• Title/Summary/Keyword: Endoscope

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Delayed rupture of a posttraumatic retromaxillary pseudoaneurysm causing massive bleeding: a case report

  • Hwang, Jae Ha;Kim, Woo Hyeong;Choi, Jun Ho;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.22 no.3
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    • pp.168-172
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    • 2021
  • Posttraumatic pseudoaneurysm of the face is caused by blunt, penetrating, or surgical trauma. Although its incidence is low, pseudoaneurysm rupture can cause a life-threatening, massive hemorrhage. A 48-year-old man visited our emergency center due to a fall-down accident. Three-dimensional computed tomography (CT) showed a comminuted zygomaticomaxillary complex fracture of the left face. After open reduction and internal fixation, the surgical wound healed without any complications. However, the patient was readmitted 10 days after surgery due to pus-like discharge from the wound. Contrast-enhanced CT to find the abscess unexpectedly revealed a pseudoaneurysm in the left retromaxillary area. Massive oral bleeding occurred on the night of re-hospitalization and emergency surgery was done. The bleeding site was identified as a pseudo-aneurysmal rupture of the posterior superior alveolar artery in the retromaxillary area. Hemostasis was achieved by packing Vaseline gauze in the maxillary sinus using an endoscope. Delayed rupture and massive bleeding of posttraumatic retromaxillary pseudoaneurysm after a zygomaticomaxillary fracture is a low-probability, but high-impact event. Therefore, additional contrast-enhanced CT should be considered to evaluate the possibility of a posttraumatic pseudoaneurysm in cases of severe comminuted zygomaticomaxillary fracture.

Per-Endoscopic Trans-Tympanic Traction Treatment of an Aural Inflammatory Polyp in a Cat

  • Park, Won-Keun;Song, Doo-Won;Shin, Dong-Hoon;Kim, So-Yeon;Lee, Ga-Won;Kang, Dong-Jae;Ro, Woong-Bin;Cho, Jong-Mun;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.147-151
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    • 2021
  • A 5-year-old castrated male Maine Coon cat presented with chronic otitis on the right ear. The clinical signs, scratching and head shaking, were recurrent despite symptomatic treatment, including antibiotics and antifungal agents. Video otoscopic examination and computed tomography (CT) examination revealed a polyp in the right ear canal. The polyp was removed via per-endoscopic trans-tympanic traction (PTT) with a grasping forceps. After treatment, Horner's syndrome occurred in the right eye but spontaneously resolved a week later. The mass was diagnosed as inflammatory polyp with a fibrovascular stroma containing plasma cells, lymphocytes, and neutrophils. All clinical signs were improved, and no recurrence was observed after 3 weeks of follow-up. This case report demonstrates that CT scan is effective in identifying the margin of polyp and PTT technique is non-invasive method for treating inflammatory polyp in cats without severe complications.

Surgical Treatment Outcomes of Acquired Benign Tracheoesophageal Fistula: A Literature Review

  • Kim, Sang Pil;Lee, Juhyun;Lee, Sung Kwang;Kim, Do Hyung
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.206-213
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    • 2021
  • Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

Single-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a technical review

  • Yuki Tanisaka;Masafumi Mizuide;Akashi Fujita;Rie Shiomi;Takahiro Shin;Kei Sugimoto;Shomei Ryozawa
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.716-725
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    • 2023
  • Endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy is technically challenging. For example, scope insertion, selective cannulation, and intended procedures, such as stone extraction or stent placement, can be difficult. Single-balloon enteroscopy (SBE)-assisted ERCP has been used to effectively and safely address these technical issues in clinical practice. However, the small working channel limits its therapeutic potential. To address this shortcoming, a short-type SBE (short SBE) with a working length of 152 cm and a channel of 3.2 mm diameter has recently been introduced. Short SBE facilitates the use of larger accessories to complete certain procedures, such as stone extraction or self-expandable metallic stent placement. Despite the development in the SBE endoscope, various steps have to be overcome to successfully perform such procedure. To improve success, the challenging factors of each procedure must be identified. At the same time, endoscopists need to be mindful of adverse events, such as perforation, which can arise due to adhesions specific to the surgically altered anatomy. This review discussed technical tips regarding SBE-assisted ERCP in patients with surgically altered anatomy to increase success and reduce the risk of adverse events associated with ERCP.

