Transient femoral neuropathy after abdominoplasty

Femoral nerve injury is a rare complication of abdominal and pelvic surgery. Although it has been described after a variety of operative procedures, this article describes what may be the first reported occurrence of femoral neuropathy after abdominoplasty.     

Incarcerated femoral hernia after radical cystectomy

A case is presented of incarcerated femoral hernia that developed in the early post-operative period after radical cystectomy. Possible causation and preventive measures are discussed.     

Cases of femoral nerve palsy after radical prostatectomy

Although postoperative femoral neuropathy is an uncommon complication occurring after pelvic surgery, we experienced several cases of femoral nerve palsy in patients after radical prostatectomy. All cases had neither previous vascular nor peripheral nerve disease. To investigate the possible etiology, we compared the difference in age, height, body weight, body mass index (BMI), duration of surgery, and volume of bleeding in patients with or without femoral nerve palsy. Although age and volume of bleeding were similar in groups, height, body weight, BMI, and duration of surgery in nerve palsy group (n = 5) were significantly larger than those without nerve palsy (n = 9). To evade these complications, inappropriate stretching and prolonged compression of the nerve during surgery, two major mechanisms of the neuropathy, were asked not to do to urological surgeons. In addition, intravenous patient-controlled analgesia (IV-PCA) was also used for postoperative analgesia instead of epidural analgesia. After these strategies, we found that the frequency of femoral nerve palsy had considerably decreased. Patients received physical therapy and showed nearly total neurological recovery. We report here unusual complication following major pelvic surgery, and discuss the possible etiology and some strategies for prevention of this injury.     

Haemorrhagic femoral neuropathy

A case of femoral nerve palsy secondary to a traumatic haematoma associated with the iliacus muscle is presented. Review of the literature suggests the existence of two types of lesion. The prognosis for recovery of the femoral nerve is different in the two groups and may be improved by appropriate treatment. The investigation of the case presented suggests that the most valuable method of differentiating the two lesions is by using a CAT scan.     

Two cases of femoral nerve palsy after radical prostatectomy

We report two cases of femoral nerve palsy after radical prostatectomy due to compression ascribed to the use of a ring retractor. The first case is in a 69-year-old man who fell when getting out of bed on the first postoperative day. Physical examination revealed hypoesthesia around the patella and weakness of the quadriceps muscle. The second case is in a 66-year-old man who complained of numbness of the anteromedial aspects of the right thigh and inability to extend his right knee on the first postoperative day. Postoperative femoral nerve palsy is not a well-recognized complication in urology. The literature was reviewed and the management of postoperative femoral nerve palsy was discussed.     

A case of sciatic neuropathy after caesarean section under spinal anaesthesia

We present a rare case in which a healthy parturient developed a left sciatic neuropathy after spinal anaesthesia for caesarean section. Intraoperatively, a wedge was placed under her right buttock to tilt the pelvis and uterus to the left, to minimise aortocaval compression. Postoperatively, she complained of being unable to move her left foot. Neurologic examination revealed a left lower leg paresis. Electromyography showed denervation potentials on muscles innervated by left sciatic nerve. Seven weeks after surgery the patient had made a full recovery. We conclude that the prolonged lateral tilt position might cause compression neuropathy of the sciatic nerve. After childbirth, re-positioning the patient supine or shortening the time of lateral tilt may reduce the risk of sciatic nerve injury.     

人工股骨头置换术后柄部蚀损反应1例

１　病例资料患者,女,５９岁,１９９７年９月２０日因右股骨颈骨折（头下型）而入院。于９月２９日在连续硬膜外麻醉下行右人工股骨头置换术（双极头、钴铬钼合金,天津市骨科医疗器械二厂产品）。术后常规抗炎、止血及对症治疗。术后第５天体温上升到３９－４℃,切口红肿。术后第９天拆除部分缝线,扩创引流,有淡绿色夹杂咖啡色稀薄状脓液,两次细菌培养均未检出细菌。于术后１个月行右髋关节扩创１９９９０３２９收稿,１９９９０６０７修回作者单位：铜陵有色金属（集团）公司职工总医院骨科,安徽　铜陵　２４４０００作者…     

Postoperative chylous ascites after radical gastrectomy. A case report

Postoperative chylous ascites is a classical but uncommon complication following extensive retroperitoneal or near the root of the mesentery dissection with an incidence ranging from 1.2 to 3%. Only 6 cases of chylous ascites have been described after ulcer surgery with troncal vagotomy associated with pyloroplasty and only 1 after gastrectomy. We report the second case of chylous ascites after a D2 distal gastrectomy. A 56-year-old female underwent a D2 distal gastrectomy and gastro-duodenostomy with omentectomy for a prepyloric T1N0M0 moderately differentiated adenocarcinoma. The patient was treated conservatively by both of parenteral nutrition and a fat free diet. By the end of 2(nd) postoperative week, the effusion became serous again and the output gradually ceased. The drain could be removed on the 20(th) postoperative day. Normal enteral nutrition was resumed, no recurrence of chylous ascites occurred. This conservative treatment proved to be effective as it as already be reported with resolution in almost 60% of the patients and remains the first choice option.     

A case of subcutaneous metastases from bladder cancer after radical cystouretherectomy

A case of transitional cell carcinoma (TCC) of the bladder metastasizing subcutaneously to the right lower abdomen and to the left back approximately 2 years after radical cystouretherectomy is reported. A 65-year-old male underwent radical cystouretherectomy with the creation of ileal couduit after preoperative intraarterial chemotherapy and radiotherapy. At the out patient clinic two years postoperatively, a subcutaneous tumor was palpated in the right lower abdomen and the left back. The tumors were removed and histopathologically diagnosed as subcutaneous metastases of TCC. The patient received three courses of postoperative systemic chemotherapy. At 15 months after the last chemotherapy, the patient remains free of metastases and relapse.     

A case report of treatment for tracheal fistula after radical esophagectomy

We report our experience of the treatment of a 60-year-old man with upper tracheal fistula which developed on the 11th day after radical surgery for esophageal cancer. Primary treatment to close the fistula was unsuccessful, resulting in the involvement of empyema due to infection. Controlled ventilation with T-tube and drainage through a chest tube for 2 months lead to depuration of the thoracic cavity. As a strategy for secondary closure of the fistula, fenestration was performed on the 87th day postoperatively. The patient's overall condition improved thereafter and closure was being considered. However, the patient died on the 116th day postoperatively due to supervenient aspiration pneumonia. Thus, long-term controlled ventilation with a T-tube was beneficial for the treatment of central airway injury.     

A case of urethral recurrence found 15 years after radical cystectomy

PURPOSE: A case of a urethral recurrence found 15 years after radical cystectomy is reported. METHODS/RESULTS: A 78-year-old man, who had undergone radical cystectomy at age 63, presented with urethral bleeding and positive cytology in urethral washing. The urethra was surgically resected. Pathologic examination revealed transitional cell carcinoma located in the distal and mid portion of the penile urethra. CONCLUSION: Evidence suggested that urethral recurrence resulted from the implantation from the primary bladder tumor; in addition, the urethral neoplasm had scarcely grown in the penile urethra for 15 years.     

Coil embolization of major bleeding after femoral fracture. A case report

Successful internal arterial embolization with steel coils in life-threatening bleeding after femoral fracture is described in an older patient.     

Coil embolization of major bleeding after femoral fracture: A case report

Successful internal arterial embolization with steel coils in life-threatening bleeding after femoral fracture is described in an older patient.