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31.
32.
S. Horita T. Shinoda H. Yoshimoto M. Masuo Y. Miura 《Clinical and experimental nephrology》2002,6(1):71-74
We report a case of infectious endocarditis in a 77-year-old woman who was undergoing maintenance hemodialysis therapy, and
who was also having a prosthetic aortic valve replacement. The disease resulted from a local skin infection at the needle
puncture site of the arteriovenous fistula. Ampicillin-resistant Staphylococcus aureus was the causal organism. Surgical treatment could not be performed because of associated intracranial hemorrhage due to septic
embolism. In spite of intensive treatment with several antibiotics, a ventricular septal abscess just beneath the prosthetic
aortic valve progressed to form a ventricular septal fistula. The resultant intracardiac left-to-right shunt led to refractory
congestive heart failure. The patient finally died of heart failure. The formation of a ventricular septal fistula is considered
to be a rare and extraordinary complication of infectious endocarditis in a hemodialysis patient with aortic valve replacement.
Received: July 25, 2001 / Accepted: November 3, 2001 相似文献
33.
K. Singh 《International urogynecology journal》2002,13(1):50-51
The author reports a complicated recurrence of genital tract fistula. The initial vesicovaginal fistula resulted from obstructed
labor, which was subsequently surgically managed without success. The patient had a recurrent vesicovaginal fistula that was
formed by the erosion of vesical stones through the anterior endopelvic fascia into the vagina. The stones eventually eroded
into the rectum, resulting in the formation of a complex vesicovaginal and rectovaginal fistula. 相似文献
34.
P. Nowakowski K. Ziaja T. Ludyga W. Kuczmik G. Biolik P. wik D. Ziaja 《Diseases of the esophagus》2007,20(4):358-360
Esophageus or gaster resection in patients with malignant disease is still a treatment of choice. It is obvious that each surgical procedure in these patients carries some possibility of complications. Esophageo-gastric or esophageo-jejuno anastomosis has a 4-27% frequency of fistula occurrence. All these result in 65% mortality in cases of poorer prognosis. The aim of this paper is not to present all types of complications but to objectively analyse the usefulness of the covered stent placement in the treatment of anastomotic fistulas. We present six patients who were treated for postoperative fistula of esophageo-gastric anastomosis (1 case) or esophageo-jejuno anastomosis (5 cases). All patients were treated with stapler suture for digestive tract reconstruction after malignancy removal during the primary surgical procedure. Signs and symptoms of suture leak between 5-8 days post-surgery were observed. Conservative therapy was not effective. Thus a new method of treatment was employed - covered stent placement. The procedure was performed under X-ray control. In all treated patients there was change for the better and quick reduction of secretion from the fistulas was observed. All patients were discharged from the department after several days and all had survived at 30 days follow-up. Covered esophageal stent placement seems to be a safe and promising method of treatment for patients with anastomotic fistula which significantly reduces mortality and improves quality of live. Our experiences confirms that of other investigators. 相似文献
35.
室间隔夹层瘤的超声诊断(附4例报告) 总被引:1,自引:0,他引:1
目的 总结室间隔夹层瘤的超声心动图诊断及临床应用价值。方法1985~2005年超声诊断罕见的室间隔夹层瘤4例。超声主要取左室长轴、四腔心、五腔心、大动脉短轴及非标准切面,观察主动脉窦的形态及结构:如扩张窦瘤的大小、窦壁厚度、窦瘤破口的部位、窦瘤破口与室间隔之间的关系,主动脉窦瘤与室间隔夹层瘤之间交通口的大小,测量形成室间隔夹层瘤的大小及夹层瘤左、右室面的厚度,结合彩色多普勒观察心动周期夹层瘤与主动脉窦瘤血流动态变化,频谱多普勒测量窦瘤与室间隔夹层瘤之间的血流速度。结果4例室间隔夹层瘤均为主动脉右窦破人室间隔基底段,且均行手术治疗证实超声诊断。结论超声心动图对室间隔夹层瘤可直接做出诊断,超声诊断价值在于早发现、早诊断、及早治疗,并可为外科选择手术方式提供重要的有价值的依据。 相似文献
36.
