringent thermal management. The present work investigates experimentally and numerically the use of staggered perforated pin fins to enhance the rate of heat transfer in these devices. In particular, the effects of the number of perforations and the diameter of perforation on each pin are studied. The results show that the Nusselt number for the perforated pins is 45 % higher than that for the conventional solid pins and it increases with the number of perforation. Pressure drop with perforated pins is also reduced by 18 % when compared with that for solid pins. Perforations produce recirculations in the x- y as well as the x- z planes downstream of the pins which effectively increase convective heat transfer. However, thermal dissipation decreases significantly when the ratio of pin diameter to perforation diameter exceeds 0.375. This is due to both a reduction in the number of perforation per pin and the decrease in the axial heat conduction along the pin.

Chin, Swee-Boon; Foo, Ji-Jinn; Lai, Yin-Ling; Yong, Terry Kin-Keong

2013-10-01

374

An Unusual Etiology of Spontaneous Pyometra Perforation; A Case Report  

PubMed Central

Introduction By presenting this case we aimed to describe an uncommon complication of generalized peritonitis following spontaneous pyometra perforation in untreated cervical carcinoma. Case Presentation This report describes a 60-year-old postmenopausal woman presenting with clinical features mimicking intestinal perforation who was later diagnosed as cervical carcinoma with pyometra perforation at exploratory laparotomy. The patient had good post-operative recovery following drainage and peritoneal lavage. Conclusion Spontaneous pyometra perforation in a case of untreated carcinoma of cervix is a rare condition, yet it should be suspected and kept in the differential diagnosis of acute abdomen in elderly women.

Agarwal, Rachna; Suneja, Amita; Sharma, Abha; Vaid, Neelam Bala

2011-01-01

375

Tubing-conveyed perforating cuts costs, boosts production  

SciTech Connect

A new Attaka Field development program was started in November 1984 with the objective of reversing the field's declining production. The Intermediate and Deep sands were the reservoirs of interest since their abundance and large areal extent account for a large volume of oil and gas. Many factors contributed to the success of this program, particularly tubing conveyed perforating, (TCP) which has reduced completion time, formation damage and maximized well production. This article discusses the determination of proper underbalance, operational aspects of tubing conveyed perforating, cost comparisons between TCP and wireline methods and a comparison of skin factors resulting from underbalanced perforating and overbalanced perforating.

Sukmadjaja, T.; Shewchenko, D.; Ajam, S.O.

1988-05-01

376

Treatment of Strip Perforation Using Root MTA: A Case Report  

PubMed Central

Root perforations are an undesired complication of endodontic treatment which result in loss of integrity of the root, and adversely affect the prognosis of the treatment. Recently, Iranian mineral trioxide aggregate [Root MTA] has been introduced as an ideal material for perforation repair. In this article a successful repair of strip root perforation of mandibular molar using Root MTA is presented with 15-month follow-up. This case suggests that Root MTA may be a substitute material for the treatment of strip perforation; however, more clinical studies with larger sample size and longer follow-ups are needed.

Froughreyhani, Mohammad; Salem Milani, Amin; Barakatein, Behnaz; Shiezadeh, Vahhab

2013-01-01

377

Perforated marginal ulcers after laparoscopic gastric bypass  

Microsoft Academic Search

Background  Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence\\u000a and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors’\\u000a center was conducted to determine the incidence of PMU and whether any causative factors were present.\\u000a \\u000a \\u000a \\u000a Methods  A prospectively kept database of all patients at the

Edward L. Felix; John Kettelle; Elijah Mobley; Daniel Swartz

2008-01-01

378

Choroidal detachment in perforated corneal ulcers: frequency and management  

PubMed Central

Aims To determine the frequency of choroidal detachment (CD) in eyes with non?traumatic corneal ulcer perforation and, also, to assess the efficacy and safety of cyanoacrylate glue in sealing corneal perforations. Methods 18 eyes of 17 patients were studied. Inclusion criterion was any patient with a non?traumatic perforated corneal ulcer. All patients had a thorough history taken and complete ophthalmic examination including B?scan ultrasonography. Patient demographics, presence of CD, and efficacy of corneal gluing were assessed. Results Eight of the 18 eyes (44%) were documented to have a CD. Among perforations of >2?mm2, six eyes (75%) were documented to have CD compared with two eyes (20%) with perforations of ?2?mm2 (p?=?0.054). No correlation could be determined between perforation duration and incidence of CD. Of the 15 eyes that underwent gluing, there were 13 successes (87%) and two failures (13%). Within the successes four patients (27%) required re?gluing because of infection (one patient) or progression of melt and glue loosening (three patients). Failure was the result of severe progression of melting (one patient) and a very large perforation (one patient). Conclusion Choroidal detachment following corneal ulcer perforation is common and is more likely in larger corneal perforations. Preoperative B?scan should be considered in cases of large corneal perforations requiring therapeutic keratoplasty to document choroidal detachment, which if large may require drainage. Cyanoacrylate glue is an effective and safe method for sealing small corneal perforations. A vigil must be maintained for infection while the glue and bandage contact lens are in situ.

Singh, R; Umapathy, T; Abedin, A; Eatamadi, H; Maharajan, S; Dua, H S

2006-01-01

379

Cephalic phase of gastric secretion in healthy subjects and duodenal ulcer patients: role of vagal innervation.  

PubMed Central

In 10 healthy subjects and 25 duodenal ulcer patients, gastric acid and pepsin and serum gastrin responses to cephalic-vagal stimulation induced by modified sham-feeding (MSF) were studied before and after vagotomy and atropinisation and compared with those to maximal stimulation with pentagastrin. When the MSF-induced peak acid output was normalised as a percentage of peak response to pentagastrin it was about 62% in healthy subjects and 66% in duodenal ulcer patients. Serum gastrin concentration was not changed significantly by modified sham-feeding either in normal subjects or in duodenal ulcer patients. Truncal vagotomy completely abolished gastric acid and pepsin responses to MSF in duodenal ulcer patients. Atropine almost completely suppressed gastric acid and pepsin responses to MSF in healthy subjects and reduced those in duodenal ulcer patients by about 62%. The combination of the modified sham-feeding and pentagastrin infusion resulted in augmentation of the acid output in duodenal ulcer patients but not in healthy subjects. This study shows that the cephalic phase results in a potent gastric acid and pepsin stimulation which is not accompanied by any change in serum gastrin concentration either in healthy subjects or duodenal ulcer patients and which is abolished by vagotomy and suppressed by atropine.

Konturek, S J; Kwiecien, N; Obtulowicz, W; Mikos, E; Sito, E; Oleksy, J; Popiela, T

1979-01-01

380

Effects of duodenal distension on antropyloroduodenal pressures and perception are modified by hyperglycemia.  

PubMed

Marked hyperglycemia (blood glucose approximately 15 mmol/l) affects gastrointestinal motor function and modulates the perception of gastrointestinal sensations. The aims of this study were to evaluate the effects of mild hyperglycemia on the perception of, and motor responses to, duodenal distension. Paired studies were done in nine healthy volunteers, during euglycemia ( approximately 4 mmol/l) and mild hyperglycemia ( approximately 10 mmol/l), in randomized order, using a crossover design. Antropyloroduodenal pressures were recorded with a manometric, sleeve-side hole assembly, and proximal duodenal distensions were performed with a flaccid bag. Intrabag volumes were increased at 4-ml increments from 12 to 48 ml, each distension lasting for 2.5 min and separated by 10 min. Perception of the distensions and sensations of fullness, nausea, and hunger were evaluated. Perceptions of distension (P < 0.001) and fullness (P < 0.05) were greater and hunger less (P < 0.001) during hyperglycemia compared with euglycemia. Proximal duodenal distension stimulated pyloric tone (P < 0.01), isolated pyloric pressure waves (P < 0.01), and duodenal pressure waves (P < 0.01). Compared with euglycemia, hyperglycemia was associated with increases in pyloric tone (P < 0.001), the frequency (P < 0.05) and amplitude (P < 0.01) of isolated pyloric pressure waves, and the frequency of duodenal pressure waves (P < 0.001) in response to duodenal distension. Duodenal compliance was less (P < 0.05) during hyperglycemia compared with euglycemia, but this did not account for the effects of hyperglycemia on perception. We conclude that both the perception of, and stimulation of pyloric and duodenal pressures by, duodenal distension are increased by mild hyperglycemia. These observations are consistent with the concept that the blood glucose concentration plays a role in the regulation of gastrointestinal motility and sensation. PMID:10070048

Lingenfelser, T; Sun, W; Hebbard, G S; Dent, J; Horowitz, M

1999-03-01

381

Management of iatrogenic facial nerve palsy and labyrinthine fistula in mastoid surgery.  

PubMed

A 6-year review of complications of mastoid surgery between June 1995 and June 2001 revealed five cases with serious iatrogenic complications from mastoid surgery, of which four were facial nerve palsy and two were labyrinthine fistula. One of these patients had concomitant facial nerve palsy and labyrinthine fistula. There were two cases of complete facial nerve palsy (House Brackmann grade VI) and two cases of incomplete palsy (House Brackmann grades IV and V). The second genu was the site of injury in three of the four cases. Of the four cases with facial nerve palsy, two patients had full recovery (House Brackmann grade I), one recovered only to House Brackmann grade III, and one was lost to follow-up. Both patients with labyrinthine fistula had postoperative vertigo and profound sensorineural hearing loss. The site of iatrogenic fenestration was the lateral semicircular canal in both cases. PMID:15564156

Long, Yeoh Thiam; bin Sabir Husin Athar, Primuharsa Putra; Mahmud, Ridzo; Saim, Lokman

2004-07-01

382

[Iatrogenic trachea and esophagus injury in intensive care practice: the surgeon's view"].  

PubMed

From 1963 to 2011 in the Department of lung and mediastinum surgery were treated 879 patients with trachea stenosis and 107 patients with benign tracheoesopageal fistula were treated in the Department of lung and mediastinum surgery from 1963 to 2011. latrogenic trachea and the esophagus damage was caused by long-term ALV in 87% of cases. Patients were aged from 5 to 79 years. 47.2% of patients came with functioning tracheostome. 25.7% of patients had a clinically significant respiratory disorder at admission, 10.2 % of which were life-threatening. Iatrogenic damage of the trachea was identified before extubation or decannulation only in 27% of patients. In such circumstances, prevention and diagnostics of iatrogenic injuries, as well as initial care alternatives takes on special significance. PMID:24000652

383

Laparoscopic repair of perforated peptic ulcer: a meta-analysis  

Microsoft Academic Search

Background Laparoscopic repair of perforated peptic ulcer has been gaining popularity in recent years, but few data exist to support the superiority of the laparoscopic approach over open repair. The objective of the current study was to compare the safety and efficacy of open and laparoscopic repair of perforated peptic ulcer in an evidence-based approach using meta-analytical techniques. Methods A

H. Lau

2004-01-01

384

Taenia saginata: A Rare Cause of Gall Bladder Perforation.  