The usability analysis of the Ray-sum technique and SSD (Shaded Surface display) technique in stomach CT Scan (위장 CT 검사에서 Ray-sum 기법과 SSD(Shaded Surface Display) 기법의 유용성 분석)

  • Kim, Hyun-Joo;Cho, Jae-Hwan;Song, Hoon
    • Journal of Digital Contents Society
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    • v.12 no.2
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    • pp.151-156
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    • 2011
  • The analysis and image evaluation the Ray-sum technique and Shaded Surface Display (under SSD) technique which is the reconstruction image processing technique after the CT scan was evaluated and the usability of the three-dimensional information offering was confirmed in the patient with stomach cancer. After obtaining the raw data by using 64-MDCT in 20 patient with stomach cancers, the image reconstruction processing was done. It was evaluated to describe accurately the analyzed result Ray-sum and SSD reconstruction image everyone anatomical structure. In the precision estimation of the image, the lesion location could coincide in the Ray-sum and SSD reconstruction image majority with the gastro fiberscope and we can know than the gastro fiberscope over 6cm that there was the error. In addition, We could know that degree of accordance of the results of the image interpretation about the lesion and endoscope and pathological opinion were high.

Special quality research by pulse transformer stabilization by high tension output module of medical ultra series laser II (산부인과용 $CO_2$ 연속형 레이저의 고압출력 모듈에 따른 펄스트랜스 안정화 특성연구(II))

  • Kim, Whi-Young
    • Journal of the Korea Computer Industry Society
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    • v.8 no.1
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    • pp.49-56
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    • 2007
  • Various kind of laser had been used on addition to endoscope for obstetrics and gynecology, gas laser such as CO2 laser had been used mainly much in laparoscope surgical operation mainly Thermal effect of beam displays other result different component parts of cellular tissue and different close of a marketplace of laser beam and priority solidification of temperature increase consists in cellular tissue, and cutting or carbonization process happens and evaporation by breakdown of cellular tissue happens more than $300^{\circ}$. <중략> Ostabilization of pulse transformer by high tension output module of CO2analog laser for obstetrics and gynecology that accomplish marks of honor kind switching and accuracy is required, and stabilize with laser output applying Turn-off in existent hard switching forward converter, on city happened switching damage, damage increase of output diode station recovery special quality, parasitism shock, design and result that manufacture, brought result that improve than existing product. Will be bought to get into superior result if supplement as systematic late.

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Thoracoscopy as a safe and effective technique for exploring calves affected with bovine respiratory disease

  • Perez-Villalobos, Natividad;Espinosa-Crespo, Inaki;Sampayo-Cabrera, Jose;Gonzalez-Martin, Juan-Vicente;Gonzalez-Bulnes, Antonio;Astiz, Susana
    • Journal of Animal Science and Technology
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    • v.59 no.3
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    • pp.5.1-5.10
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    • 2017
  • Background: Bovine respiratory disease (BRD) is one of the leading causes of economic losses in the beef and dairy industry. Reliable antemortem tools for diagnosing BRD would improve the efficacy of treatment and reduce costs. Here we examined whether the relatively simple technique of thoracoscopy can support BRD diagnosis under field conditions. We also compared various equipment set-ups in order to optimize the safety and efficacy of the procedure. A total of 24 thoracoscopic procedures were performed in 17 calves diagnosed with BRD and in 2 healthy control calves. Rigid and flexible endoscopes and industrial videoscopes were tested using various insertion approaches. The suitability of the technique was assessed in terms of duration, volume of air extracted, visualization score, and image quality. Safety was assessed in terms of rectal temperature, body weight, breaths/min, presence of fibrinogen, pain score, recovery time, intraoperative complications and risk of laceration or threatening collapse. Results: Insertion of a flexible endoscope via a right, dorso-caudal approach at the $5^{th}$ intercostal space allowed complete examination of the right lung in 15 min, as well as identification of main lung lesions and adherences in calves with BRD, without compromising calf welfare. While the dorso-caudal approach was optimal, it was associated with substantial discomfort when rigid endoscopes were used, minimal complications or mortality due to thoracoscopy were observed up to 28 days after the procedure. Videoscopes were as safe and easy to use as endoscopes, but endoscopes provided better image quality. Conclusion: This study provides the first field evidence that thoracoscopy can be safe to explore BRD-diseased calves. These results justify a larger study to rigorously assess the diagnostic performance of the technique.