Perianal mucinous adenocarcinoma is a rare tumour which may be associated with long‐standing chronic perianal sepsis. Early diagnosis is challenging and is based on a high index of clinical suspicion and specific histological features. Definitive treatment is surgical, in the form of an abdomino‐perineal resection. We hereby describe a case of a perianal mucinous adenocarcinoma arising from long‐standing recurrent perianal fistula and complement this with a brief review of the literature pertaining in particular to the management of this condition. 相似文献
37.
A. K. Singh M. Gujar S. Shiral R. M. Raizada 《Indian journal of otolaryngology and head and neck surgery》2004,56(4):297-298
A case of rhinolith in a 60 years old male prsenting with palatal performation is, presented alongwith a brief discussion
on the pathogenesis and treatment. 相似文献
38.
Nenad Ilijevski Petar Otasevic Bratislav Milosavljevic Ljiljana Jovovic Dragan Sagic Djordje Radak 《Surgical Practice》2007,11(2):54-59
Objective: To analyse the incidence, clinical presentation, and outcome of heart insufficiency in patients with chronic arteriovenous fistulas (AVF). Methodology: From 1991 to 2000 we treated 49 patients with traumatic AVF. The present study included 19 patients with AVF present for 6 months or longer, as it was presumed that these AVF will have an impact on cardiac overload. There were 16 male and three female patients with a mean age of 36 years (17–59). The time from injury to admission varied from 6 months to 33 years. Cardiological examination checked for dyspnoea and palpitation. ECG, chest X‐ray and ECHO‐cardiography were also performed. All AVF were deleted, magistral vessels reconstructed, non‐magistral obliterated, either surgically or by percutaneous embolization. Results: Mean follow up was 44.2 months (3–93). Serious heart insufficiency was seen in two patients only, with AVF in the subclavial vessels. Both suffered from serious heart disease prior to the therapeutic procedures that resulted in iatrogenic AVF, so it was difficult to connect heart insufficiency to the AVF alone. Despite surgical closure of AVF and intensive medical treatment, signs of heart insufficiency remained in both patients. Signs of cardiac overload were seen in six patients with long‐standing AVF in major vessels. Except for one patient who refused surgical closure of femoral AVF, the remaining five were symptom free for cardiac overload during the follow‐up period. Conclusion: In our series, heart insufficiency was an infrequent complication in long‐standing AVF, even when major vessels were involved. 相似文献
39.
A. Ravikumar S. Mohanty R. P. Vatsanath S. Raghunandhan 《Indian journal of otolaryngology and head and neck surgery》2004,56(4):317-320
The co-existence of fungal elements in allergic nasal Polyposis, has given rise to a distinct clinical entity known as ‘Allergic
fungal sinusitis ’ (AF’S). Many a time, these fungal elements may not be diagnosed pre-operatively by routine diagnostic nasal
endoscopy or CT scan of paranasal sinuses, due to the florid presentation of nasal polyps, which usually obscure the underlying
fungal pathology. The diagnosis is often made intra-operatively. The post-operative confirmation of AFS is by histopathology,
fungal smear, fungal culture, allergic murin study and fungal specific IgE titres. We report a series often such cases done
in our institution, which highlight that AFS should be considered as a differential diagnosis in Sinonasal Polyposis cases,
for their effective management. 相似文献
40.
扩大经鼻蝶入路海绵窦的内镜解剖研究 总被引:1,自引:1,他引:0
目的通过对扩大经鼻蝶窦入路的内镜解剖学研究,为临床应用提供形态学基础.方法在10具动脉灌注染料的成人尸头上模拟扩大经鼻蝶窦手术入路,测量海绵窦内重要结构与鞍底的距离.结果扩大经鼻蝶手术入路可清晰显示鞍底的骨膜、硬脑膜外层、海绵窦内侧壁,及海绵窦内的颈内动脉及其分支血管、动眼神经、滑车神经、展神经及视神经等结构.结论内镜下行扩大经鼻蝶手术入路可清晰显露海绵窦及其内的解剖结构,适用于鞍内病变侵犯海绵窦的外科治疗. 相似文献