PubMed

We report a case of biliary peritonitis caused by gall bladder perforation due to Taenia saginata induced gangrenous cholecystitis. Although parasites are not unusual causes of biliary tract disorders, especially in disease endemic areas, but this is for the first time that Taenia saginata has been reported to cause gall bladder perforation. PMID:22792505

Hakeem, Suhail Yaqoob; Rashid, Arshad; Khuroo, Suhail; Bali, Rajandeep Singh

2012-06-26

385

Taenia saginata: A Rare Cause of Gall Bladder Perforation  

PubMed Central

We report a case of biliary peritonitis caused by gall bladder perforation due to Taenia saginata induced gangrenous cholecystitis. Although parasites are not unusual causes of biliary tract disorders, especially in disease endemic areas, but this is for the first time that Taenia saginata has been reported to cause gall bladder perforation.

Hakeem, Suhail Yaqoob; Rashid, Arshad; Khuroo, Suhail; Bali, Rajandeep Singh

2012-01-01

386

A Passive Method to Control Combustion Instabilities with Perforated Liner  

Microsoft Academic Search

The effectiveness of perforated liner with bias flow on the control of combustion instability is investigated. Combustion instabilities result from the coupling between acoustic waves and unsteady combustion heat release. Sometimes the phenomenon happens in afterburners of aeroengine and rocket engine, and it always causes damage to flame holders, liner sections and other engine components. Passive methods, such as perforated

Li Lei; Guo Zhihui; Zhang Chengyu; Sun Xiaofeng

2010-01-01

387

Powder composite materials for plugless facing of perforator shaped charges  

Microsoft Academic Search

Shaped changes are used for driving perforation channels in casing and rock though which oil enters a well. Important characteristics governing the quality of exposing an oil stratum are the depth of the perforation channel and its free volume. Currently shaped charges are mainly supplied with formed copper facings. Use of these facings, depending on charge construction, is accompanied in

Yu. A. Bykov; T. E. Vorkina

1994-01-01

388

Perforated Peptic Ulcer Disease: A Review of History and Treatment  

Microsoft Academic Search

Background: In the last one hundred years much has been written on peptic ulcer disease and the treatment options for one of its most common complications: perforation. The reason for reviewing the literature was evaluating most common ideas on how to treat perforated peptic ulcers (PPU) in general, opinions on conservative treatment and surgical treatment and summarizing ideas about necessary

Mariëtta J. O. E. Bertleff; Johan F. Lange

2010-01-01

389

Laparoscopic repair of perforated peptic ulcer-technical tip.  

PubMed

Increasing number of gastrointestinal emergencies are managed laparoscopically. Laparoscopic repair of a perforated peptic ulcer remains contentious. Fashioning an omental patch is a crucial and an essential part of this repair, whether it is performed open or laparoscopically. This article describes a technique to fashion an adequate omental patch over the perforated peptic ulcer. PMID:23917602

Jayanthi, Naga Venkatesh Gupta

2013-08-01

390

Method for placing ball sealers onto casing perforations  

Microsoft Academic Search

A method is disclosed for transporting ball sealers down a perforated casing of a well to affect fluid diversion when hydraulically treating a formation penetrated by the well. In this invention, ball sealers are transported to said perforations in a carrier fluid system comprising a leading fluid portion having a density greater than said ball sealers and a trailing fluid

S. R. Erbstoesser; C. M. Shaughnessy

1980-01-01

391

Hydroelastic natural vibrations of perforated plates with cracks  

Microsoft Academic Search

This paper deals with the modal analysis of the clamped-edge circular perforated plates with ligament penetrated cracks both in air and submerged in fluid. The effect of the cracks to natural frequencies and modal strain energy of a perforated plate with ligament fractured cracks is studied by finite element analysis. The numerical results indicate that the cracks have clear effect

Tong Liu; Ke Wang; Qi-Wu Dong; Min-Shan Liu

2009-01-01

392

Jejunal diverticula - a rare cause of intestinal perforation.  

PubMed

Jejunal diverticuli is a extremely rare entity. We report a case of jejunal diverticulum as a cause of perforation peritonitis, which has been managed by resection anastomosis. This study is important from the perspective that clear cut guidelines for managment of jejunal perforation are not available in litreture. PMID:23133127

Borgaonkar, Viraj; Borgaonkar, Vijay

2009-05-02

393

Perforation of medium thick plate by a sharp projectile  

Microsoft Academic Search

The paper predicts the ballistic performance of the normal perforation of a medium thick plate by a rigid projectile with sharp nose. Ductile hole- enlargement is the failure mechanism in the perforation process. It shows that the analytical formulae depend only on three dimensionless numbers, i.e., the dimensionless target thickness ´, the dimensionless impact function I and geometry function N

X. W. Chen; Q. M. Li; Y. Z. Chen

2005-01-01

394

Evaluation of fasciocutaneous perforators using color duplex imaging.  

PubMed

Technological improvements in conventional ultrasound, including color duplex imaging, have greatly facilitated the evaluation of vascular-related problems for virtually every specialty. Higher-frequency transducers now permit the scanning of superficial depths beneath the skin surface with high sensitivity for an analysis specific to the microcirculation. This attribute has already been recognized as a valuable tool for the preoperative mapping of musculocutaneous perforators. A logical extension of this capability would be for the localization and calibration of deep fascial perforators, which may have even greater clinical significance because anomalies at this level are more the rule rather than the the exception. Over the preceding 10-month period, all eight elective fasciocutaneous flaps performed in eight patients had initial scans using color duplex imaging to identify and calibrate all relevant cutaneous perforators. All fasciocutaneous flap subtypes were included. If feasible at the time of flap elevation, all identified perforators were dissected and measured. All were found at the exact site as marked preoperatively, and their diameter closely approximated that predicted. The occasional unanticipated presence in vivo of minor perforators suggests that color duplex imaging may not be reliable for fascial perforators less than 0.5 mm in diameter. Since perforator caliber qualitatively is a major determinant of flow, color duplex imaging can then objectively establish a hierarchy of the importance of perforators in a given region. From such data, the definition of new and more reliable fasciocutaneous flap donor territories should be forthcoming.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7938287

Hallock, G G

1994-10-01

395

Perforation of a thick plate by rigid projectiles  

Microsoft Academic Search

Perforation of a thick plate by rigid projectiles with various geometrical characteristics is studied in the present paper. The rigid projectile is subjected to the resistant force from the surrounding medium, which is formulated by the dynamic cavity expansion theory. Two perforation mechanisms, i.e., the hole enlargement for a sharp projectile nose and the plugging formation for a blunt projectile

X. W. Chen; Q. M. Li

2003-01-01

396

Delayed appearance of coronary artery perforation following cutting balloon angioplasty.  

PubMed

Coronary artery perforation is a potential complication of percutaneous coronary intervention (PCI). It usually develops immediately following PCI, particularly when an atheroablate device is used. We report a case in which coronary artery perforation developed 4 days after PCI with a nondebulking device, a cutting balloon catheter. PMID:12455089

Maruo, Takeshi; Yasuda, Satoshi; Miyazaki, Shunichi

2002-12-01

397

Jejunal perforation in gallstone ileus – a case series  

Microsoft Academic Search

INTRODUCTION: Gallstone ileus is an uncommon complication of cholelithiasis but an established cause of mechanical bowel obstruction in the elderly. Perforation of the small intestine proximal to the obstructing gallstone is rare, and only a handful of cases have been reported. We present two cases of perforation of the jejunum in gallstone ileus, and remarkably in one case, the gallstone

Louise E Browning; Jeremy D Taylor; Sue K Clark; Nariman D Karanjia

2007-01-01

398

Perforated Meckel's diverticulum presenting as a hematocele on scrotal sonography.  

PubMed

Hemorrhage from ectopic gastric mucosa is the most common presenting symptom of Meckel's diverticulum. Diverticular perforation, although rare, is a potentially life-threatening complication. Various imaging modalities can aid in the preoperative detection of Meckel's diverticulum. We report the sonographic findings of a hematocele as the heralding sequela of a perforated Meckel's diverticulum in an 11-month-old boy. PMID:22886435

Kwait, Dylan C; Nazarenko, Anna; Derman, Anna; Lui, Paul

2012-08-10

399

Emergency operations for nondiverticular perforation of the left colon  

Microsoft Academic Search

Objective: Although diverticulitis is the most common cause of large bowel perforation, other disease may result in left colonic peritonitis. The aim of this study was to evaluate and compare the incidence, management, and outcome of patients with different causes of nondiverticular left colonic perforations.Patients and methods: From January 1992 to September 2000, 212 surgical patients underwent emergency operation for

Sebastiano Biondo; David Parés; Juan Mart?? Ragué; Javier De Oca; David Toral; Francisco G Borobia; Eduardo Jaurrieta

2002-01-01

400

COMBINED ENDOSCOPIC ? LAPAROSCOPIC OPERATION OF PERFORATED GASTRIC ULCER WITH OMENTOPLASTY  

Microsoft Academic Search

SUMMARY ? A combined laparoscopic ? endoscopic operation of perforated gastric ulcer with gastric mucosa biopsy and use of great omentum as a vital material in ulcer perforation is described. The combination of endoscopy and laparoscopic surgical procedure allows a good insight into the pylorus and duodenum patency. Intraoperative biopsy of the antrum and gastric corpus mucosa pro- vides a

Miroslav Bekavac-Be?lin; Hrvoje Hochstadter; Marijan Huis

401

Neonatal spontaneous colonic perforation due to cystic fibrosis.  

PubMed

We report two cases of spontaneous colonic perforation associated with cystic fibrosis (CF) in the neonatal period. Both presented with an acute abdomen soon after birth and required laparotomy and stoma formation. Colonic perforation as an initial presentation of CF is reviewed and management options are discussed. PMID:18438672

Siddiqui, M M F; Burge, D M

2008-04-26

402

[Prophylaxis of acute pancreatitis during resection of the stomach for "difficult" complicated of duodenal ulcers].  

PubMed

The authors have performed 407 resections of the stomach for duodenal ulcers. In 9 cases the major duodenal papilla was found to be involved into the zone of ulcer destruction. It was noted that operations for "difficult" complicated ulcers of the duodenum with the involvement into the zone of destruction of the major duodenal papilla required a delicate surgical strategy directed to minimization of trauma and blockade of the main factors of the development of acute postoperative pancreatitis, the proximal duodenojejunoanastomosis being the operation of choice for "difficult" complicated ulcers of the duodenum. PMID:20020623

Morozov, S V; Poluektov, V L; Dobrovol'ski?, A I; Dolgikh, V T

2009-01-01

403

Iatrogenic Iliac Artery Rupture: Emergency Management by Longer Stent-Graft on a Shorter Balloon  

SciTech Connect

Rupture of an iliac artery during percutaneous transluminal coronary angioplasty is a rare but potentially devastating complication. We report a case of iatrogenic external iliac artery rupture that was successfully treated by temporary balloon occlusion followed by endovascular stent graft placement in an unusual manner. Limited availability of the hardware necessitated the use of a longer bare stent graft mounted on a relatively shorter balloon.

