Successful transcatheter perforation of the atretic pulmonary valve membrane in a newborn using the new Coe radiofrequency end hole catheter

The new 2 French Coe radiofrequency (RF) end hole catheter was first used to successfully perforate the atretic pulmonary valve membrane using an antegrade approach in a newborn with intact ventricular septum (IVS). Nine watts of energy for 8 sec was required with simultaneous delivery of a 0.014 in. coronary guidewire coaxially through the end hole RF catheter for balloon valvuloplasty. This new ringed-tip end hole RF catheter offers considerable advantages to the pediatric interventionalist in the transcatheter therapy in neonates with pulmonary atresia (PA) and IVS. Cathet. Cardiovasc. Diagn. 45:162–166, 1998. © 1998 Wiley-Liss, Inc.     

Complete left atrial obliteration due to localized tamponade after coronary artery perforation during PTCA

Coronary artery perforation is a rare but important complication of percutaneous revascularization (PTCA). Clinical events following coronary perforation may include cardiac tamponade. After bypass graft operation (CABG), however, cardiac tamponade with subsequent hemodynamic instability is unusual due to the development of pericardial adhesions. We report an unusual case of localized tamponade after coronary artery perforation during PTCA in a patient with previous CABG. Cathet. Cardiovasc. Diagn. 45:61–63, 1998. © 1998 Wiley-Liss, Inc.     

食管穿孔16例治疗体会

目的:探讨食管穿孔的诊断和治疗方法。方法:回顾性分析1996年-2004年收治的16例食管穿孔患者的临床资料,对其诊断和治疗方法进行总结。结果:术前经X线、胸腔穿刺、上消化道造影、胃镜及CT确诊。行食管Ⅰ期修补、颈部引流2例,行食管Ⅰ期修补、胸腔引流3例,胸腔引流、空肠造瘘4例,食管部分切除、食管胃吻合4例,放置食管支架2例,未手术1例。死亡6例(37.5%),发生并发症7例(43.8%)。结论:早期诊断、闭合瘘口、防止感染,是降低并发症,减少死亡率的根本措施。     

1例急性胰腺炎合并胆囊坏疽和穿孔

2020年4月青岛大学附属威海市中心医院重症医学科收治1例脓毒性休克患者。此患者因腹痛入院,经急诊诊治鉴别,以“急性胰腺炎”收入消化内科。其病情进展迅速,因休克转入重症医学科进行抢救。对休克原因进行评估和筛查,经剖腹探查术术中明确诊断为急性胆囊坏疽并穿孔、急性胰腺炎。术后经抗感染、容量复苏、脏器功能支持,最终抢救成功。     

Delayed appearance of distal coronary perforation following stent implantation

Coronary perforations are usually apparent immediately after the occurrence. We report a case of a 67-year-old woman where coronary perforation presented 16 hours after the procedure. This case illustrates the need for extra vigilance and careful evaluation of distal vasculature while using stiff coronary guidewires. Cathet. Cardiovasc. Diagn. 43:311–312, 1998. © 1998 Wiley-Liss, Inc.     

十二指肠溃疡穿孔单纯修补术后加用药物治疗的远期疗效

目的确定十二指肠溃疡穿孔单纯修补术+口服H2受体阻滞剂和(或)质子泵抑制剂或抗幽门螺杆菌(HP)等药物治疗的远期效果。方法对宣武医院1991年1月至2000年12月序贯收治的77例十二指肠溃疡穿孔单纯修补术+口服H2受体阻滞剂等药物的出院病人进行随访。结果随访到65例患者,术后溃疡症状复发率(VisickⅢ~Ⅳ)为15.4%(10/65)、再穿孔手术率为1.5%(1/65);40例复查内镜者复发7例(17.5%)。结论十二指肠溃疡穿孔修补术加H2受体阻滞剂或质子泵抑制剂及抗HP治疗的远期效果较满意。     

耳内镜下金因肽棉片贴补治疗外伤性鼓膜穿孔35例

我科于2009-12-2011-03在耳内镜下对35例外伤性鼓膜穿孔患者采用金因肽棉片贴补治疗,疗效满意,报告如下。1资料与方法1.1临床资料35例外伤性鼓膜穿孔患者中,男26例,女9例;年龄14～65岁;病程1～15d。6例并发中耳感     

Mucosal carcinoma within a colonic diverticulum

We report a case of a mucosal carcinoma and adenoma within a diverticulum in the cecum. Radiographic, endoscopic, and pathologic evaluation of the tumor is presented. Surgical resection was undertaken because of the size and shape of the lesion, risk of perforation, and the possibility of malignancy. A recent review of the literature with respect to clinical signs, diagnosis, growth of the carcinoma, and treatment of tumors around or within diverticula is also presented. A carcinoma or adenoma arising within the diverticulum is very rare. Endoscopic resection of the tumor could entail the risk of perforation, because of the lack of muscular coats in the diverticula. Surgical treatment may be the procedure of choice for lesions near or within the diverticula. Received: November 19, 1998 / Accepted: March 26, 1999     

新生儿胃穿孔的治疗

目的:提高新生儿胃肠穿孔的治愈率。方法:总结1983年3月至1997年3月13例经手术证实诊断为胃穿孔的新生儿。分析了影响预后的因素:就诊时间,早期处理.胎龄,体重和有无合并症等。结果:成活6例,死亡7例,死亡率53.8％。结论:积极处理腹膜炎及中毒性休克,加强围术期处理是提高治愈率的关键。     

急性心肌梗塞并发心脏破裂的救治及心电监护指导

心脏破裂是急性心肌梗塞（ＡＭＩ）的致命性并发症,及时准确的诊断、抢救措施对其的救治率有着重要的决定作用,是心血管内、外科临床医师研究的重要课题。科学的心电监测是准确及时诊断的关键性手段,是判断病情演变和预后必不可少的措施,指导治疗及治疗措施的调整更显出它的重要地位。文章重点就室间隔穿孔的诊断与处理;心脏游离壁破裂的诊断与处理;室壁瘤的诊断与处理;乳头肌断裂的诊断与处理及ＡＭＩ并发心脏破裂的心电监测与康复疗法等问题进行论述