Retained fecalith after laparoscopic appendicectomy

The subhepatic abscess due to retained fecalith is a rare complication following appendicectomy. The incidence of this complication is probably going to increase due to high rate of laparoscopic appendicectomy. We report 2 cases of subhepatic abscess 1 and 2 years after laparoscopic appendectomies. This potentially serious complication could be preventing with technical recommendations. When it occurs, this complication has to be directly treated by surgical drainage, percutaneous drainage couldn't be successful because it leaves fecalith in its place which is a cause of recurrence. Our reports are the first to use a laparoscopic treatment of this complication.     

Lesser curve necrosis following selective proximal vagotomy--a case report

A case of the lesser curve necrosis following selective proximal vagotomy for a perforated duodenal ulcer is reported. Although little is known of this very rare complication, it is potentially a fatal complication after selective proximal vagotomy. Early recognition and immediate reoperation must be save the life of the patient when this complication is suspected.     

Acute arterial occlusion associated with total knee arthroplasty

Acute arterial occlusion is a rare but limb-threatening complication in total knee arthroplasty. Most of the previously reported cases of this complication required surgical intervention. This report illustrates an unusual case of this complication that was managed conservatively with an acceptable outcome. The case is also indicative of the etiology and the optimal prevention of this complication. In a patient with advanced arteriosclerosis, as indicated by vascular calcification around the knee or in the abdomen, knee arthroplasty should be performed without a tourniquet, and intra-operative manipulation should be done cautiously because of the potential for intimal disruption. Received: 18 September 1997     

Lesser curve necrosis following selective proximal vagotomy a case report

A case of the lesser curve necrosis following selective proximal vagotomy for a perforated duodenal ulcer is reported. Although little is known of this very rare complication, it is potentially a fatal complication after selective proximal vagotomy. Early recognition and immediate reoperation must be done to save the life of the patient when this complication is suspected.     

Intraoperative hypotension due to unrecognized bleeding from a continuous spinal catheter site

We recently cared for a patient who had a rare complication from a continuous spinal catheter: extensive bleeding around the catheter insertion site. This complication went unrecognized intraoperatively because the bleeding was hidden from view. The possible etiologies for this bleeding are discussed, as well as methods to recognize this complication before significant bleeding occurs.     

Peritoneal cysts: a complication of ventriculoperitoneal shunts.

Large abdominal cysts are not a common complication of peritoneal shunts. In our experience only 11 of 1,585 peritoneal shunts developed this complication (0.7 percent). We believe that infection, particularly by S. epidermidis and multiple-shunt revisions, is related to the development of the cysts. Simple parencentesis and replacement of the shunt usually are sufficient treatment for this complication if infection is not present.     

Avascular necrosis of the femoral head--an unusual complication of an intertrochanteric fracture.

Avascular necrosis of the femoral head is an uncommon complication after intertrochanteric fracture. We report six patients with this unusual complication 1-5 years after intertrochanteric fracture. The possible etiologies of this complication include a more proximal intertrochanteric fracture, a high-energy injury with fracture displacement resulting in vascular damage, and adverse influences of the operative procedures on the vascularity of the femoral head.     

Femoral shaft perforation: a complication of total hip reconstruction.

Perforation of the femoral shaft by the stem of the prosthesis is a rare, but serious complication following total hip replacement. It is a complication that is avoidable if meticulous attention is given to preoperative planning and intraoperative technique. The major predisposing factors for this complication are previous hip surgery, hip dysplasia, osteoporosis and poor exposure. Every attempt should be made to discover a perforation during surgery and to correct the alignment of the femoral stem. The patients who have experienced this complication have had a poor result suffering pain, loosening or femoral shaft fracture necessitating surgical revision.     

Tension chylothorax

Thoracic duct injury resulting in chylothorax is a well-known and documented complication of thoracic surgery. However, chylothorax under tension is a rarely reported complication that results in respiratory and hemodynamic collapse. Early recognition and treatment of this entity are essential for optimal patient outcome. Herein we present two cases of postoperative tension chylothorax followed by a review of the diagnostic work-up and therapy for this complication.     