Trehan, Vijay; Nigam, Arima; Ramakrishnan, S. [G. B. Pant Hospital, Department of Cardiology (India)], E-mail: ramakgmc@rediffmail.com

2007-02-15

404

Surgical Treatment of Iatrogenic Lesions of the Proximal Common Bile Duct  

Microsoft Academic Search

.   Between January 1979 and September 1999 a series of 96 patients were operated on at our institution for iatrogenic biliary\\u000a injuries, and among them 62 involved the proximal biliary tract. Injuries, according to the Strasberg classification, were\\u000a type E2 in 18 patients, type E3 in 29 patients, and type E4 in 15 patients. The most frequent primary surgical procedures

Gian Massimo Gazzaniga; Marco Filauro; Lorenzo Mori

2001-01-01

405

A nationally representative survey of hospital malnutrition: the Italian PIMAI (Project: Iatrogenic MAlnutrition in Italy) study  

Microsoft Academic Search

Hospital malnutrition is high in every country it was investigated, but no nationally representative prevalence study, considering\\u000a potential geographical interfering factors, has yet been performed. We designed a multidisciplinary, cross-sectional, nation-wide\\u000a survey: the PIMAI study (Project: Iatrogenic MAlnutrition in Italy). Adult (>18 years old) patient inclusion was managed on\\u000a a four-strata randomisation model according to sex and age (<65 and

Lucio Lucchin; Amleto D’Amicis; Maria Gabriella Gentile; Nino Carlo Battistini; Maria Antonia Fusco; Augusta Palmo; Maurizio Muscaritoli; Franco Contaldo; Emanuele Cereda

2009-01-01

406

Female breast cancer in relation to exposure to medical iatrogenic diagnostic radiation during life  

PubMed Central

Aim of the study Exposure to radiation and aging are the leading causes of breast cancer among female patients. We aimed to investigate and assess the relationship between exposure to medical, diagnostic and iatrogenic radiation and breast cancer using a questionnaire among 100 newly diagnosed female breast cancer patients and 100 control female subjects without cancer. Material and methods A case control study using a family ambulatory based survey was conducted among 200 female patients from all municipalities of Zenica-Doboj Canton. New cases of breast cancer among subjects of experimental groups (n = 100) were diagnosed between 1 January 2003 and 31 December 2007 using the institutional clinical procedure for breast cancer diagnosis. Data were obtained using a self-rated questionnaire on radiation as a breast carcinogen. Data analysis was performed using SPSS version 19.0. Results There were no significant differences between the two groups and their subgroups for individual data and demographics except for prevalence of decreased family financial situation (practical poverty) among subjects with breast cancer in relation to control subjects (31%: 17% among control subjects; p = 0.001). Female patients who are exposed to iatrogenic radiation before the 3rd year of life (OR = 1.29; 95% CI: 0.839–1.985) and those who are exposed to CT more than twice per year are more than twice as likely to have breast carcinoma (OR = 2.02; 95% CI: 1.254–3.261) compared to control subjects. Poverty and low family income are vulnerability factors associated with elevated levels of breast carcinoma. This result is not in accordance with prior study results. ConcIusions It is necessary to develop an adequate registration system of iatrogenic exposure to radiation for each patient of any age, particularly for children aged < 3 years and for CT iatrogenic exposure.

Pranjic, Nurka; Drljevic, Kenan; Prasko, Subhija; Drljevic, Irdina; Brzezinski, Piotr

2013-01-01

407

Iatrogenic Migration of an Impacted Pharyngeal Foreign Body of the Hypopharynx to the Prevertebral Space  

PubMed Central

Impaction of foreign bodies in the upper aerodigestive tract is commonly encountered in ENT practice. The present paper describes an iatrogenic complication with migration of an impacted foreign body (chicken bone) of the hypopharynx into the prevertebral space, after unsuccessful attempt of endoscopic removal. The foreign body was visualized with cervical CT scan lying extraluminally between the major vessels of the neck. An open surgical procedure with neck exploration was necessary for the definite treatment.

Hajiioannou, Jiannis; Kousoulis, Panagiotis; Florou, Vassiliki; Stavrianou, Eleni

2011-01-01

408

Management of Iatrogenic Rupture of Profunda Femoris Artery after Femoral Fracture Fixation with Stent Graft Implantation  

PubMed Central

Vascular injuries with acute or chronic arterial hemorrhage after femoral shaft fractures are a rare but a life-threatening complication. We observed a case of iatrogenic rupture of the profunda femoris artery after the internal fixation of a femoral shaft fracture. The pseudoaneurysm, presenting with painful expansile swelling and hemodynamic instability, together with the rupture was evident on femoral angiography. Endovascular stent graft placement was performed successfully, and there was no sign or symptom at 9 months’ follow-up.

Varastehravan, Hamidreza; Nough, Hossein; Ansari, Zahra

2010-01-01

409

Iatrogenic diabetes mellitus during ACTH therapy in an infant with West syndrome  

Microsoft Academic Search

West syndrome is a rare epileptic disease of infancy, typified by an association of characteristic spasms, hypsarrhythmia\\u000a on electroencephalography and severe psychomotor retardation or deterioration. Adrenocorticotropic hormone (ACTH) is the current\\u000a first-line therapy for West syndrome despite the fact that ACTH therapy is associated with various adverse effects. We describe\\u000a a rare case of iatrogenic diabetes mellitus during ACTH therapy

Valeria Calcaterra; Andrea Bottazzi; Chrissoula Tzialla; Stefano D’Arrigo; Daniela Larizza

410

Iatrogenic damage to the mandibular nerves as assessed by the masseter inhibitory reflex  

Microsoft Academic Search

Iatrogenic injury of the inferior alveolar or lingual nerves frequently leads to legal actions for damage and compensation\\u000a for personal suffering. The masseter inhibitory reflex (MIR) is the most used neurophysiological tool for the functional assessment\\u000a of the trigeminal mandibular division. Aiming at measuring the MIR sensitivity and specificity, we recorded this reflex after\\u000a mental and tongue stimulations in a

A. Biasiotta; P. Cascone; R. Cecchi; G. Cruccu; G. Iannetti; A. Mariani; A. Spota; A. Truini

411

Iatrogenic trigeminal sensorimotor neuropathy resulting from local anesthesia: A case report  

Microsoft Academic Search

Chang WK, Mulford GJ. Iatrogenic trigeminal sensorimotor neuropathy resulting from local anesthesia: a case report. Arch Phys Med Rehabil 2000;81:1591-3. Trigeminal neuropathy resulting from local anesthetic injection has not been reported in the literature. We present a 49-year-old man with 8 months of unilateral facial sensorimotor deficits in the distribution of the trigeminal nerve, following a local anesthetic injection. His

Wing K. Chang; Gregory J. Mulford

2000-01-01

412

Amplatzer stuffing technique in the treatment of an iatrogenic mesenteric arteriovenous fistula.  

PubMed

We describe a novel technique for placement of an Amplatzer Vascular Plug I in a relatively short space. A mesenteric, relatively large-caliber, iatrogenic, high-flow arteriovenous fistula associated with a pseudoaneurysm was successfully closed using a single vascular plug. The "stuffing technique" allowed us to place a second plug within a very limited residual fistula tract, avoiding the plug extending parent vessels. PMID:19495869

Peynircioglu, Bora; Cil, Barbaros

2009-06-04

413

Transcatheter coil embolization of an iatrogenic superior mesenteric arteriovenous fistula: Report of a case  

Microsoft Academic Search

A 37-year-old male patient presented with abdominal pain and diarrhea. Computed tomography showed a large superior mesenteric\\u000a vein aneurysm. The patient had a history of Crohn’s disease and underwent an ileocecal resection 7 years previously. A selective\\u000a angiogram of the superior mesenteric artery revealed that a dilated branch of this artery fed directly into the superior mesenteric\\u000a vein. The iatrogenic

Tsunehiro Shintani; Hiroshi Mitsuoka; Mikio Masuda

2011-01-01

414

Iatrogenic Arteriovenous Fistula in a Renal Allograft: The Result of a TAD Guidewire Injury  

Microsoft Academic Search

A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation\\u000a during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the\\u000a renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution\\u000a of flow to the peripheral renal cortex. The diagnosis

Catherine Lee-Elliott; Kok-Tee Khaw; Anna-Maria Belli; Uday Patel

2000-01-01

415

Iatrogenic Arteriovenous Fistula in a Renal Allograft: The Result of a TAD Guidewire Injury  

SciTech Connect

A case is presented of an iatrogenic arteriovenous fistula developing in a renal allograft following guidewire manipulation during transplant renal artery angioplasty. Hyperdynamic flow through the fistula was causing a shunt of blood away from the renal cortex as demonstrated on sonography and scintigraphy. Selective embolization was performed, correcting the maldistribution of flow to the peripheral renal cortex. The diagnosis and difficulty in management of asymptomatic renal arteriovenous fistulae is also discussed.

Lee-Elliott, Catherine; Khaw, Kok-Tee; Belli, Anna-Maria; Patel, Uday [Department of Radiology, St. George's Hospital NHS Trust, London SW17 0QT (United Kingdom)

2000-07-15

416

[Two cases of iatrogenic vertebral arteriovenous fistulas successfully treated by surgery].  

PubMed

Cervical vertebral arteriovenous fistulas (AVFs) are very rare. The most frequent cause is trauma including iatrogenesis which result from vertebral artery penetration during central venous catheterization. Some endovascular techniques have been reported for this type of lesion. However, several potential problems exist, such as possibility of recurrence of AVFs and VA occlusion with endovascular treatment. In this article, we review two cases with iatrogenic vertebral AVFs which were successfully treated surgically and report the advantages of surgical treatment. PMID:21372336

Ishiguro, Taichi; Kawashima, Akitsugu; Yoneyama, Taku; Yamaguchi, Koji; Kawamata, Takakazu; Okada, Yoshikazu

2011-03-01

417

Amplatzer Stuffing Technique in the Treatment of an Iatrogenic Mesenteric Arteriovenous Fistula  

Microsoft Academic Search

We describe a novel technique for placement of an Amplatzer Vascular Plug I in a relatively short space. A mesenteric, relatively\\u000a large-caliber, iatrogenic, high-flow arteriovenous fistula associated with a pseudoaneurysm was successfully closed using\\u000a a single vascular plug. The “stuffing technique” allowed us to place a second plug within a very limited residual fistula\\u000a tract, avoiding the plug extending parent

Bora Peynircioglu; Barbaros Cil

2009-01-01

418

Somatostatin depletion by cysteamine: mechanism and implication for duodenal ulceration  

SciTech Connect

Cysteamine (CSH) and its close derivatives deplete immunoreactive somatostatin (SS) in rat organs. The effect of CSH is dose and time dependent and reversible. Structural requirements of the analogs are the presence of either -SH or -NH2 on a two- or three-carbon alkyl molecule; both radicals together increase, whereas insertion of carboxyl abolishes potency. The duodenal ulcerogenic potency of CSH derivatives is correlated significantly with their SS-depleting activity in the gastric mucosa. The mechanism of this action of CSH is poorly understood, but it is not caused by increased release, enhanced degradation of the peptide, or selective necrosis of SS cells. It is likely that in the intracellular environment CSH causes a conformational change in the peptide that affects the antigenic and functional properties of SS.

