Aortic perianeurysmal fibrosis causing bilateral ureteral obstruction: a case report

A 54-year-old male with the chief complaint of bilateral flank pain was admitted to our hospital. Blood chemistry test revealed marked azotemia and retrograde pyelogram showed bilateral hydronephrosis with median shift of narrowed ureters. Abdominal CT scan demonstrated a well-defined dense mass around the aorta implicating bilateral ureters. These findings were interpreted as aortic perianeurysmal fibrosis resulting in bilateral ureteral obstruction. On laparotomy, a large hard mass was found in the lower part of aorta, vena cava, common iliac vessels, inferior mesenteric artery and bilateral ureters. Because of the extension of the mass, ureterolysis and intraperitoneal displacement of ureters wrapped with isolated omentum was performed. Postoperative recovery from azotemia and ureteral obstruction was satisfactory. Biopsy specimen of the mass showed marked fibrosis with non-specific inflammation.     

Leiomyoma of the bladder causing bilateral hydronephrosis: a case report

We report a case of bladder leiomyoma with marked bilateral hydronephrosis caused by chronic urinary retention. Surgical finding was that the mass was smooth, fist-sized and had a thin stalk connected to the bladder wall. The tumor was completely removed. Histopathological diagnosis was leiomyoma of the bladder and the post-operative course was uneventful.     

Lymphangiectasis of lower limb: A rare challenging case

Lymphangiectasis usually occurs in the viscera. Involvement of the lower limb is very rare. It is difficult to establish the diagnosis without detailed investigations. Clinical features are peculiar and may mimic lymphoedema of different origins which needs to be ruled out. Contrary to the expectation, the post-operative result is excellent in the long-term follow-up.     

Von recklinghausen neurofibromatosis-pachydermatocele causing lower limb gigantism: a case report

Gigantism of the lower limb can occur because of plexiform neurofibromas. This condition is seen with café au lait patches and multiple neurofibromatosis in this case of von Recklinghausen neurofibromatosis. We report our patient and review literature of this uncommon condition.     

Pathologic consequences of bilateral pulmonary lower lobectomies: case report.

Most injuries to the lung can be managed nonoperatively and rarely require resection. A case of bilateral hilar injuries requiring bilateral pulmonary lower lobectomies is presented. The resulting pulmonary hypertension, right ventricular failure, and cardiogenic shock explain the high mortality following extensive pulmonary resection in thoracic trauma and support the concept of a conservative approach.     

源于血友病的小腿筋膜室综合征1例

<正>患者李某,男,30岁,工人。入院前7h不慎跌倒,致左小腿肿胀疼痛,不能行走,当时未到医院就诊,自服三七片治疗症状不见减轻,反而加重。前来我院就诊,门诊拍X线片诊断:"左胫腓骨骨折"收入院治疗。     

Management of a hypoplastic lower urinary tract: a case report

This case relates to a child with an antenatal diagnosis of severe bilateral hydronephrosis with congenital anomalies of the ureters, bladder, and urethra. We describe the presentation and surgical management, highlighting the complexity of this anomaly and the surgical technique used to reconstruct the lower urinary tract. To our knowledge, there has not been a similar case in the literature and the use of a segment of colon for ureteric substitution in children has not been previously reported in the literature.     

急性下肢深静脉血栓形成治疗的临床分析

目的探讨急性下肢深静脉血栓形成(deep vein thrombosis,DVT)的治疗方法. 方法回顾分析1995年7月～2002年7月我院82例DVT的临床资料,保守治疗62例,手术取栓20例. 结果全部患肢水肿均有不同程度的消退,但完全再通15例,部分再通9例,其余58例均未通或复发,遗留血栓形成后综合征. 结论 DVT早期治疗效果好,保守治疗和手术治疗均为治疗急性DVT的方法,早期中心或混合型以手术为主,周围型或晚期中心型多采用保守治疗,静脉腔内介入治疗是一种较新、较好的血管外科技术.     

