• Title/Summary/Keyword: Iatrogenic lesion

Search Result 23, Processing Time 0.031 seconds

Spinal Arteriovenous Fistula with Progressive Paraplegia after Spinal Anaesthesia

  • Baltsavias, Gerasimos;Argyrakis, Nikolaos;Matis, Georgios K.;Mpata-Tshibemba, Stephanie
    • Journal of Korean Neurosurgical Society
    • /
    • v.55 no.2
    • /
    • pp.106-109
    • /
    • 2014
  • A case of an iatrogenic spinal arteriovenous fistula with progressive paraplegia in a young woman is reported. The fistula was eventually created after repetitive lumbar punctures performed in the process of spinal anaesthesia. Her symptoms were progressed to paraplegia over a period of 2 years. The digital subtraction angiography demonstrated a single-hole fistula, involving the anterior spinal artery and vein. The lesion was occluded by embolization with immediate improvement. The potential mechanism is discussed.

Traumatic Disc Injuries and the Iatrogenic Spinal Disability (외상성 추간판 손상과 의원성 척추장애인 만들기)

  • Lee, Kyeong-Seok;Doh, Jae-Won;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.7
    • /
    • pp.935-939
    • /
    • 2000
  • Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

  • PDF

Periodontal healing following non-surgical repair of an old perforation with pocket formation and oral communication

  • Asgary, Saeed;Verma, Prashant;Nosrat, Ali
    • Restorative Dentistry and Endodontics
    • /
    • v.43 no.2
    • /
    • pp.17.1-17.7
    • /
    • 2018
  • Iatrogenic perforations negatively impact the outcome of endodontic treatments. Studies on prognostic factors showed that perforations in the coronal third of the root with periodontal pocket formation have an unfavorable prognosis. A 36-year-old female was referred for endodontic evaluation of tooth #13 with a history of an iatrogenic perforation, happened 3 years ago. There was a sinus tract associated with perforation, 10 mm probing on the mesial and mesio-palatal, bleeding on probing, radiolucent lesion adjacent to the perforation and complete resorption of the interdental bone between teeth #13 and #12. After the treatment options were discussed, she chose to save the tooth. The tooth was accessed under rubber dam isolation, the perforation site was cleaned and disinfected using 0.5% sodium hypochlorite and sealed with calcium-enriched mixture cement. Eighteen months after treatment the tooth was functional and asymptomatic. The probing depths were normal without bleeding on probing. Radiographically, the interdental crestal bone formed between teeth #13 and #12. Despite all negative prognostic factors in this case (i.e., perforations in the coronal third, pocket formation, and radiolucent lesion), healing was unexpectedly achieved via non-surgical repair of the perforation. Further research on biological aspects of healing in the periodontium following iatrogenic perforations are recommended.

Surgical Treatment of Tracheal Stenosis -Report of 3 Cases- (기관협착증 치험 3례)

  • Park, Cheol-Ho;U, Jong-Su;Jo, Gwang-Hyeon
    • Journal of Chest Surgery
    • /
    • v.21 no.2
    • /
    • pp.395-402
    • /
    • 1988
  • Increasing success in the management of patients with severe respiratory failure by mechanical respirators has produced iatrogenic tracheal stenosis. And the surgical management of these lesions have provided a major field for tracheal reconstructive surgery. Recently we have experienced three cases of postintubation tracheal stenosis between December, 1985 and October, 1987 and successfully performed circumferential resection and end to end anastomosis of the trachea. The lesion of the first case which was located in the subcricoid level was resected about 2cm length with cervical incision. And the lesion of the second case located at the cuff site was also resected about 2.5cm length with cervical and median sternotomy incision. Also the lesion of the third case located at the stoma site was resected about 1.8cm length with cervical incision. The postoperative courses were uneventful but there was extubation difficulty in the third case because of stupor mentality and problem of secretion excretion. So we have observed the postoperative course after T-tube insertion.

  • PDF

Management of Vocal Cord Palsy during Thyroid Surgery (갑상선 수술 시의 성대마비의 처치)

  • Choi Hong-Shik;Kim Se-Heon;Park Kuk-Jin;Kim Kwang-Moon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.14 no.1
    • /
    • pp.27-34
    • /
    • 1998
  • Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

  • PDF

Advantages of Scorpion Suture Passer and 70 Degrees Arthroscope in Arthroscopic Bankart Repair: Usefulness for Inferior Labral Repair

  • Hyun, Yoon-Suk;Shin, Woo-Jin
    • Clinics in Shoulder and Elbow
    • /
    • v.20 no.4
    • /
    • pp.201-207
    • /
    • 2017
  • Background: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a $70^{\circ}$ arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. Methods: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a $30^{\circ}$ arthroscope in the conventional group, but two portals and a $70^{\circ}$ arthroscope as well as the $30^{\circ}$ one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. Results: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the $70^{\circ}$ arthroscope. Conclusions: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a $70^{\circ}$ arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.