Szabo, S.; Reichlin, S.

1985-06-01

419

The clinical significance of duodenal lymphocytosis with normal villus architecture.  

PubMed

Context.-The finding of increased intraepithelial lymphocytes with normal villous architecture (Marsh I lesion) is seen in up to 3% of duodenal biopsies. The differential diagnosis includes a wide range of possibilities, including celiac disease, bacterial overgrowth, nonsteroidal antiinflammatory drug damage, reaction to Helicobacter pylori infection, tropical sprue, and chronic inflammatory bowel disease. Objectives.-To highlight the histologic features of the Marsh I lesion, review the diseases and conditions associated with that finding, and to provide pathologists with a rationale and a template for how to identify and report such cases. Data Sources.-A review of the literature regarding the histologic features and clinical associations of Marsh I lesions. Conclusions.-Marsh I lesions are a nonspecific finding associated with a number of disease conditions. Historically, between 9% and 40% of cases have been shown to represent celiac disease. Current data do not suggest histologic features to differentiate between diseases associated with this histologic change. PMID:23991733

Hammer, Suntrea T G; Greenson, Joel K

2013-09-01

420

Long-Term Experience with Duodenal Switch in Adolescents  

Microsoft Academic Search

Background  Severe or extreme obesity in children and adolescents is a progressive damaging disease, increasingly requiring surgical treatment.\\u000a Timing and choice of operation are controversial.\\u000a \\u000a \\u000a \\u000a \\u000a Method  In the last 16 years, we performed open biliopancreatic diversion with duodenal switch (DS) in 13 adolescents aged 15–17 years,\\u000a who have been followed up for 2–16 years (mean, 10.6 years); three with Prader-Willi syndrome (PWS) are presented separately.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Among

Picard Marceau; Simon Marceau; Simon Biron; Frederic-Simon Hould; Stefane Lebel; Odette Lescelleur; Laurent Biertho; John G. Kral

2010-01-01

421

Optimal conditions for tissue perforation using high intensity focused ultrasound  

NASA Astrophysics Data System (ADS)

To perforate tissue lying deep part in body, a large size transducer was assembled by combining four spherical-shaped transducers, and the optimal conditions for tissue perforation have studied using ventricle muscle of chicken as a target. The ex vivo experiments showed that ventricle muscle was successfully perforated both when it was exposed to High Intensity Focused Ultrasound (HIFU) directly and when it was exposed to HIFU through atrial muscle layer. Moreover, it was shown that calculated acoustic power distributions are well similar to the perforation patterns, and that the acoustic energy distributes very complexly near the focus. Lastly, perforation on the living rabbit bladder wall was demonstrated as a preliminary in vivo experiment.

Mochizuki, Takashi; Kihara, Taizo; Ogawa, Kouji; Tanabe, Ryoko; Yosizawa, Shin; Umemura, Shin-ichiro; Kakimoto, Takashi; Yamashita, Hiromasa; Chiba, Toshio

2012-10-01

422

The incidence and distribution of iatrogenic retinal tears in 20-gauge and 23-gauge vitrectomy  

PubMed Central

Purpose The development of 23-gauge vitrectomy surgery has many benefits including a reduction in surgical time and faster postoperative rehabilitation; however, some have suggested that the complication rate is higher. To assess this we compared the incidence and distribution of iatrogenic retinal tears in 20- and 23-gauge surgery. Methods Fifty consecutive 23-gauge and 50 consecutive 20-gauge vitrectomy cases were selected; eyes with a history of previous vitreoretinal surgery were excluded. All surgery was performed by two surgeons (JL and RN). Entry-site breaks (ESB) were defined as any new vitreoretinal abnormality occurring within 1 clock hour of an entry site for which treatment with cryotherapy was deemed necessary. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher's exact and ?2-tests. Results ESB occurred in 24% (12/50) of cases in the 20-gauge group compared with 8% (4/50) in the 23-gauge group (P=0.03); 88% (14/16) occurred superiorly on the same side as the surgeons' dominant hand. Iatrogenic breaks recorded elsewhere indicated an increased incidence in the 20-gauge group (9/50 compared with 6/50 in 23-gauge) but this did not achieve significance; the most common position was at 6 o'clock. Conclusions 23-Gauge vitrectomy is associated with significantly fewer ESB when compared with conventional 20-gauge vitrectomy. The incidence of other iatrogenic breaks did not appear to be significantly different between the two groups.

Gosse, E; Newsom, R; Lochhead, J

2012-01-01

423

[Iatrogenic meningitis after diagnosis lumbar puncture: 3 cases reports in the paediatric Children's Hospital of Tunis].  

PubMed

We have collected cases of iatrogenic meningitis managed in the Children's Hospital of Tunis, between January 1998 and December 2006. Clinical information about each patient were collected, all bacterial samples were investigated in the microbiology laboratory of the hospital. Bacterial isolates were identified according to conventional criteria. In the interval under study, we recorded three cases of iatrogenic meningitis after lumbar puncture. Two cases occurred in newborn admitted for suspicion of neonatal infection and one in a 2-month-old infant admitted for exploration of hyperpyretic convulsion. In all patients, the initial cerebrospinal fluid was normal. All patients developed symptoms of acute meningitis within 72 hours after lumbar puncture; the second cerebrospinal fluid was, then, typical for purulent meningitis. The causal agents isolated in the three cases were Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens, all resistant to beta-lactams by extended spectrum beta-lactamase production. The use of quinolones was required in all cases. Different complications were recorded: hydrocephalus and brain abscess in one case, respiratory and hemodynamic failure managed in the intensive care unit in the second, and brain hygroma in the third case. This study shows high morbidity of iatrogenic meningitis. Simple aseptic precautions undertaken before the procedure of lumbar puncture can prevent such cases. The urgent need for increasing the awareness among medical personnel in hospitals of developing countries cannot be overemphasized. PMID:21103965

Smaoui, H; Hariga, D; Hajji, N; Bouziri, A; Ben Jaballah, N; Barsaoui, S; Bousnina, S; Sammoud, A; Kechrid, A

2010-11-19

424

Iatrogenic subclavian arteriovenous fistula: rare complication of plate osteosynthesis of clavicle fracture.  

PubMed

Iatrogenic subclavian arteriovenous fistula is rare and has not been reported as a complication of plate osteosynthesis of clavicle fracture. This article describes the first case of iatrogenic subclavian arteriovenous fistula caused by plate osteosynthesis. A 36-year-old man sustained a right middle clavicle fracture in an injury and underwent open reduction and internal fixation with clavicular compression plate 3 days later in a local hospital. On the second postoperative day, a pulsatile mass and thrill were detected at the right supraclavicular region. The patient was discharged 3 days postoperatively with no extra inspection. Three months later, he was admitted to our institution because the mass was getting bigger and weakness was felt in his right upper limb. Digital subtraction angiography confirmed a subclavian arteriovenous fistula. Vascular surgeons treated the patient successfully using endovascular techniques. The subclavian arteriovenous fistula was eliminated with a fully expanded stent graft, and the plate was removed simultaneously. The result was satisfactory, and the postoperative course was uneventful. This case demonstrated that subclavian arteriovenous fistula could be an iatrogenic complication of screw-and-plate osteosynthesis of clavicle fracture. The operative manipulation in the process of fracture reduction and hole drilling should be meticulous, and the screw length must be accurate. Orthopedic surgeons should be aware of this uncommon complication with plate osteosynthesis of clavicle fracture. We recommend using an endovascular surgical technique for treatment of this complication. PMID:22310422

Ding, Muliang; Hu, Jianzhong; Ni, Jiangdong; Lv, Hongbin; Song, Deye; Shu, Chang

2012-02-17

425

Duodenal-mucosal bacteria associated with celiac disease in children.  

PubMed

Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of cereal gluten proteins. This disorder is associated with imbalances in the gut microbiota composition that could be involved in the pathogenesis of CD. The aim of this study was to characterize the composition and diversity of the cultivable duodenal mucosa-associated bacteria of CD patients and control children. Duodenal biopsy specimens from patients with active disease on a gluten-containing diet (n = 32), patients with nonactive disease after adherence to a gluten-free diet (n = 17), and controls (n = 8) were homogenized and plated on plate count agar, Wilkins-Chalgren agar, brain heart agar, or yeast, Casitone, and fatty acid agar. The isolates were identified by partial 16S rRNA gene sequencing. Renyi diversity profiles showed the highest diversity values for active CD patients, followed by nonactive CD patients and control individuals. Members of the phylum Proteobacteria were more abundant in patients with active CD than in the other child groups, while those of the phylum Firmicutes were less abundant. Members of the families Enterobacteriaceae and Staphylococcaceae, particularly the species Klebsiella oxytoca, Staphylococcus epidermidis, and Staphylococcus pasteuri, were more abundant in patients with active disease than in controls. In contrast, members of the family Streptococcaceae were less abundant in patients with active CD than in controls. Furthermore, isolates of the Streptococcus anginosus and Streptococcus mutans groups were more abundant in controls than in both CD patient groups, regardless of inflammatory status. The findings indicated that the disease is associated with the overgrowth of possible pathobionts that exclude symbionts or commensals that are characteristic of the healthy small intestinal microbiota. PMID:23835180

Sánchez, Ester; Donat, Ester; Ribes-Koninckx, Carmen; Fernández-Murga, Maria Leonor; Sanz, Yolanda

2013-07-08

426

Obstructive Jaundice Caused by Clonorchiasis-associated Duodenal Papillitis: A Case Report  

PubMed Central

We describe an unusual presentation of Clonorchis sinensis infection with obstructive jaundice due to duodenal papillitis which was relieved dramatically by endoscopic sphincterotomy. A 26-yr-old male presented with complaints of fatigue, weight loss and painless jaundice. The history was significant for frequent ingestion of raw freshwater fish. The patient underwent endoscopic retrograde cholangiopancreatography for evaluation of obstructive jaundice. The duodenal papilla was markedly edematous with a bulging configuration and hyperemic changes at the orifice. Cholangiography revealed mild bile duct dilatation and irregular wall changes with multiple indentations. However, there were no biliary stricture or stones noted as the cause of obstructive jaundice. We performed an endoscopic sphincterotomy for effective bile drainage through the duodenal papilla. After the sphincterotomy, the patient's jaundice was dramatically improved. Pathology of the duodenal papilla showed eosinophilic infiltration of the mucosa. Parasitic eggs, consistent with the diagnosis of C. sinensis, were found in the bile sample.

