Radiographic manifestations of normal postoperative anatomy and gastrointestinal complications of bariatric surgery, with emphasis on CT imaging findings.

Recently, there has been a tremendous increase in the frequency of utilization of surgery to control morbid obesity that is very common and increasing in incidence in Western industrialized nations. Imaging plays an important role in the evaluation and management of patients before and after bariatric surgery. In this article, we discuss the imaging findings relating to bariatric procedures, focusing on the role of computed tomography (CT) in the evaluation of normal postoperative anatomy and gastrointestinal complications.     

Results and Complications of Laparoscopic Adjustable Gastric Banding: An Early and Intermediate Experience

Background: Laparoscopic adjustable silicone gastric banding (LASGB) has been performed as the initial procedure for weight reduction in the authors' institution for the past 22 months. The efficacy and safety of the procedure were studied. Methods: Patients were followed up prospectively during the perioperative and long-term course and for complications. Results: 391 patients, aged 16-72 years, with a mean body mass index (BMI) of 43.1 (range 33-66) were operated on. The laparoscopic procedure was completed in all but four. The mean operative time was 78 min (range 36-165), and the mean postoperative hospital stay was 1.2 days (range 1-8). There were four (1%) intraoperative complications: pneumothorax in one patient, bleeding in two patients, and injury to the stomach in one. Early postoperative complications were subphrenic abscess in two patients and band malposition in five. Of the patients operated on, 356 (91%) were available for follow-up. Over an average follow-up period of 13 months (range 1-22), band slippage occurred in 16 patients (4.1%), resistant port infection in 1, and longstanding pain in the port area in 9. There were 2 cases of port migration. A total of 26 (6.4%) reoperations were performed: early band repositioning (5), bleeding port site (1), late band repositioning (13), band removal (5), and local relocation of the port (2). All abdominal operations were performed laparoscopically. During the 18-month follow-up, the average BMI dropped from 43.1 to 29.8. Conclusion: LASGB is a safe procedure, with low early complication rates. Most reoperations may be performed laparoscopically, with subsequent low morbidity and short hospitalizations. On intermediate-term follow-up it seems to be an effective bariatric procedure.     

Comparison of peri‐implant clinical and radiographic inflammatory parameters among cigarette and waterpipe (narghile) smokers and never‐smokers

1 Background

The authors hypothesized that peri‐implant clinical and radiographic inflammatory parameters are worse in waterpipe smokers (WS) and cigarette smokers (CS) compared with never‐smokers (NS). The aim of the present retrospective study is to compare peri‐implant clinical and radiographic inflammatory parameters among WS, CS, and NS.

2 Methods

Forty‐four CS (group 1), 41 WS (group 2), and 43 NS (group 3) were included. Demographic data were collected using a questionnaire. Peri‐implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Sample size was estimated, and statistical analyses were performed using Kruskal–Wallis and Wilcoxon rank‐sum tests. For multiple comparisons, Bonferroni post hoc test was performed. P values < 0.05 were considered statistically significant.

3 Results

Peri‐implant PI and PD were higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. Peri‐implant BOP was significantly higher in group 3 compared with individuals in groups 1 (P < 0.01) and 2 (P < 0.01). Peri‐implant total marginal bone loss was significantly higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. There were differences in PI, BOP, PD, and CBL among participants in groups 1 and 2.

4 Conclusions

Peri‐implant soft tissue inflammatory parameters and CBL are worse in CS and WS compared with NS. There is no difference in these parameters between CS and WS.     

Bioprosthetic mitral valve paravalvular leak closure using intracardiac echocardiography‐guided three dimensional electroanatomic mapping

The development of paravalvular leak (PVL) following surgical replacement of an aortic or mitral valve is an uncommon complication with significant morbidity and mortality. Surgical or percutaneous repair of PVL can be technically challenging. We describe the application of intracardiac echocardiography guided 3‐dimensional electroanatomic mapping to facilitate PVL closure in a symptomatic patient with a previously placed bioprosthetic mitral valve. © 2017 Wiley Periodicals, Inc.     

Primary Lingual Tuberculosis in Immunocompetent Patient: a Case Report

Oral manifestations of tuberculosis are quite rare with an incidence rate of 1.4%. The tongue is the most common site of oral tuberculosis having varied presentations. Lingual tuberculosis is a diagnostic dilemma because of its rarity, particularly in immunocompetent patients. We are reporting a rare case of primary tuberculosis of the tongue in a 38 year old male diagnosed on fine needle aspiration cytology.     

Total occlusion of the left main and proximal right coronary artery: Case report and review of the literature

Chronic total left main coronary artery occlusion at angiography is very rare, and there are only four cases reported with concomitant total right coronary artery occlusion. We describe a case of total left main and proximal right coronary artery occlusion and review the clinical and angiographic characteristics of this condition which represents the most severe form of coronary artery disease compatible with life. © 1996 Wiley-Liss, Inc.