广泛性下肢动脉闭塞症治疗的选择

目的：探讨广泛性下肢动脉闭塞症治疗方法的选择。方法：自1994年3月至2008年5月对49例51条具有慢性缺血表现的下肢,经多普勒超声和数字减影血管造影（DSA）、CT血管造影（CTA）或磁共振血管造影（MRA）检查,确诊为下肢动脉广泛性闭塞症。根据影像提示的病变部位与程度不同,分别采用3种血管重建方式：①35例（37条下肢）行静脉动脉化手术治疗;②8例（8条下肢）行股深动脉重建;③6例（6条下肢）行血管腔内介入治疗。结果：28例（30条下肢）静脉动脉化术后随访1．5～13．5年,7条截肢;8例（8条下肢）股深动脉重建术后随访1-4年,2条截肢;6例（6条下肢）血管腔内介入治疗术后随访6个月至1．5年,1条截肢。除10条截肢外,其余41条患肢的症状均有不同程度好转,病人基本可正常生活。结论：根据广泛性下肢动脉闭塞症病变部位与程度不同,选择合适的治疗方法是提高其疗效的关键。     

Traumatic autonephrectomy due to explosion: A case report and literature review

A 47-year-old man presented 33 years after major trauma resulting from an explosion with asymptomatic microhaematuria. An IVU showed a completely calcified non-functioning right kidney with hypertrophic left kidney. Investigations for other causes of haematuria were negative. The results of long-term conservative management of traumatic renal infraction are reviewed.     

成人小腿胚胎性横纹肌肉瘤侵袭骨髓1例

横纹肌肉瘤是源于胚胎间充质的高度恶性肿瘤,年轻女性胚胎性横纹肌肉瘤常见转移部位为乳房,侵袭骨髓者非常罕见,多在数月内死亡。笔者在2013年3月期间收治1例横纹肌肉瘤伴骨髓侵袭的年轻女性患者,给予综合治疗后随访半年,恢复良好,现报告如下。患者,女,26岁,农民。患者2个月前无意间发现左小腿远端内侧有一软组织肿物,约鸡蛋大小,触之无痛感,2周前无诱因出现间断发热,最高38℃,     

Reconstruction of burned lower extremities by free flaps

Summary Three latissimus dorsi muscle flaps with skin grafts, one latissimus dorsi myocutaneous flap, and one scapular flap were used in reconstruction of deep burns of the heels and calf caused by various agents. The follow-up period was 11 to 46 months. Of the five patients treated, two sustained electrical injuries, two had contact burns and one suffered a degloving injury with a contact burn resulting from a car accident. The latissimus dorsi muscle flaps with skin grafts gave excellent results in reconstruction of the calf and ankle areas due to their large caliber vessels and versatility. The latissimus dorsi myocutaneous flap was indicated in a case with extensive soft tissue loss on the sole of the foot with stiffness of the ankle joint in plantar flexion. A non-sensory scapular flap was satisfactory for reconstruction of the medial half of the heel since the remaining lateral half of the heel provided adequate sensation for weight-bearing and protection. Early reconstruction of the burned lower part of the leg with free flaps shortens hospitalization and prevents further extension of the injury. Reconstruction of a burned distal lower extremity provides a challenge for the reconstructive surgeon due to limited availability of local tissue; there is durable soft tissue in the weight-bearing area and a relatively poor blood supply compared to other areas of the body. The basic requirement in the treatment of a full thickness burn is early debridement and immediate coverage of the defect with a skin graft or a well vascularized flap. Even though multiple local flaps, such as axial [7, 17], muscle [1], musculocutaneous [5], fasciocutaneous [11], and island flaps [4], have been described. These flaps are useful in relatively small wounds with undamaged sourrounding tissues. Electrical injuries are manifested in a variety of clinical and pathologic ways with early, as well as delayed, tissue damage complicating reconstruction. With the advent and refinement of microvascular techniques, it has become possible to reconstruct extensive defects of the distal lower extremity with either free muscle flaps with skin grafts [8], myocutaneous free flaps [10], or axial free flaps [18]. This paper relates our experience in reconstruction of extensive defects of the lower extremities caused by various burning agents.     

Early surgical treatment of severe electrical injury of bilateral upper extremities: a case report

A patient with both upper limbs injured by high-voltage current was treated by early wound débridement, segmental excision of the necrosed humerus of the left upper arm, internal screw fixation and vascularized skin free grafting on the right wrist. Functional recovery were satisfactory.