Lim, Jun Uk; Shin, Hyun Phil; Cha, Jae Myung; Lee, Joung Il; Lim, Sung Jig

2011-01-01

427

Pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis in familial adenomatous polyposis  

PubMed Central

Background Patients with familial adenomatous polyposis (FAP) develop duodenal and ampullary polyps that may progress to malignancy via the adenoma–carcinoma sequence. Objective The aim of this study was to review a large series of FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary polyposis. Methods A retrospective case notes review of all FAP patients undergoing pancreaticoduodenectomy for advanced duodenal and ampullary adenomatosis was performed. Results Between October 1993 and January 2010, 38 FAP patients underwent pancreaticoduodenectomy for advanced duodenal and ampullary polyps. Complications occurred in 29 patients and perioperative mortality in two. Postoperative histology revealed five patients to have preoperatively undetected cancer (R = 0.518, P < 0.001). Conclusions Pancreaticoduodenectomy in FAP is associated with significant morbidity, but low mortality. All patients under consideration for operative intervention require careful preoperative counselling and optimization.

Skipworth, James R A; Morkane, Clare; Raptis, Dimitri Aristotle; Vyas, Soumil; Olde Damink, Steven W; Imber, Charles J; Pereira, Stephen P; Malago, Massimo; West, Nicholas; Phillips, Robin K S; Clark, Sue K; Shankar, Arjun

2011-01-01

428

Determinants of Hearing Loss in Perforations of the Tympanic Membrane  

PubMed Central

Background Although tympanic membrane perforations are common, there have been few systematic studies of the structural features determining the magnitude of the resulting conductive hearing loss. Our recent experimental and modeling studies predicted that the conductive hearing loss will increase with increasing perforation size, be independent of perforation location (contrary to popular otologic belief), and increase with decreasing size of the middle-ear and mastoid air space (an idea new to otology). Objective To test our predictions regarding determinants of conductive hearing loss in tympanic membrane perforations against clinical data gathered from patients. Study Design Prospective clinical study. Setting Tertiary referral center. Inclusion Criteria Patients with tympanic membrane perforations without other middle-ear disease. Main Outcome Measures Size and location of perforation; air-bone gap at 250, 500, 1,000, 2,000, and 4,000 Hz; and tympanometric estimate of volume of the middle-ear air spaces. Results Isolated tympanic membrane perforations in 62 ears from 56 patients met inclusion criteria. Air-bone gaps were largest at the lower frequencies and decreased as frequency increased. Air-bone gaps increased with perforation size at each frequency. Ears with small middle-ear volumes, ?4.3 ml (n = 23), had significantly larger air-bone gaps than ears with large middle-ear volumes, >4.3 ml (n = 39), except at 2,000 Hz. The mean air-bone gaps in ears with small volumes were 10 to 20 dB larger than in ears with large volumes. Perforations in anterior versus posterior quadrants showed no significant differences in air-bone gaps at any frequency, although anterior perforations had, on average, air-bone gaps that were smaller by 1 to 8 dB at lower frequencies. Conclusion The conductive hearing loss resulting from a tympanic membrane perforation is frequency-dependent, with the largest losses occurring at the lowest sound frequencies; increases as size of the perforation increases; varies inversely with volume of the middle-ear and mastoid air space (losses are larger in ears with small volumes); and does not vary appreciably with location of the perforation. Effects of location, if any, are small.

Mehta, Ritvik P.; Rosowski, John J.; Voss, Susan E.; O'Neil, Ellen; Merchant, Saumil N.

2010-01-01

429

Viscous damping of perforated planar micromechanical structures  

PubMed Central

The paper gives an analytical approximation to the viscous damping coefficient due to the motion of a gas between a pair of closely spaced fluctuating plates in which one of the plates contains a regular system of circular holes. These types of structures are important parts of many microelectromechanical devices realized in MEMS technology as microphones, microaccelerometers, resonators, etc. The pressure satisfies a Reynolds’ type equation with coefficients accounting for all the important effects: compressibility of the gas, inertia and possibly slip of the gas on the plates. An analytical expression for the optimum number of circular holes which assure a minimum value of the total damping coefficient is given. This value realizes an equilibrium between the squeeze-film damping and the viscous resistance of the holes. The paper also provides analytical design formulas to be used in the case of regular circular perforated plates.

Homentcovschi, D.; Miles, R.N.

2008-01-01

430

Viscous damping of perforated planar micromechanical structures.  

PubMed

The paper gives an analytical approximation to the viscous damping coefficient due to the motion of a gas between a pair of closely spaced fluctuating plates in which one of the plates contains a regular system of circular holes. These types of structures are important parts of many microelectromechanical devices realized in MEMS technology as microphones, microaccelerometers, resonators, etc.The pressure satisfies a Reynolds' type equation with coefficients accounting for all the important effects: compressibility of the gas, inertia and possibly slip of the gas on the plates. An analytical expression for the optimum number of circular holes which assure a minimum value of the total damping coefficient is given. This value realizes an equilibrium between the squeeze-film damping and the viscous resistance of the holes.The paper also provides analytical design formulas to be used in the case of regular circular perforated plates. PMID:19365579

Homentcovschi, D; Miles, R N

2005-01-01

431

Urinary excretion of duodenal purine derivatives in Kedah-Kelantan cattle  

Microsoft Academic Search

Three male Kedah-Kelantan (KK) cattle each fitted with a ruminal and a T-shaped duodenal cannulae, with an initial body weight of 178.3±5.78kg were used to study the recovery rate of urinary purine derivatives (PD) after duodenal infusion of incremental amounts of purine bases (PB). During the experiment, the cattle were fed at a maintenance energy level with a diet containing

O Pimpa; J. B Liang; Z. A Jelan; N Abdullah

2001-01-01

432

Acid secretory and duodenal ulcerogenic responses induced by mepirizole in anesthetized rats  

Microsoft Academic Search

The role of body temperature in the acid stimulatory mechanism by meprizole, a duodenal ulcerogen, was investigated in urethane-anesthetized rats. Subcutaneous administration of mepirizole (60 and 200 mg\\/kg) increased acid secretion in a dose-dependent manner and resulted in duodenal lesions within 8 hr. The acid secretory and ulcerogenic responses induced by mepirizole were inhibited completely by vagotomy and significantly reduced

Koji Ueshima; Koji Takeuchi; Tomohisa Ohuchi; Susumu Okabe

1994-01-01

433

Usefulness of F-18 FDG-PET in detection of multiple endocrine tumors with duodenal carcinoid.  

PubMed

In a 76-year-old woman in whom hypercalcemia had been followed, whole body fluorodeoxyglucose positron emission tomography (FDG-PET) scan detected hypermetabolic areas in the left lower region of the thyroid gland, pancreas tail, and duodenum. CT, MR, biopsy, and surgery were performed and parathyroid adenoma, pancreatic gastrinoma, and duodenal carcinoid were diagnosed. Fluorine-18 (F-18) FDG-PET may be useful for diagnosis of multiple endocrine tumors with duodenal carcinoid. PMID:17383156

Hayasaka, Kazumasa; Nihashi, Takashi; Matsuura, Toshihiro; Itoh, Kengo; Tokuda, Haruhiko

2007-03-23

434

Effect of Orally Administered Duodenal Fluid on Serum Proteins in Neonatal Calves  

Microsoft Academic Search

This study was to determine if orally administered duodenal fluid, as a source of intestinal microorganisms, would influ- ence absorption of v-globulin of colos- trum in newborn calves. Duodenal fluid was obtained 2 h postfeeding from a cannulated milk-fed calf. Twenty-seven male and female Holstein calves obtained within 6 h of birth were assigned random- ly to one of three

R. E. James; C. E. Polan

1978-01-01

435

CT evaluation of hepatic paragonimiasis with simultaneous duodenal or splenic involvement.  

PubMed

Paragonimiasis is a parasitic infection caused by the genus Paragonimus and usually leads to pulmonary disease. Hepatic paragonimiasis is rare, but duodenal and splenic involvement of this disease has not yet been reported in the literature. Herein, we report two rare cases of hepatic paragonimiasis with simultaneous duodenal or splenic involvement, respectively, and described their CT features. Both patients were lifelong residents of an endemic area of paragonimiasis and were confirmed clinicopathologically. PMID:22726983

Li, Xue-Ming; Yu, Jian-Qun; He, Du; Peng, Li-Qing; Chu, Zhi-Gang; Chen, Dong-Dong; Luo, Yi

2012-06-08

436

Improved Oral Intake After Palliative Duodenal Stenting for Malignant Obstruction: A Prospective Multicenter Clinical Trial  

Microsoft Academic Search

OBJECTIVES:We sought to test the hypothesis that placement of a new nitinol duodenal self-expandable metallic stent (SEMS) for palliation of malignant gastroduodenal obstruction is effective and safe in allowing patients to tolerate an oral diet.METHODS:In a prospective multicenter study, SEMSs (Duodenal WallFlex, Boston Scientific) were placed to alleviate gastroduodenal obstruction in inoperable patients without the ability to tolerate solid food.

Michael Piesman; Richard A Kozarek; John J Brandabur; Douglas K Pleskow; Ram Chuttani; Viktor E Eysselein; William B Silverman; John J Vargo; Irving Waxman; Marc F Catalano; Todd H Baron; Willis G Parsons; Adam Slivka; David L Carr-Locke

2009-01-01

437

Simultaneous primary gastric and duodenal MALT lymphoma presenting with gastrointestinal bleeding.  

PubMed

The gastrointestinal tract, particularly the stomach, is the most common site of mucosa-associated lymphoid tissue lymphoma (MALToma). Many studies describe primary MALT lymphoma arising from the gastric mucosa, especially in association with Helicobacter pylori infection. On the contrary, primary MALT duodenal lymphoma is a very rare neoplasm. We report a case of a patient with gastrointestinal bleeding in whom primary gastric and duodenal MALT lymphoma were occurred simultaneously. PMID:23007819

Zippi, M; Pica, R; Scialpi, R; Paoluzi, P; Occhigrossi, G

2012-07-01

438

Effects of glucagon-like peptide-1 (7-36) on antro-pyloro-duodenal motility  

US Patent & Trademark Office Database

The present invention provides an effective method for inhibiting antro-duodenal motility in healthy subjects and patients suffering from various disorders, without the side effects associated with other pharmaceutical compositions. GLP1(7-36)amide slows antro-duodenal motility and may be used for the treatment or prevention of gastrointestinal disorders such as diarrhea, postoperative dumping syndrome and irritable bowel syndrome, and also premedication in endoscopic procedures.

