• Title/Summary/Keyword: Incarcerated

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New Surgical Approach for Gastric Bezoar: "Hybrid Access Surgery" Combined Intragastric and Single Port Surgery

  • Son, Tae-Il;Inaba, Kazuki;Woo, Yang-Hee;Pak, Kyung-Ho;Hyung, Woo-Jin;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.230-233
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    • 2011
  • Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus.

Arthroscopic Reduction of Irreducible Knee Dislocation - A Case Report - (정복 불가능한 슬관절 탈구의 관절경적 치료)

  • Jeong, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.161-164
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    • 2009
  • Irreducible knee dislocation is a rare injury and often need an open procedure with ligaments reconstruction. This report describes a case of arthroscopic treatment of a patient with traumatic knee dislocation unable to reduce in a closed method. MRI revealed incarceration of the medial collateral ligament and capsule in the medial compartment. And arthroscopic examination confirmed incarcerated medial capsuloligamentous structures which prevented the knee from reduction. Arthroscopic procedure without ligaments reconstruction was complete when the medial condyle was well visualized and the knee reduced. After 4 weeks of immobilization in extension, range of motion exercise and gradual increases in weight bearing was allowed. At the 3- year follow-up, mild laxity was remained but the patient did not have any discomfort of doing ADL activity and showed full range of motion of the knee.

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Acute Pancreatitis after Additional Trauma in Chronic Traumatic Pancreatic Diaphragmatic Hernia

  • Mun, You Ho;Park, Sin Youl
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.66-70
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    • 2019
  • Traumatic diaphragmatic injuries (TDIs) are a rare complication in thoraco-abdominal trauma. The diagnosis is difficult and if left untreated, TDI can cause traumatic diaphragmatic hernia (TDH). Through an injured diaphragm, the liver, spleen, stomach, small intestine, and large intestine can be herniated to the thoracic cavity, but pancreatic herniation and pancreatitis are quite rare in TDH. This paper reports a case of pancreatitis developed by additional trauma in a patient with asymptomatic chronic TDH. A 58-year-old male visited the emergency department with a left abdominal injury after a fall 6 hours earlier. The vital signs were stable, but the amylase and lipase levels were elevated to 558 U/L and 1,664 U/L, respectively. Abdominal computed tomography (CT) revealed a left diaphragmatic hernia and an incarceration of the stomach, pancreatic ductal dilatation, and peripancreatic fatty infiltration. Additional history taking showed that he had suffered a fall approximately 20 years ago and had an accidentally diaphragmatic hernia through a chest CT 6 months earlier. A comparison with the previous CT revealed the pancreatitis to be caused by secondary pancreatic ductal obstruction due to the incarcerated stomach. For pancreatitis, gastrointestinal decompression was performed, and after 3 days, the pancreatic enzyme was normalized; hence, a thoracotomy was performed. A small ruptured diaphragm was found and reposition of the organs was performed. This paper reports the experience of successfully treating pancreatitis and pancreatic hernia developed after trauma without complications through a thoracotomy following gastrointestinal decompression.

The "Logos" Bible Study: An Experience of Building a Model of Effective Religious Education in the 21st Century ("로고스" 성경 연구: 21세기 효과적인 종교교육 모형의 구축)

  • Atkins, Charles Jr.
    • Journal of Christian Education in Korea
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    • v.65
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    • pp.215-241
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    • 2021
  • New models for prison ministry are crucial during the current era of mass incarceration in America-a time when the potential reach of prison ministries can grow as the population of incarcerated individuals grows. In this article, I lift up one prison ministry in New Jersey as an example of how Christian evangelicals who are engaged in traditional prison ministry can bravely open their minds and hearts to models of religious education that go beyond individual conversion toward communal transformation. In this article I present an example of a neo-evangelical group named Jericho Ministries, Inc., a prison ministry that understood this and consequently tried to develop a prison ministry that was not only a charitable endeavor, but also a just one.

Pleural Incarceration of the Transverse Colon after Transthoracic Esophagectomy - A case report - (개흉적 식도절제술 후 횡행결장의 흉강 내 탈장 - 1예 보고 -)

  • Jang, Hee-Jin;Lee, Hyun-Sung;Zo, Jae Ill
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.115-118
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    • 2009
  • A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

Isolated Anterior Dislocation of the Radial Head in Adult - A Case Report - (성인에서 발생된 요골 두 급성 전방 탈구 - 증례 보고 -)

  • Heo, Youn-Moo;Kim, Woo-Sik;Kim, Sung-Hun;Jeon, Teak-Soo;Kim, Sang-Bum;Oh, Byung-Hak
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.131-135
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    • 2007
  • We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

Correction of Persistent Enophthalmos after Surgical Repair of Blow Out Fracture Using Orbital Decompression Technique of Contralateral Eye (안와골파열골절 정복술 후 지속되는 안구함몰 환자에서 정상측 안구의 안구 감압술의 치험례)