Extended Application of Endoscopic Repair for Frontal Sinus Fractures (전두동 골절에서 내시경적 치료의 확대 적용)

  • Jeong, Jae-Yeon;Lim, So-Young;Pyon, Jai-Kyong;Bang, Sa-Ik;Oh, Kap-Sung;Mun, Goo-Hyun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.613-618
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    • 2010
  • Purpose: The coronal approach for repair of frontal sinus fractures is associated with significant adverse sequelae including a long scar, alopecia, paresthesias, and, uncommonly, facial nerve injury. To minimize these complications, an endoscopic approach for repair of frontal sinus fractures was developed. The authors now present the results of an endoscopy-assisted approach for the treatment of frontal sinus fractures. Methods: From 2002 to 2009, five patients with frontal sinus fracture underwent endoscopic repair. Two slit incisions were placed in the scalp, and one or two stab incisions directly over the fractures were placed in the forehead. After subperiosteal dissection, fracture segments were reduced under direct vision and fixed with microplates or fibrin glue. Results: All patients had good cosmetic results and remained free of sinus complaints. There were no perioperative complications reported. Conclusion: Endoscopic repair of frontal sinus fractures is an efficacious technique that significantly reduces patient morbidity. A relatively wide range of anterior table fractures can be reduced using an endoscope. In cases of complicated comminuted fractures, fibrin glue helps to achieve satisfactory endoscopic reduction. Endoscopic repair is an alternative treatment for various anterior table fractures of the frontal sinus.

ENDOSCOPIC-ASSISTED OPEN REDUCTION AND INTERNAL FIXATION (EAORIF) FOR CONDYLAR FRACTURE (내시경을 이용한 하악골 과두경부 골절의 정복 및 견고 고정술)

  • Paeng, Jun-Young;Ok, Yong-Ju;Myoung, Hoon;Hwang, Soon-Jung;Seo, Byoung-Moo;Choi, Jin-Young;Lee, Jong-Ho;Choung, Pill-Hoon;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.474-481
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    • 2006
  • The endoscopic assisted approach for the treatment of condylar fracture is a less invasive alternative treatment modality and is considered to be able to overcome the limited access to the operation field to obtain an accurate reduction and fixation. Six patients with condylar neck and subcondylar fracture underwent the endoscopic assisted open reduction and internal fixation through the transoral approach at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital. The endoscope was inserted through an intraoral incision and the reduction of fracture fragment was performed via a transbuccal approach with two transcutaneous stab incisions. Five patients showed anatomic reduction without any complications. One patient, whose fracture site was fixed with a single plate, showed displacement of fractured condylar segment during the follow up period. No patient had any facial nerve damage.

Endoscopic Removal of Traumatic Intracerebral Hematoma via Superolateral Keyhole (외상성 뇌실질내 혈종에 대한 상측방 키홀을 통한 내시경적 혈종 제거)

  • Park, Sung-Jin;Ha, Ho-Gyun;Jung, Ho;Lee, Sang-Keol;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.249-254
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    • 2000
  • Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.

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