Goeke; Burkhard (Gauting, DE); Schirra; Joerg (Kirchhain, DE)

2003-06-17

439

Laser-mediated perforation of plant cells  

NASA Astrophysics Data System (ADS)

The functional analysis of plant cells at the cellular and subcellular levels requires novel technologies for the directed manipulation of individual cells. Lasers are increasingly exploited for the manipulation of plant cells, enabling the study of biological processes on a subcellular scale including transformation to generate genetically modified plants. In our setup either a picosecond laser operating at 1064 nm wavelength or a continuous wave laser diode emitting at 405 nm are coupled into an inverse microscope. The beams are focused to a spot size of about 1.5 ?m and the tobacco cell protoplasts are irradiated. Optoporation is achieved when targeting the laser focal spot at the outermost edge of the plasma membrane. In case of the picosecond laser a single pulse with energy of about 0.4 ?J was sufficient to perforate the plasma membrane enabling the uptake of dye or DNA from the surrounding medium into the cytosol. When the ultraviolet laser diode at a power level of 17 mW is employed an irradiation time of 200 - 500 milliseconds is necessary to enable the uptake of macromolecules. In the presence of an EYFP encoding plasmid with a C-terminal peroxisomal signal sequence in the surrounding medium transient transformation of tobacco protoplasts could be achieved in up to 2% of the optoporated cells. Single cell perforation using this novel optoporation method shows that isolated plant cells can be permeabilized without direct manipulation. This is a valuable procedure for cell-specific applications, particularly where the import of specific molecules into plant cells is required for functional analysis.

Wehner, Martin; Jacobs, Philipp; Esser, Dominik; Schinkel, Helga; Schillberg, Stefan

2007-06-01

440

Evaluation of perforated and nonperforated appendicitis with CT.  

PubMed

Fifty-three patients with 38 cases of perforated appendicitis and 15 cases of appendicitis without perforation were evaluated based on the computed tomography (CT) appearances of appendiceal diameter, phlegmon, abscess, extraluminal air, appendiceal wall enhancement, lateroconal fascial thickening, appendicolith, bowel wall thickening, ascites, ileal wall enhancement, peritoneal enhancement, periappendiceal fluid, omental haziness, retrocecal appendix, intraluminal air, and the combination of intraluminal air and appendicolith. The result of appendiceal diameter was compared using two-sample Student's t test, and the other CT findings were analyzed by Fisher's Exact Test. Our results showed that appendix was larger in caliber in perforated appendix (P< .05). Direct CT signs (i.e., phlegmon, abscess, and extraluminal air) were more specific for perforated appendicitis (P< .05). Indirect signs (bowel wall thickening, ascites, ileal wall enhancement, intraluminal air, and combined intraluminal air and appendicolith) were also found in higher incidence in appendiceal perforation (P< .05). Appendiceal enlargement and ileal wall enhancement were the two predominant findings in one case of perforation. We concluded that direct and indirect CT appearances can differentiate appendicitis with and without perforation. Indirect signs may be helpful in difficult case. PMID:15531143

Yeung, Kwok-Wan; Chang, Ming-Sung; Hsiao, Chao-Peng

441

Radio frequency perforation of cardiac tissue: modelling and experimental results.  

PubMed

Radio frequency (RF) current delivered through a thin catheter can be used to perforate the pulmonary valve or the atrial septum to treat pulmonary atresia in newborns. To understand better the mechanisms of RF perforation, a numerical model is developed, and experiments are performed in isolated canine cardiac tissue. The model consists of a cylindrical domain with a tissue layer between two blood layers. The finite-difference method is used to compute both the potential and temperature distributions. When the tissue temperature exceeds 100 degrees C in all points that are directly in front of the catheter, these points are considered to be instantly vaporised, and the catheter advances over these points. The computed temperature time course coincides with measured temperature at small voltages (< 16 V). Simulated perforation occurs when the voltage exceeds a threshold of 70-80 V for a catheter diameter of 0.30-0.44 mm, which coincides with experimental observations in the myocardium. A voltage exceeding this perforation threshold tends to decrease tissue damage. Shorter electrodes (0.7 mm as against 2.4 mm) with smaller diameters produce a more rapid perforation. In conclusion, numerical simulations provide insights into aspects of RF perforation, such as electrode size, current, speed of perforation and collateral damage. PMID:11094817

Shimko, N; Savard, P; Shah, K

2000-09-01

442

Cellular bicarbonate protects rat duodenal mucosa from acid-induced injury  

PubMed Central

Secretion of bicarbonate from epithelial cells is considered to be the primary mechanism by which the duodenal mucosa is protected from acid-related injury. Against this view is the finding that patients with cystic fibrosis, who have impaired duodenal bicarbonate secretion, are paradoxically protected from developing duodenal ulcers. Therefore, we hypothesized that epithelial cell intracellular pH regulation, rather than secreted extracellular bicarbonate, was the principal means by which duodenal epithelial cells are protected from acidification and injury. Using a novel in vivo microscopic method, we have measured bicarbonate secretion and epithelial cell intracellular pH (pHi), and we have followed cell injury in the presence of the anion transport inhibitor DIDS and the Cl– channel inhibitor, 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB). DIDS and NPPB abolished the increase of duodenal bicarbonate secretion following luminal acid perfusion. DIDS decreased basal pHi, whereas NPPB increased pHi; DIDS further decreased pHi during acid challenge and abolished the pHi overshoot over baseline observed after acid challenge, whereas NPPB attenuated the fall of pHi and exaggerated the overshoot. Finally, acid-induced epithelial injury was enhanced by DIDS and decreased by NPPB. The results support the role of intracellular bicarbonate in the protection of duodenal epithelial cells from luminal gastric acid.

Akiba, Yasutada; Furukawa, Osamu; Guth, Paul H.; Engel, Eli; Nastaskin, Igor; Sassani, Pejvak; Dukkipatis, Ramanath; Pushkin, Alexander; Kurtz, Ira; Kaunitz, Jonathan D.

2001-01-01

443

Effect of tyrosine administration on duodenal ulcer induced by cysteamine in the rat  

SciTech Connect

Duodenal ulcers were produced by administering cysteamine to rats. Pretreatment with the catecholamine precursor, L-tyrosine (40 mg/100 g i.p. for 5 days), decreased the intensity of duodenal ulcers induced by cysteamine. Equimolar doses of tyrosine methyl ester (51.2 mg/100 g i.p. or s.c.) were equally effective in reducing ulcer intensity. Other amino acids (i.e., alanine, aspartic acid, glutamic acid, glycine, leucine, lysine, tryptophan and valine) did not prevent experimental duodenal ulcers. Coadministration of other large neutral amino acids (e.g., leucine and valine) that compete with tyrosine for uptake into the brain did not inhibit the effect of tyrosine on duodenal ulcers induced by cysteamine. Gastric, duodenal and brain dopamine concentrations were increased 1 hr after the injection of tyrosine methyl ester (25.6 mg/100 g s.c.). These results suggest that the effect of tyrosine on duodenal ulcer induced by cysteamine may be mediated by changes in gastrointestinal dopamine metabolism.

Oishi, T.; Szabo, S.

1987-03-01

444

SOX9 Is Highly Expressed in Nonampullary Duodenal Adenoma and Adenocarcinoma in Humans  

PubMed Central

Background/Aims SOX9 is a marker for stem cells in the intestine, and overexpression of SOX9 is found in gastric and colon cancer; however, the expression of SOX9 in nonampullary duodenal adenoma and adenocarcinoma has not yet been evaluated. This study aimed to investigate SOX9 expression in nonampullary duodenal adenoma and adenocarcinoma by immunohistochemistry. Methods We evaluated SOX9 expression in 43 clinical samples (nonampullary duodenal adenoma in 22 lesions and nonampullary duodenal adenocarcinoma in 21 lesions) resected under endoscopic mucosal resection or endoscopic submucosal dissection. Results SOX9 was expressed in part of the base of the normal duodenal mucosa surrounding adenomas and adenocarcinomas. In contrast, SOX9-positive cells were found in more than half of the crypts from the bottom part of the crypt in all of the 43 samples. Moreover, in 15 adenoma samples (68.2%) and 19 carcinoma samples (90.5%), SOX9 was expressed in more than three-quarters of the crypts from the bottom part of the crypt. Conclusions SOX9 is overexpressed in nonampullary duodenal adenoma and adenocarcinoma in humans.

Sakamoto, Hirotsugu; Miura, Yoshimasa; Sashikawa, Miho; Yamamoto, Hironori; Sugano, Kentaro

2013-01-01

445

Duodenal Lipid Sensing Activates Vagal Afferents to Regulate Non-Shivering Brown Fat Thermogenesis in Rats  

PubMed Central

Previous evidence indicates that duodenal lipid sensing engages gut-brain neurocircuits to determine food intake and hepatic glucose production, but a potential role for gut-brain communication in the control of energy expenditure remains to be determined. Here, we tested the hypothesis that duodenal lipid sensing activates a gut–brain–brown adipose tissue neuraxis to regulate thermogenesis. We demonstrate that direct administration of lipids into the duodenum increases brown fat temperature. Co-infusion of the local anesthetic tetracaine with duodenal lipids abolished the lipid-induced increase in brown fat temperature. Systemic administration of the CCKA receptor antagonist devazepide blocked the ability of duodenal lipids to increase brown fat thermogenesis. Parenchymal administration of the N-methyl-d-aspartate receptor blocker MK-801 directly into the caudomedial nucleus of the solitary tract also abolished duodenal lipid-induced activation of brown fat thermogenesis. These findings establish that duodenal lipid sensing activates a gut–brain–brown fat axis to determine brown fat temperature, and thereby reveal a previously unappreciated pathway that regulates thermogenesis.

Blouet, Clemence; Schwartz, Gary J.

2012-01-01

446

Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage  

PubMed Central

Background. Duodenal gastrointestinal stromal tumours (GISTs) are an uncommon malignancy of the gastrointestinal (GI) tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5?cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

Shaw, Alexander; Jeffery, John; Dias, Laura; Nazir, Sarfraz

2013-01-01

447

Colonic perforation in collagenous colitis: an unusual complication.  

PubMed

Collagenous colitis is generally regarded as a benign disease with few serious complications. We report two women with collagenous colitis who presented with colonic perforation, one spontaneously and one 7 days after a barium enema, and a review of the literature. Including the present cases, 13 patients with collagenous colitis and colonic perforation have been reported, in two patients spontaneously and in 11 patients after a colonoscopy or barium enema. All were operated on except one patient who recovered after medical treatment. The pathogenesis of this complication is unknown. We propose that there might be a connection between mucosal tears and colonic perforation in collagenous colitis. PMID:15647652

Bohr, Johan; Larsson, Lars-Göran; Eriksson, Sune; Järnerot, Gunnar; Tysk, Curt

2005-01-01

448

Spontaneous perforation of the esophagus in a patient with achalasia.  

