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Needle decompression

M K Arevalo, J C Prieto, N Cost, G Nuss, B J Brown, L A Baker
INTRODUCTION: Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG)...
September 17, 2016: Journal of Pediatric Urology
Yuji Yamamoto, Kazuaki Tanabe, Ryuichi Hotta, Nobuaki Fujikuni, Tomohiro Adachi, Toshihiro Misumi, Yoshihiro Saeki, Hiroki Takehara, Hideki Ohdan
INTRODUCTION: Morgagni's or Larrey's diaphragmatic hernias are relatively uncommon. If the defect is too large for primary closure, the use of a mesh is inevitable. Although primary closure is adaptable for relatively small defects, it is difficult to suture the hernial orifice in which the anterior rim is absent. Herein, we present the case of a patient with Larrey's diaphragmatic hernia that was easily and securely repaired using the recently developed laparoscopic extra-abdominal suturing technique via the port closure needle (Endo Close(®); Medtronic, Minneapolis, USA)...
September 21, 2016: International Journal of Surgery Case Reports
Eduard Tornero, Josep Maria De Bergua-Domingo, Pedro Domenech, Francisco Soldado, Ferran Torner, Juan Castellanos, Alex Soriano, Jorge Knörr
BACKGROUND: Early joint decompression associated to antibiotic therapy is the most important procedure to reduce joint damage in septic knee arthritis in children. Several joint decompression methods have been described such as arthrotomy with open debriding, arthroscopic drainage or needle joint aspiration. The aim of the present study was to determinate which patients with acute septic knee arthritis could be safely treated with needle joint aspiration. METHODS: Patients with an acute knee arthritis diagnosed between September 2003 and December 2013 in our children's tertiary hospital were retrospective review...
September 22, 2016: Journal of Pediatric Orthopedics
Naoki Otani, Kojiro Wada, Terushige Toyooka, Kazuya Fujii, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Yasuaki Nakao, Takuji Yamamoto, Kentaro Mori
BACKGROUND: Surgical clipping of paraclinoid aneurysm can be very difficult because strong adhesions may hinder the dissection of the perforators and surrounding anatomical structures from the aneurysm dome. We describe our experience with using retrograde suction decompression during the clipping of paraclinoid aneurysms and discuss the relative advantages and pitfalls. MATERIALS AND METHODS: This study included 23 patients with large and giant paraclinoid aneurysms who underwent surgical treatment consisting of direct clipping with suction decompression between March 2004 and August 2014...
2016: Acta Neurochirurgica. Supplement
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
Nicola Persico, Alfredo Berettini, Isabella Fabietti, Chiara Dallagiovanna, Dario Minoli, Fabio Mosca, Luigi Fedele, Gianantonio Manzoni
Prenatal ultrasound detection of fetal ureterocele with bilateral hydro-ureteronephrosis, obstruction of the bladder outlet and progressive amniotic fluid reduction can be associated with a significant risk of end-stage chronic renal disease after birth. Fetal cystoscopic laser incision of the ureterocele, with the aim of relieving the bladder outflow obstruction to preserve renal function, has been previously reported in one case, with a favourable outcome. This report employed standard 3.5-mm fetoscopic access to the amniotic cavity and the fetal bladder...
September 8, 2016: Ultrasound in Obstetrics & Gynecology
Christine M Van Dillen, Matthew R Tice, Archita D Patel, David A Meurer, Joseph A Tyndall, Marie Carmelle Elie, Jonathan J Shuster
Introduction. Limited evidence is available on simulation training of prehospital care providers, specifically the use of tourniquets and needle decompression. This study focused on whether the confidence level of prehospital personnel performing these skills improved through simulation training. Methods. Prehospital personnel from Alachua County Fire Rescue were enrolled in the study over a 2- to 3-week period based on their availability. Two scenarios were presented to them: a motorcycle crash resulting in a leg amputation requiring a tourniquet and an intoxicated patient with a stab wound, who experienced tension pneumothorax requiring needle decompression...
