静脉注射血管外渗报警装置的研制

当进行静脉注射时，由于有的患者不能很好的配合，所以常发生药液的血管外渗，造成局部皮肤和皮下组织的损伤而延误治疗。为了尽最大可能的减少损伤并使患者得到及时治疗最需要一种报警装置，但国内目前尚无此装置的报道，因此我们研制静脉注射血管外渗自动报警装置用于监控进行静脉注射的患者。该装置可以用在医院的日常护理工作中     

Early detection of extravasation of radiographic contrast medium. Work in progress.

Microwave radiometry is a passive and noninvasive technique that allows quick detection of subcutaneous temperature changes. The feasibility of this technique for differentiating normal intravenous infusions of radiographic contrast medium from extravasations of contrast medium was tested in anesthetized dogs. Room-temperature and heated ionic and nonionic contrast media were administered at flow rates ranging from 0.2 to 9.9 mL/sec by means of a power injector. On the basis of these experiments, an algorithm to adjust for extravasation detection thresholds as a function of injection flow rates was developed. With this algorithm, results showed a false-positive rate of 0% at all infusion rates and false-negative rates of 2%, 2%, and 4% at pump speeds of 0.2, 1.0, and 9.9 mL/sec, respectively. The times of these extravasation "alarms" corresponded to maximum extravasated volumes, respectively, of 4, 6.5, and 8 mL. Microwave radiometry has clinical potential for early detection of extravasation of contrast medium administered with power injectors.     

Urine extravasation into the scrotum

A case report demonstrating urine extravasation into the scrotum following renal transplantation is presented. An anatomic explanation of the pathway of urine drainage into the scrotum is offered with a brief discussion of extravasation following renal transplantation and its detection by scintigraphy.     

Spontaneous urinary extravasation: detection rate with 64-row multidetector computed tomography in patients presenting with acute abdomen

The aim of this study was to detect the rate of spontaneous urinary extravasation (SUE) with computed tomography (CT) in patients presenting with acute abdomen. Seven hundred thirteen abdominal CT examinations with i.v. contrast media requested mainly from the emergency department and urology clinics for sudden onset abdominal pain, flank pain, nonspecific abdominal pain with nausea and vomiting, and renal colic between September 2007 and August 2011 were retrospectively reviewed. Only adult patients were included in the study. Three patients with SUE were detected. One had a mid-ureteral stone while the etiology for the other two patients was unknown. Two of the patients were treated conservatively; one was treated with stenting with a double-j catheter. SUE should be considered in the differential diagnosis of patients presenting with acute abdomen and perinephric–periureteral fluid collection inconsistent with stone size and who are occasionally stone free. Early and precise diagnosis of SUE plays an important role in the management protocol of patients presenting with acute abdomen.     

Radioscintigraphic demonstration of unsuspected urine extravasation

Three cases of unsuspected urine extravasation first detected by radionuclide scintigraphy are presented with subsequent confirmation by CT and, retrograde pyelograms. A renal study done to rule out acute transplant rejection demonstrates gallbladder uptake which was initially thought to be consistent with urine extravasation.     

Recognition and management of contrast media extravasation

Intravenous contrast agents are frequent adjuncts used in diagnostic imaging. Despite the well-recognized complications of contrast media extravasation, its treatment remains an enigma to many. This article reviews the recognition, prevention and treatment options, with a summary of the contrast media extravasation policy implemented in our department.     

Perirenal extravasation of contrast media during urography

The authors report on 28 cases of contrast medium extravasates during urography. Own results and those obtained by other authors in respect of clinical findings, diagnosis and therapy are discussed. Our experiences have shown that an aggressive diagnostic or therapeutic approach is not indicated, since the sequels of these extravasates have no special clinical importance. As a rule, treatment is unnecessary, especially inpatient observation. Hence, our experiences confirm the trend to proceed as conservatively as possible.     

Bone scintigraphy and postoperative ureteropelvic urine extravasation

A case of severe urinary extravasation after renal pyeloplasty resulted in symptoms strongly suggestive of musculoskeletal origin. Bone scintigraphy revealed no findings relating to the skeletal system, but because of renal excretion of the tracer, the cause of the postoperative pain was revealed. The value of bone scintigraphy as a urinary tract diagnostic screening tool is probably underrated, even though at least 15% of studies fortuitously detect abnormalities of the urinary tract.     

Self-limiting extravasation in the unused urinary bladder

Patients being evaluated as potential renal transplant recipients routinely undergo voiding cystourethrography. Eight patients were encountered in whom extraperitoneal extravasation was noted from the region of the ureterovesical junction during voiding (seven patients) or during filling (one patient). Extravasation was bilateral in six patients and unilateral in two. The patients neither experienced symptoms related to the extravasation, required treatment, nor had sequelae. Five of the eight patients have subsequently received renal transplants and their bladders were observed to be normal at surgery. Cystoscopy was also performed in two of these five patients and was unremarkable. After transplantation, these patients' bladders functioned normally and gave rise to no symptoms.     

Contrast medium extravasation in traumatic intracerebral haematoma

Summary One case of contrast medium extravasation in a post-traumatic intracerebral haematoma is reported; the arterial wound concerning the small and deep vessels are noteworthy.

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Kontrasimittel-Austritt in traumatische intracerebrale Hämatome

Zusammenfassung Fallbeschreibung eines Patienten mit einem traumatischen intracerebralen Hämatom, bei dem die Angiographie einen Kontrastmittelaustritt in das Hämatom zeigte.

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Extravasation du produit de contraste en cas d'hématome intracérébral post-traumatique

Résumé Les auteurs rapportent un cas d'extravasation du produit de contraste lors d'un hématome intra-cérébral post-traumatique; La blessure artérielle concernant les petits vaisseaux profonds n'est pas négligeable.

     

Venous contrast extravasation during digital subtraction angiography

Six episodes of contrast extravasation occurred in 5 patients during intravenous digital subtraction angiography in a period of 9 months. The extravasations were into the mediastinum (3), pericardium (1), and right atrial wall (2). These occurred using a variety of catheters, all the same size (5.0 F—1.67 mm). Three were Katzen catheters, one had a pigtail configuration, and two were straight catheters. We believe that the extravasations are due to three main factors. The first is catheter-related, owing to the small size (5.0 F) creating recoil and marked jet stream effect due to the large volume and pressure that must be delivered through the side holes. The second factor is related to positioning of the catheter in the superior vena cava. Finally, the respiratory phase at the time of injection becomes crucial. Understanding of these factors may help to decrease this potentially serious complication.