PubMed

Esophageal perforation in achalasia is rare. The risk would mainly follow pneumatic dilatation, and spontaneous perforation has not been described. We report a case of spontaneous rupture of the midesophagus in a 56-year-old woman with treated achalasia in whom the perforation occurred during a meal and was not preceded by emesis. A gastrografin swallow confirmed extravasation of contrast medium from the esophagus, and endoscopy revealed significant esophageal food stasis, consistent with achalasia, with a large tear in the midesophagus and gross mediastinal contamination. She subsequently underwent a three-stage esophagectomy with an uneventful recovery. PMID:24088458

Moriarity, Andrew R; Larkin, John O; O'Sullivan, Katie E; Ravi, Narayanasamy; Reynolds, John V

2013-10-01

449

Colon perforation as a critical complication of exertional heat stroke.  

PubMed

Although reduced intestinal blood flow causing barrier dysfunction and endotoxemia is well documented in the pathogenesis of heat stroke (HS), complications of the gastrointestinal tract are less appreciated in HS patients. Herein, we report the case of a young man with exertional HS complicated with colon perforation. Acute abdomen, bloody diarrhea, dilated bowel loop, and unexplained shock should be considered as warning signs of colonic ischemia and consequent perforation. Early recognition is the key factor for improving the outcome of HS patients complicated with colon perforation. PMID:21088352

Tsai, Ming-Kai; Chen, I-Hung; Wang, Chih-Chiang; Shiang, Jeng-Chuan

2010-11-15

450

Epidemiology of perforated peptic ulcer: Age- and gender-adjusted analysis of incidence and mortality  

PubMed Central

AIM: To investigate the epidemiological trends in incidence and mortality of perforated peptic ulcer (PPU) in a well-defined Norwegian population. METHODS: A retrospective, population-based, single-center, consecutive cohort study of all patients diagnosed with benign perforated peptic ulcer. Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010. Ulcers with a malignant neoplasia diagnosis, verified by histology after biopsy or resection, were excluded. Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes (K25.1, K25.2, K25.5, K25.6, K26.1, K26.2, K26.5, K26.6). Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures (e.g., JDA 60, JDA 61, JDH 70 and JDH 71) were performed to enable a complete identification of all patients. Patient demographics, presentation patterns and clinical data were retrieved from hospital records and surgical notes. Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS: In the study period, a total of 172 patients with PPU were identified. The adjusted incidence rate for the overall 10-year period was 6.5 per 100?000 per year (95%CI: 5.6-7.6) and the adjusted mortality rate for the overall 10-year period was 1.1 per 100?000 per year (95%CI: 0.7-1.6). A non-significant decline in adjusted incidence rate from 9.7 to 5.6 occurred during the decade. The standardized mortality ratio for the whole study period was 5.7 (95%CI: 3.9-8.2), while the total 30-d mortality was 16.3%. No difference in incidence or mortality was found between genders. However, for patients ? 60 years, the incidence increased over 10-fold, and mortality more than 50-fold, compared to younger ages. The admission rates outside office hours were high with almost two out of three (63%) admissions seen at evening/night time shifts and/or during weekends. The observed seasonal variations in admissions were not statistically significant. CONCLUSION: The adjusted incidence rate, seasonal distribution and mortality rate was stable. PPU frequently presents outside regular work-hours. Increase in incidence and mortality occurs with older age.

Thorsen, Kenneth; S?reide, Jon Arne; Kval?y, Jan Terje; Glomsaker, Tom; S?reide, Kjetil

2013-01-01

451

Reappraising the Surgical Approach on the Perforated Gastroduodenal Ulcer: Should Gastric Resection Be Abandoned?  

PubMed Central

Background Advancements in medical care for peptic ulcer disease (PUD) have reduced the need for invasive surgical procedures such as gastric resection (GR). Community-based PUD studies from a large sampling of PUD patients designed to analyze hospital resource use and outcomes after different surgical procedures have been rare. We aimed to exhaustively reappraise the risk factors and patient demographics that affect PUD patient recoveries after GR compared to those after simple closure (SC). Methods We used a Japanese administrative database for 6 consecutive months each year between 2006 and 2010. The database included a total of 68,432 PUD patients; we analyzed 6,334 perforation cases and 3,148 cases of patients who underwent GR or SC. Study variables were demographics, comorbidities, characteristics of PUD, and operative day. Study outcomes that were analyzed included mortality, postoperative complications, ventilation administration, postoperative blood transfusions, length of stay, total charges, operating room (OR) time, and the postoperative fasting period (defined as the day of surgery to the day oral food intake was resumed.) To reduce selection bias in study procedures and to control the variation in hospital practice, a propensity score (PS) matching cohort analysis and a mixed linear regression model were used to assess the effects of GR on the outcomes. Results In 699 hospitals, 322 GRs and 2,826 SCs were observed. Younger age, duodenal ulcers, preexisting anemia and an operative day no more than 24hours were significant associated with the choice of SCs. No significant differences were observed in study outcomes after either GR or SC; more postoperative blood transfusions and longer OR times but shorter postoperative fasting periods were observed after GR. Longer OR times, ventilation and postoperative blood transfusion were significantly associated with mortality. Not GR but longer OR times use of ventilation and complications were the most significant indicators of increased resource use. Conclusions There were no major significant differences in GR when compared to SC with regards to patient recoveries. Surgeons should obtain the skills and establish strategies to optimize either type of surgical procedure including minimizing OR time and establishing the best perioperative critical care. Keywords Peptic ulcer perforation; Simple closure; Gastric resection; Outcome; Resource use

Kuwabara, Kazuaki; Matsuda, Shinya; Fushimi, Kiyohide; Ishikawa, Koichi B.; Horiguchi, Hiromasa; Fujimori, Kenji

2011-01-01

452

Furcation Perforation Repair Comparing Gray and White MTA: A Dye Extraction Study  

Microsoft Academic Search

The purpose of this study was to evaluate the ability of gray and white ProRoot MTA to seal furcation perforations in mandibular molars using a dye extraction leakage model. Sixty-four mandibular molars were randomly divided into four experimental groups. Six teeth with perforations were used as positive controls and six teeth without perforations were used as negative controls. Perforations in

Hatim A. Hamad; Patricia A. Tordik; Scott B. McClanahan

2006-01-01

453

Surveillance and Treatment of Periampullary and Duodenal Adenomas in Familial Adenomatous Polyposis.  

PubMed

Patients with familial adenomatous polyposis (FAP) have a cumulative lifetime risk of over 90% for developing duodenal adenomas, which are the precursor lesions for duodenal adenocarcinoma. Consequently, these patients have a 5% to 10% lifetime risk of periampullary or duodenal adenocarcinoma, making this the leading cause of cancer death in FAP patients who have had prophylactic colectomies. The increased relative risk of duodenal carcinoma in FAP patients and the poor outcomes associated with the treatment of advanced duodenal cancer have led to the development of prevention strategies for this cancer in the setting of FAP. It is generally accepted that surveillance for duodenal adenomas and adenocarcinomas should be included in the management of patients with FAP, although there are few data from clinical trials that demonstrate the effectiveness of surveillance strategies or chemoprevention for the prevention of death from duodenal cancer. Prospective case series have shown that endoscopic surveillance with endoscopic or surgical treatment of high-risk lesions in the duodenal or periampullary region can be performed with successful removal of the at-risk lesion(s). Surveillance should begin at about 21 years of age and should be performed using both an end-viewing and a side-viewing upper endoscope. An interval of 3 to 5 years between examinations appears to be adequate if no polyposis is evident. Once polyposis develops, an interval of 1 to 3 years between screenings for mild polyposis is appropriate. Patients with denser polyposis or larger adenomas are recommended to undergo examination every 6 to 12 months because of their increased risk of developing duodenal adenocarcinoma. Nonsteroidal anti-inflammatory drug therapy with sulindac, a nonselective cyclooxygenase (COX) inhibitor, or celecoxib, a COX-2 selective inhibitor, may be of benefit after the development of duodenal polyposis by inducing the regression or stabilization of the polyposis, although there is limited evidence from randomized, controlled trials to support its routine use. Almost all cases of adenocarcinoma occur in patients with advanced polyposis (Spigelman stage IV disease), and approximately 33% of this group will go on to develop adenocarcinoma if left untreated. The most definitive procedure for reducing the risk of adenocarcinoma is surgical resection of the ampulla and/or duodenum. Pancreaticoduodenectomy or pancreas-sparing duodenectomy are appropriate surgical therapies that are believed to substantially reduce the risk of developing periampullary adenocarcinoma. However, these procedures are associated with significant morbidity and mortality, including the risk of inducing desmoid tumor formation in FAP patients. PMID:15010021

Johnson, J. Chad; DiSario, James A.; Grady, William M.

2004-04-01

454

Symptomatic duodenal duplication cyst in an adult demonstrated by endoscopic retrograde cholangiopancreatography. Case report and literature review.  

PubMed

A patient with a symptomatic duodenal duplication cyst demonstrated by endoscopic retrograde cholangiopancreatography (ERCP) is presented. This lesion usually does not communicate with duodenal lumen but should be added to the list of cystic duodenal lesions demonstrable by ERCP. ERCP preoperatively is helpful to the surgeon in isolating adjacent duct structures but cyst wall histology is mandatory for correct anatomic diagnosis as this lesion has often been confused with Type III choledochal cysts. PMID:474555

Luckmann, K F; Welch, R W; Schwesinger, W; Oswalt, C; Bannayan, G

1979-08-01

455

Perforated Brake Efficiency Measurements Using a 20-mm Cannon.  

National Technical Information Service (NTIS)

Over the past few years, several field experiments have been performed using 105-mm and 120-mm cannons having perforated muzzle brakes. Significant differences in impulse reduction and gasdynamic efficiency have been reported in tests using the same 105-m...

G. C. Carofano

1993-01-01

456

Test Comparison for 20mm Perforated Muzzle Brakes.  

National Technical Information Service (NTIS)

Tests were conducted at the Ballistic Research Laboratory for a 20mm perforated muzzle brake. Six muzzle brake designs were analyzed for their influence on muzzle velocity, blast overpressure, and brake efficiency. The designs were a combination of scaled...

D. S. Savick

1993-01-01

457

Pulmonary Artery Perforation Repair During Thrombectomy Using Microcoil Embolization  

SciTech Connect

A distal pulmonary artery perforation was successfully occluded by percutaneous microcoil embolization via a microcatheter. Microcoil embolization is a reasonable alternative therapeutic approach for this rare complication of pulmonary interventional procedures.