2016: Emergency Medicine International
J Geng, M Li
A patient with previous L3-4 posterior lumbar interbody fusion, pedicle screws instrumentation and L3-4 decompression, was scheduled for left total hip arthroplasty. Two years ago, due to poor landmarks palpation, the patient experienced a failed lumbar puncture after multiple attempts before herniorrhaphy. His plain radiography showed bilateral partial laminectomy at L3-4 level, and between L3 and L4, two posterior pedicle screws connected by metal rods on both sides. This time, we used ultrasound to locate L4-5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Grace Lim, Jamie M Zorn, Yuanxu J Dong, Joseph S DeRenzo, Jonathan H Waters
OBJECTIVE: This report aimed to describe the characteristics and impact of subdural hematoma (SDH) after labor epidural analgesia. CASE REPORTS: Eleven obstetric patients had SDHs associated with the use of labor epidural analgesia over 7 years at a tertiary care hospital. Ten of 11 patients had signs consistent with postdural puncture headache before the diagnosis of SDH. Five patients (45%) had a recognized unintentional dural puncture, 1 (9%) had a combined spinal-epidural with a 24-gauge needle, and 5 (45%) had no recognized dural puncture...
September 2016: Regional Anesthesia and Pain Medicine
Masahiro Morita, Akira Miyauchi, Shinya Okuda, Takenori Oda, Motoki Iwasaki
STUDY DESIGN: A case series study. OBJECTIVE: To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA: Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars interarticularis due to proliferation of fibrous cartilage, there is no electrophysiological study in relation to this accomplished fact...
June 3, 2016: Clinical Spine Surgery
Mihajlo Gjeorgjievski, Palaniappan Manickam, Gehad Ghaith, Mitchell S Cappell
Analyze efficacy, safety of endoscopic therapy for duodenal duplication cysts (DDC) by comprehensively reviewing case reports.Tandem, independent, systematic, computerized, literature searches were performed via PubMed using medical subject headings or Keywords "cyst" and "duodenal" and "duplication"; or "cyst", and "endoscopy" or "endoscopic", and "therapy" or "decompression"; with reconciliation of generated references by two experts. Case report followed CARE guidelines.Literature review revealed 28 cases (mean = 1...
May 2016: Medicine (Baltimore)
Joseph Maddry, Alejandra G Mora, Shelia Savell, Lauren K Reeves, Crystal A Perez, Vikhyat S Bebarta
BACKGROUND: Medical evacuation (MEDEVAC) is the movement and en route care of injured and medically compromised patients by medical care providers via helicopter. Military MEDEVAC platforms provide life-saving interventions that improve survival in combat. There is limited evidence to support decision making related to en route care and allocation of resources. The association between provider type and en route care is not well understood. Our objective was to describe MEDEVAC providers and identify associations between provider type, procedures performed, and outcomes...
May 27, 2016: Journal of Trauma and Acute Care Surgery
Gregory P Lekovic, Marc S Schwartz, John L Go
In this report the authors report on a patient with a very indolent course of granulocytic sarcoma, characterized by steroid-induced remission of spinal and cranial tumors and recurrence over a period of several years. This 24-year-old man with history of leukemia presented with rapid-onset quadriparesis secondary to multiple extraaxial masses of the cervicothoracic spine, from C-5 to T-3, and lumbosacral spine, from L-5 to the coccyx. Although the imaging features were highly suggestive of neurofibromatosis Type 2, the patient's history and clinical course were consistent with granulocytic sarcoma; repeat imaging and, later, needle biopsy definitively established the diagnosis of granulocytic sarcoma...
May 13, 2016: Journal of Neurosurgery. Spine
Charles E Mackel, Shane M Burke, Taylor Huhta, Ron Riesenburger, Simcha J Weller
Osteomyelitis is an infection of the bone that can involve the vertebral column. A rare cause of vertebral osteomyelitis is Mycobacterium bovis after intravesical Bacillus Calmette-Guerin (BCG) therapy for transitional cell carcinoma of the bladder. In this report, we describe the case of a 64-year-old male presenting with constitutional symptoms, progressive thoracic kyphosis, and intractable T11 and T12 radiculopathies over the proceeding six months. A CT scan revealed erosive, lytic changes of the T12 and L1 vertebrae with compression of the T12 vertebra...