'Plunging' during burr hole craniostomy: a persistent problem amongst neurosurgeons in Britain and Ireland

The inadvertent 'plunging' of an instrument into the cranial cavity is a feared complication of drilling a burr hole and while anecdotes abound, little is known about the extent or the consequences of this problem. A survey by anonymous postal questionnaire of 304 neurosurgeons in Britain and Ireland was conducted to analyse the extent of this complication. Of respondents, 65.6% had experienced 'plunging', 22.3% having 'plunged' at least twice, indicating a high prevalence of this complication. The Cushing perforator was implicated by most. 'Plunging' carried a 12% risk of death or permanent neurological morbidity. The authors analyse the prevalence and significance of this preventable complication, and discuss various options available to minimize its occurrence.     

Postoperative bleeding: coagulopathy, bleeding, hemothorax

Several issues are involved in determining a patient's risk for postoperative hemorrhage and in managing this potential postoperative complication. The impact of minimally invasive procedures on the incidence of this complication is addressed in this article.     

Acquiring Tetanus After Hemorrhoid Banding and Other Gastrointestinal Procedures

Tetanus after hemorrhoidal banding is an extremely rare but serious complication of the procedure. We describe the second reported case of this complication and review the literature concerning tetanus after different gastrointestinal procedures. Although a rare complication, practicing physicians need to be aware of the clinical presentation of this deadly disease when encountered in at-risk patient populations. Such cases also reemphasize the importance of primary tetanus immunization and follow-up boosters for all vulnerable patients.     

Right vocal-cord paralysis after open-heart operation.

We report a previously unrecorded complication of open-heart operations and discuss the cause. Suggestions for effectively eliminating this complication are offered.     

Tension pneumothorax during flexible fiberoptic bronchoscopy in a newborn

IMPLICATIONS:A newborn undergoing flexible fiberoptic bronchoscopy before repair of a tracheoesophageal fistula developed a life-threatening tension pneumothorax. The mechanisms of this complication are discussed and recommendations are made for preventing this complication.     

Pneumothorax associated with laparoscopic cholecystectomy

Pneumothorax is an uncommon but potentially serious complication that can occur during laparoscopic procedures. A patient under-going laparoscopic cholecystectomy developed an 80% pneumothorax during the course of the procedure and required chest tube insertion. She then underwent an uneventful recovery. The etiology of this complication as well as methods for avoiding this problem have been reviewed. Because of the potential serious nature of this complication, it is imperative that the surgeon be aware of the possibility and implement appropriate immediate therapy.     

Venous infarction of the testis--a cause of non-response to conservative therapy in epididymo-orchitis. A case report

Acute epididymo-orchitis occasionally responds poorly to conservative measures. Testicular infarction may be one reason for this complication. Ultrasonography and radionuclide scanning can elucidate the cause. A patient with this complication is described.     

Bariatric surgery,a risk factor for rhabdomyolysis

Rhabdomyolysis has been increasingly recognized as a complication of bariatric surgery. We report a case of this complication and its consequences, in a patient who had undergone bariatric surgery, with a very high creatine kinase (CK) concentration, and whose renal function failed. Obesity causes a range of effects on all major organ systems. Knowledge of these effects and issues specific to the intensive care unit care of bariatric patients can help to predict and manage this underestimated complication in this population in which early diagnosis can alter the outcome.     

Potassium-titanyl-phosphate laser vaporization of the prostate: a case series of an unusual complication

Abstract Despite its increasing use in the management of symptomatic benign prostatic hyperplasia, the long-term complications after potassium-titanyl-phosphate photoselective vaporization of the prostate are poorly reported. We describe a rare complication of this technology-calculi formation in the prostatic urethra. All patients presented with visible hematuria and variable lower urinary tract symptoms up to 5 years after the original surgery. In all cases, the calculi were successfully removed endoscopically. Possible causes for this unusual complication are discussed, and the importance of warning patients about this potential long-term complication are highlighted.     

Ruptured semimembranosus bursa—a complication of arthroscopy: A short case report

Rupture of a semimembranosus bursa is a rare complication of arthroscopy. The presentation and natural history of this complication are described and the literature is reviewed.     

A case of DeBakey IIIb dissecting aortic aneurysm with complete intimal disruption.

We describe a rare complication of DeBakey type IIIb dissecting aortic aneurysm in whose reentry the entire circumference of the aorta was involved and the true lumen was disrupted at this point. We successfully treated this complication in a two-stage operation.