A Case of Paranasal Sinus Papilloma with Increased FDG Uptake (부비동 유두종에서의 FDG 섭취 증가를 보인 예)

  • An, Young-Sil;Park, Yong-Koo;Kim, Deog-Yoon
    • Nuclear Medicine and Molecular Imaging
    • /
    • v.42 no.5
    • /
    • pp.419-421
    • /
    • 2008
  • The false-positive FDG uptakes on head and neck areas are common due to benign lesion, iatrogenic and physiologic changes. The Schneiderian papilloma is uncommon benign tumor arising from the mucosa of the paranasal sinuses and nasal cavity. The findings of paranasal papilloma on conventional modality such as CT and MRI are non-specific and they could be confused with inflammatory polyp or retention cyst. Despite of benign tumor, the papilloma usually shows locally aggressive growth with malignant potential, therefore the FDG can be actively accumulated in this lesion. We describe the case of 18F-FDG PET/CT finding in a 77-year-old woman who demonstrates oncocytic papilloma in maxillary sinus.

A rare case report of neonatal calcinosis cutis induced by distant and delayed extravasation of intravenous calcium gluconate

  • Ahn, Kwang Hyeon;Park, Eun Soo
    • Archives of Plastic Surgery
    • /
    • v.48 no.6
    • /
    • pp.641-645
    • /
    • 2021
  • A 3,480 g male neonate showed tachypnea symptom with a serum ionized calcium level of 0.66 mmol/L by routine clinical analysis. He was injected calcium gluconate intravenously through femoral vein catheter to treat the hypocalcemia. On second day after the injection, he started to show erythema in the flank area. The lesion became firm and changed into whitish crust consist of small crystals. Abdominal X-ray and ultrasonography showed the accumulation of calcium deposit in the subcutaneous layer of the lesion. Surgical debridement was performed to remove the crust with calcium deposit and acellular fish skin graft rich in omega-3 (Kerecis) was applied to the defect site for secondary intention of the defect wound. After 2 months, the skin and soft tissue defect were fully covered with healthy normal skin without depression or contracture. This report is a first case of iatrogenic calcinosis cutis without extravasation symptom.

Irreducible Elbow Dislocation Associated with Hill-Sachs-like Lesion over the Capitellum

  • Weng, Hung-Kai;Chang, Wei-Lun;Yeh, Ming-Long;Su, Wei-Ren;Hsu, Kai-Lan
    • Clinics in Shoulder and Elbow
    • /
    • v.22 no.1
    • /
    • pp.37-39
    • /
    • 2019
  • Irreducible dislocation of the elbow is an uncommon event. We present the case of a posterolateral elbow dislocation after a fall injury in a 67-year-old woman. A closed reduction performed in the emergency department was unsuccessful since the limited passive range of motion resulted in difficulty to perform longitudinal traction and flexion. Computed tomography images showed that the posterolateral aspect of the capitellum was impacted by the tip of the coronoid process, thus appearing similar to the Hill-Sachs lesion in the humeral head. Subsequent open reduction of the elbow revealed the dislocation to be irreducible since the tip of the coronoid process had wedged into a triangular Hill-Sachs-like lesion in the capitellum. The joint was reduced by providing distal traction on the forearm, and main fragments were disengaged using digital pressure. At the 3-month follow-up, the patient reported no dislocations, and had an acceptable range of motion. Thus, we propose that to avoid iatrogenic injury to the joint or other nearby structures, irreducible dislocations should not be subjected to repeated manipulation.

Iatrogenic epidermoid cyst in the parotid gland: A case report (이하선에서 발견된 유표피낭: 증례 보고)

  • Lee, Choong-Sang;Kim, Hyoung-Keun;Lim, Jae-Hyung;Jeon, Kug-Jin;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.37 no.3
    • /
    • pp.237-240
    • /
    • 2011
  • Epidermoid cysts presents as a nodular and fluctuant subcutaneous lesion beneath the skin and are most common in acne-prone areas of the head, neck and back. This cyst often arises after localized inflammation of the hair follicle and occasionally after the implantation of epithelium following trauma and surgery including a biopsy procedure. It is often associated with Gardner syndrome, particularly before puberty. The lesion is normally treated by a surgical excision or enucleation, and recurrence is uncommon. A 27 year old woman complained of a swelling of the left parotid gland when she visited our clinic. A cystic lesion was found in the left parotid gland from the high signal intensity on the MR images. Ultrasonography showed that the cystic lesion was heterogeneous echogenic. Six months earlier, botulinum toxin was injected in her left masseter muscles six months earlier and progressive swelling of the left parotid area was noticed four months after treatment. The lesion was surgically removed. It was encapsulated by a thin wall and filled mainly with keratin. The final diagnosis was an epidermoid cyst.