2016: Curēus
Jennifer Davies, David Spitzer, Maria Phylactou, Martin Glasser
A 91-year-old presented with a rare cause of cardiac arrest. He was initially admitted with severe back pain following vomiting and diagnosed with probable aspiration pneumonia. On day 3 of admission, he was discovered in cardiac arrest and cardiopulmonary resuscitation was started. On intubation, a left-sided pneumothorax and subcutaneous emphysema were noted. Needle decompression showed gastric fluid leaking from the cannula. The patient regained a cardiac output, and a subsequent CT scan confirmed a large pneumomediastinum with air tracking to the neck and chest, and bilateral pneumothoraces...
2016: BMJ Case Reports
Jordan Breed, Tony Goldschlager, Ronil V Chandra
BACKGROUND CONTEXT: Neurogenic claudication from posterior epidural extension of a Baastrup interspinous bursal cyst is rare. Surgical decompression is the gold standard of treatment. This case report describes successful percutaneous treatment with good early clinicoradiological outcome. PURPOSE: This study aimed to describe the successful percutaneous treatment of a central posterior epidural Baastrup cyst causing neurogenic claudication. STUDY DESIGN: This is a case report study...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Hidetaka Arishima, Satoshi Kawajiri, Hiroshi Arai, Yoshifumi Higashino, Toshiaki Kodera, Ken-Ichiro Kikuta
Percutaneous treatments for trigeminal neuralgia (TN) including glycerol rhizotomy (GR), radiofrequency thermocoagulation (RT), and balloon compression (BC) are effective for patients with medical comorbidities and risk factors of microvascular decompression (MVD). These procedures are usually performed under fluoroscopy. Surgeons advance the needle to the trigeminal plexus through the foramen ovale while observing landmarks of fluoroscopic images; however, it is sometimes difficult to appropriately place the needle tip in Meckel's cave...
May 15, 2016: Neurologia Medico-chirurgica
E Nohuz, D Gallot, C Rousset, A Brunel, M Albaut, S Bayeh, F Vendittelli, H Laurichesse-Delmas, D Lemery
BACKGROUND: Congenital cystic lesions of the oral cavity are an extremely rare occurrence. Their prenatal diagnosis is essential since they can impede respiratory and swallowing functions. We describe a case that was detected prenatally and discuss its management. CASE REPORT: A 21-year-old primigravida patient who was 23 weeks pregnant was referred to our obstetrics and gynecology center after fetal ultrasonography showed a cystic lesion of the oral cavity. She had no family history of any congenital anomalies...
March 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
David M Flores, Katie S Murray, Tomas L Griebling, Joshua A Broghammer
The treatment for prostate abscesses includes a combination of antimicrobial therapy and surgical drainage of the abscess cavity. There is a lack of published cases involving treatment options for a prostate abscess after a failed transurethral resection of the prostate. This is a case report describing a successful salvage treatment after a failed attempt at abscess drainage by a transurethral resection of the prostate. The patient was successfully managed with a needle drainage of his prostate abscess utilizing a transrectal ultrasound guided needle decompression his prostate abscess...
July 2015: Urology Case Reports
Hajime Imai, Masayuki Kitano, Shunsuke Omoto, Kumpei Kadosaka, Ken Kamata, Takeshi Miyata, Kentaro Yamao, Hiroki Sakamoto, Yogesh Harwani, Masatoshi Kudo
BACKGROUND AND AIMS: EUS-guided bile duct drainage (EUS-BD) is a well-recognized rescue biliary drainage method after unsuccessful ERCP. EUS-guided gallbladder drainage (EUS-GBD) was recently used to treat acute cholecystitis. The aim of this study was to assess the efficacy and safety of EUS-GBD for malignant biliary stricture-induced obstructive jaundice after unsuccessful ERCP as well as unsuccessful or impractical EUS-BD. METHODS: Between January 2006 and October 2014, 12 patients with obstructive jaundice due to unresectable malignant distal biliary stricture underwent EUS-GBD after ERCP failed...
July 2016: Gastrointestinal Endoscopy
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