Tajima, Hiroyuki, E-mail: h-tajima@nms.ac.jp; Murata, Satoru; Kumazaki, Tatsuo; Abe, Yutaka; Takano, Teruo [Nippon Medical School, Department of Radiology/Center for Advanced Medical Technology, and Department of Internal Medicine I (Japan)

2006-02-15

458

A Case of Spontaneous Intestinal Perforation in Osteogenesis Imperfecta  

PubMed Central

A 51-year-old male with known osteogenesis imperfecta (OI) (type 1) presented with symptoms and signs of infective endocarditis. Transthoracic echocardiography showed chordal rupture and free mitral regurgitation, resulting in an emergency mitral valve repair. The surgical procedure was largely uneventful but subsequent clinical course on the intensive care unit was complicated by bowel perforation requiring two laparatomies for a colonic resection and loop ileostomy formation. Histology of the excised tissue demonstrated absent musculature with no evidence of ischemia. Spontaneous non-ischemic bowel perforation as a complication of osteogenesis imperfecta is to date unreported. Our case highlights the need for a high index of suspicion of non-ischemic bowel perforation in patients with connective tissue disorders. Keywords Osteogenesis imperfecta; Bowel perforation; Collagen; Non-ischemic; Connective tissue disorders; Pathogenesis; Collagen vascular disorder; Acute abdomen

Wheatley, Katherine; Heng, Ee Ling; Sheppard, Mary; Schneider, Hank; Moat, Neil; Cordingley, Jeremy; Kaul, Sundeep

2010-01-01

459

A novel technique to close large perforation of sinus membrane  

PubMed Central

SUMMARY Maxillary sinus floor elevation is generally accepted as a regenerative procedure to facilitate dental implants placement in the posterior atrophic maxilla. Although the sinus lift procedure is relatively safe, some potential problems could be occur. The most prevalent intraoperative complication is perforation of sinus membrane, which can lead to graft infection and early failure. The Aim of this work Is to present a new technique to repair large perforation of sinus membrane. This case report Is focused on a 10 mm perforation of sinus membrane occurred during preparation of the sinus window. The obliteration of the perforation was obtained by means of suturing sinus membrane with a resorbable material to the bone directly lateral to the osteotomy site. Sinus augmentation procedure could complete and the insertion of a graft was permitted.

CLEMENTINI, M.; OTTRIA, L.; PANDOLFI, C.; BOLLERO, P.

2013-01-01

460

Perforated jejunal diverticulitis: a rare presentation of acute abdomen.  

PubMed

Jejunal diverticulosis is a rare clinical finding with possible serious complications. A case of acute abdomen due to a perforated jejunal diverticulum is discussed, followed by a literature review concerning aetiology, symptoms, complications, diagnosis and treatment is provided. PMID:20690527

Vanrykel, F; Pattyn, P; Vuylsteke, P; Smet, B

461

Oblique Perforation of Thick Metallic Plates by Rigid Projectiles  

NASA Astrophysics Data System (ADS)

Oblique perforation of thick metallic plates by rigid projectiles with various nose shapes is studied in this paper. Two perforation mechanisms, i.e., the hole enlargement for a sharp projectile nose and the plugging formation for a blunt projectile nose, are considered in the proposed analytical model. It is shown that the perforation of a thick plate is dominated by several non-dimensional numbers, i.e., the impact function, the geometry function of projectile, the non-dimensional thickness of target and the impact obliquity. Explicit formulae are obtained to predict the ballistic limit, residual velocity and directional change for the oblique perforation of thick metallic plates. The proposed model is able to predict the critical condition for the occurrence of ricochet. The proposed model is validated by comparing the predictions with other existing models and independent experimental data.

Chen, Xiaowei; Li, Qingming; Fan, Saucheong

2006-08-01

462

Closure of Gastrointestinal Perforations with Cyanoacrylate Tissue Adhesive.  

National Technical Information Service (NTIS)

Intestinal patch closure of multiple perforations in gastrointestinal tract using N-butyl-cyanoacrylate or monomer mixture of 95% heptyl- and 5%-methyl cyanoacrylate was significantly faster, than the conventional suture method and no mortality was seen. ...

T. Matsumoto K. C. Pani R. M. Hardaway F. Leonard

1966-01-01

463

Perforation of the gallbladder due to blunt abdominal trauma.  

PubMed

Gallbladder perforation due to blunt trauma is an uncommon finding. We report our experience with six patients. The factors predisposing to perforation include a distended gallbladder because of either fasting or alcohol ingestion in normal patients, and obstruction of the cystic in patients with cholelithiasis. The diagnosis of gallbladder perforation after blunt injury may be suspected in patients with signs of an acute abdomen and hypotension that is not explained by blood loss. Peritoneal lavage that contains bile suggests the tentative diagnosis of trauma to the biliary tract or gallbladder, as well as to the liver or upper bowel. A cholecystectomy is the preferred treatment when gallbladder perforation occurs in the traumatized patient. PMID:7082171

Wiener, I; Watson, L C; Wolma, F J

1982-06-01

464

Theoretical analysis of flow rate into perforated drain tubes  

NASA Astrophysics Data System (ADS)

Perforated drain tubes have, in many places, supplanted the use of drain tiles in drainage from agricultural lands, airports and the like. However, the few existent formulae for predicting drainage rates are complex and unwieldy. In this paper, a formula is derived by using a series solution of Laplace's equation and techniques of solution of dual trigonometric series, for the rate of water flow into a perforated drain tube, showing the effects of such parameters as hole size, number and spacing of holes, and drain size and depth. The formula applies to pipes perforated by small circular holes or by longitudinal slits. Recommendations for the design of perforated pipes are made, based on the delivery ratio.

Hazenberg, G.; Panu, U. S.

1991-07-01

465

Iatrogenic retinal breaks during 20-gauge vitrectomy for proliferative diabetic retinopathy  

PubMed Central

Background We classified iatrogenic retinal break formation during 20-gauge pars plana vitrectomy for proliferative diabetic retinopathy into three types according to the mechanism of development, and evaluated the association of each type with postoperative complications. This is the largest series of such patients published to date. Methods This was a retrospective comparative study of 760 eyes from 609 cases who underwent primary 20-gauge vitrectomy for proliferative diabetic retinopathy and were followed-up for at least 6 months after surgery. Postoperatively, the eyes were classified as having vitreous hemorrhage only (group 1), fibrovascular membrane without traction retinal detachment (group 2), or fibrovascular membrane with traction retinal detachment (group 3). Results The overall incidence of iatrogenic retinal breaks was 29%. Fibrovascular membrane dissection was associated with retinal break formation in 50 of the eyes in group 3, an incidence which was significantly higher than that in group 2 (P < 0.001). Posterior vitreous detachment creation and peripheral vitreous shaving were associated with retinal break formation in 8% of eyes overall, and oral dialysis occurred in 2%. Postoperatively, vitreous hemorrhage requiring washout, neovascular glaucoma, recurrent retinal detachments, and fibrovascular proliferation at the sclerotomy sites occurred in 4%, 4%, 3%, and 1%, respectively, of all eyes. Outcomes of eyes with these postoperative complications, other than vitreous hemorrhage, were poor. Multiple regression analysis revealed retinal break formation during fibrovascular membrane dissection to be significantly related to postoperative vitreous hemorrhage (P = 0.019), recurrent retinal detachments (P < 0.001), and neovascular glaucoma (P = 0.048). Oral dialysis was also significantly related to postoperative vitreous hemorrhage (P = 0.001). Conclusion Iatrogenic retinal break formation during fibrovascular membrane dissection was more likely to be the cause of poor outcomes than peripheral retinal breaks or oral dialysis.

Kamura, Yumi; Sato, Yukihiro; Deguchi, Yuzou; Yagi, Fumihiko

2013-01-01

466

Perforation equations for conical and ogival nose rigid projectiles into aluminum target plates  

Microsoft Academic Search

We developed closed-form perforation equations for rigid, conical and ogival nose projectiles that perforate aluminum target plates at normal impact. An existing cylindrical, cavity-expansion model that was experimentally verified with perforation data into 5083-H131 aluminum armor plates was used as the starting point for the development of the perforation equations. We identified a small parameter in those perforation equations, performed

Michael J. Forrestal; Thomas L. Warren

2009-01-01

467

Duodenal biopsy for diagnosis of renal involvement in amyloidosis.  

PubMed

Amyloidosis results from extracellular deposition of a fibrillary protein in various organs, and renal biopsy is the best, but a complicated tool for diagnosis. Therefore, alternative biopsy sites have been proposed with varying degrees of sensitivity. We aimed to find the most appropriate biopsy site in patients with chronic kidney disease (CKD) in whom renal biopsy is contraindicated or unavailable. 42 patients (29 male; mean age 46 ± 16 y) with CKD in whom amyloidosis was suspected as the underlying etiology on clinical grounds, but renal biopsy was not available (Group I), and 36 patients (25 male; mean age 40 ± 16 y) with CKD in whom renal biopsy revealed AA-amyloidosis (Group II) were investigated. Upper and lower gastrointestinal tract (GIT) endoscopies were performed and multiple biopsies from gingiva, esophagus, antrum, duodenum and rectum were obtained. In Group I, no amyloidosis was detected in gingival and GIT biopsies among 13 patients. In the remaining 29 patients AA-amyloidosis was detected in various sites with the following frequencies: duodenum 100%, rectum 83%, antrum 79%, esophagus 44% and gingiva 29%. In Group II, frequency of amyloid deposition was 97% in duodenum, 76% each in antrum and rectum, 59% in esophagus and 32% in gingival mucosa. In conclusion, duodenal biopsy is sensitive for diagnosing amyloidosis in CKD patients, and highly correlates with renal amyloidosis. PMID:22257541

Yilmaz, Murvet; Unsal, Abdulkadir; Sokmen, Mehmet; Harmankaya, Ozlem; Alkim, Canan; Kabukcuoglu, Fevziye; Ozagari, Aysim

2012-02-01

468

Different types of peroxisomes in human duodenal epithelium.  

PubMed Central

Peroxisomes are ubiquitous organelles containing enzyme sequences for beta oxidation of fatty acids, synthesis of bile acids, and ether phospholipids. In the inherited peroxisomal diseases one or more enzymes are deficient in hepatic, renal, and fibroblast peroxisomes. We have examined peroxisomes by light and electron microscopy in 29 duodenal biopsy specimens (21 with normal mucosa) after staining for catalase activity, a marker enzyme. Peroxisomes were most numerous in the apices of the nucleus and at the villus base. Two types were distinguished: rounded to oval forms with a median lesser diameter of 0.23-0.31 microns, and tubular, vermiform organelles 0.1 microns thick and up to 3 microns long. Both types coexist in most patients. Tilting of sections and examination of semithin sections at 120 kV did not show connections between individual organelles. By morphometry, volume density was at least 0.45-0.62% of cellular volume, compared to 1.05% in human liver. In contrast, in four out of five individuals surface density of the peroxisomal membrane was 1.4-2.3 times higher than in control livers; this is expected to favour the exchange of metabolites. We suggest that intestinal peroxisomes contribute substantially to the breakdown of very long chain fatty acids. Images Figures 1 and 2 Figure 3 Figure 4 F