  • Lee, Jun-Ho;Park, Won-Yong;Nam, Hyun-Jae;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.101-104
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    • 2008
  • Purpose: Diplopia and cosmetically unacceptable enophthalmos are the major complications of blow out fracture. Prolapse of orbital tissue into the sinuses, enlarged orbital volume, atrophy of orbital fat and loss of support of orbital walls play a role in the pathogenesis of enophthalmos. To correct post-traumatic enophthalmos, freeing of incarcerated orbital contents combined with reduction of bony orbital volume and reconstruction of suspensory support of globe is necessary. But remained enophthalmos after surgical treatment is difficult to correct completely. In this case, the authors performed implant insertion for affected orbit and endoscopic orbital decompression for unaffected orbit for correction of late enophthalmos. Method: We reviewed a girl patient with right inferomedial orbital wall blow out fracture, right zygoma fracture treated at our hospital for correction of enophthalmos. An 18-year-old female had sustained posttraumatic enopthalmos. Two surgical management was performed for correction blow out fracture at the other hospital. But residual diplopia, enophthalmos, cheek drooping were found. And then she transferred to our hospital. She had severe enophthalmos(5 mm) also had diplopia and extraocular muscle limitation. We performed operation for correction of enophthalmos. After operation, she showed minimal improvement of diplopia and enophthalmos(3 mm). The authors make plan for operation for correction enophthalmos due to cosmetical improvement. Implant insertion was performed for affected orbit. For unaffected orbit, nasoendoscopic medial orbital wall decompression was proceeded. Result: Correction of enophthalmos was found after operation and was maintained for nine years follow-up. Patient expressed satisfaction for the result. Conclusion: To correct persistant enophthalmos, we could have satisfactory result with orbital wall reconstruction on affected eye and decompression on unaffected eye.

Small Intestine Resection and Anastomosis for Epiploic Foramen Entrapment of a Horse (말의 그물막구멍포착 교정을 위한 소장 절제 및 문합 1례)

  • Hwang, Hye-shin;Park, Chull-gyu;Hwang, Jun-seok;Chun, Yong-woo;Han, Janet H.;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.374-379
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    • 2015
  • A 10-year-old gelding Warmblood weighing 560 kg was referred to J&C Equine Hospital with the history of hyperpnea, depression, pawing, and rolling for 7 hours. According to the results of clinical and ultrasound examination, it was considered that intestines were distended with thickened wall. The horse had been treated with lactated Ringers' solution (14 L, IV), flunixin meglumine (1.1 mg/kg, IV), and mineral oil (1 L, PO), but he did not show any responses to those treatments. Exploratory laparotomy was performed and identified incarcerated small intestine through the epiploic foramen. The horse received resection and anastomosis of the entrapped small intestine. After surgery, the horse was treated with intensive postoperative care of fluid therapy (5 L with 20 mEq/L KCl, every 2 hours), flunixin meglumine (1.1 mg/kg, IV, sid), antibiotics (penicillin 22,000 IU/kg, IV, qid and gentamicin 6.6 mg/kg, IV, sid), lidocaine constant rate infusion (bolus 1.3 mg/kg over 15 minutes then 0.05 mg/kg/minute), common nutritional supplements, nasogastric intubation every 2 hours and trunk bandage. Postoperative feeding program had started with small amount of hay every 4 hours and gradually increased to normal amount till 5 days. At 77 days after surgery, he showed sudden outbreak of colic and was euthanized. The causes of colic were small intestinal strangulation by passing through the mesenteric rents and postoperative adhesion between small intestines. According to the results, it is recommended to perform perioperative intensive care of horse with colic and to use several methods to prevent adhesions during abdominal surgery of horses.

Prognostic Factors of Orbital Fractures with Muscle Incarceration

  • Lee, Seung Chan;Park, Seung-Ha;Han, Seung-Kyu;Yoon, Eul-Sik;Dhong, Eun-Sang;Jung, Sung-Ho;You, Hi-Jin;Kim, Deok-Woo
    • Archives of Plastic Surgery
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    • v.44 no.5
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    • pp.407-412
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    • 2017
  • Background Among the various signs and symptoms of orbital fractures, certain clinical findings warrant immediate surgical exploration, including gaze restriction, computed tomographic (CT) evidence of entrapment, and prolonged oculocardiac reflex. Despite proper surgical reconstruction, prolonged complications such as diplopia and gaze restriction can occur. This article evaluated the prognostic factors associated with prolonged complications of orbital fractures with muscle incarceration. Methods The medical records of 37 patients (37 orbits) with an orbital fracture with muscle incarceration from January 2001 to January 2015 were reviewed. The presence of Incarcerated muscle was confirmed via CT, as well as by intraoperative findings. Various factors potentially contributing to complications lasting for over 1 year after the injury were categorized and analyzed, including age, cause of injury, injury-to-operation time, operative time, fracture type, nausea, vomiting and other concomitant symptoms and injuries. Results All patients who presented with extraocular muscle limitations, positive CT findings, and/or a positive forced duction test underwent surgery. Of the 37 patients, 9 (24%) exhibited lasting complications, such as diplopia and gaze restriction. The mean follow-up period was 18.4 months (range, 1-108 months), while that of patients who experienced prolonged complications was 30.1 months (range, 13-36 months). Two factors were significantly associated with prolonged complications: injury-to-operation time and nausea/vomiting. Loss of vision, worsening of motility, and implant complication did not occur. Conclusions Patients who present with gaze limitations, with or without other signs of a blow-out fracture, require a thorough evaluation and emergent surgery. A better prognosis is expected with a shorter injury-to-operation time and lack of nausea and vomiting at the initial presentation.