• Title/Summary/Keyword: iatrogenic injury

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Esophageal Fistula Related to Anterior Cervical Spine Surgery after Severe Cervical Trauma (심한 경추부 외상후에 전방 경추부 수술후 발생한 식도의 누공)

  • Paeng, Sung Hwa
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.278-282
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    • 2012
  • An esophageal perforation following anterior cervical fusion is rare. Early development of an esophageal perforation after anterior cervical fusion is usually due to iatrogenic injury from retraction, injury associated with the original traumatic incident, improperly placed instruments or a bone graft. A 31-year-old man had a cervical dislocation and spinal cord injury because of severe cervical trauma after a traffic accident. He was quadriplegic and had no feeling below T4 dermatome. Anterior decompression of the cervical spine and anterior fusion with mesh with autobone were performed. An esophagocutaneous fistula occurred 7 days after anterior cervical surgery. A second anterior surgery was done because of pus drainage. The mesh was changed with an iliac bone graft, and the esophagocutaneous fistula site was primary repaired, but pus continued to drain. Conservative treatment, which consisted of wound drainage and intravenous administration of antibiotics, was tried, but was unsuccessful. After all, we removed the plate and screws, but did not removed the iliac bone graft, We closed the esophageal fistula, and transposed the sternocleidomastoid muscle flap to the interspace between the esophagus and the cervical spine. The wound to the esophagus was well repaired. In conclusion, precautionary measures are needed to avoid the complication, and adequate treatment is necessary to resolve those complications when they occur.

Delayed surgical repair of the deltoid following acromioplasty: a case report

  • Zohaib Sherwani;Chase Kelley;Hassan Farooq;Nickolas G. Garbis
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.334-338
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    • 2022
  • Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

Fenestrated popliteal vein pierced by a branch of the tibial nerve

  • Edward C. Muo;Joe Iwanaga;Juan J. Cardona;Lukasz Olewnik;Aaron S. Dumont;R. Shane Tubbs
    • Anatomy and Cell Biology
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    • v.56 no.4
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    • pp.566-569
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    • 2023
  • Knowledge of anatomical variations is important so as to avoid potential iatrogenic injury or misdiagnosis on imaging. Here we report an unusual finding and relationship between the tibial nerve and popliteal vein. During the routine dissection of an adult cadaver, it was noted that a branch of the tibial nerve in the popliteal fossa pierced the most distal part of the popliteal vein. This unusual finding is described and relevant reports in the literature discussed. Our hopes are that such a report might help surgeons avoid injury to such a fenestrated popliteal vein and the tibial nerve branch traveling through it therefore decreasing patient morbidity.

Surgical Treatment of a True Radial Artery Aneurysm in the Palm, and This Was Caused by Handclapping and Repetitive - A case report - (박수 및 반복되는 직업적 가위질로 인하여 손바닥에 발생한 요골 동맥 진성 동맥류의 수술적 치험 - 1예 보고 -)

  • Lee, Woo-Surng;Kim, Yo-Han;Chee, Hyun-Keun;Hwang, Jae-Joon;Kim, Jun-Seok;Lee, Song-Am
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.384-387
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    • 2009
  • Radial artery aneurysm is an extremely rare disease and this is usually caused by iatrogenic trauma such as arterial cannulation. Most traumatic aneurysms in the extremities are false aneurysms and most cases have occurred at the level of the wrist. Very few true aneurysms of the radial artery have been reported, with most of them being iatrogenic. A right handed 38-year-old female had a true aneurysm of the distal radial artery in the thenar groove of the palm. The patient had a history of excessive handclapping and the injury was suggestive of repetitive occupational injury due to scissoring. She underwent surgical treatment for the aneurysm of the radial artery in the thenar groove of the palm of her hand.

Preemptive pyloroplasty for iatrogenic vagus nerve injury in intrahepatic cholangiocarcinoma patients undergoing extensive left-sided lymph node dissection: a retrospective observational study

  • Hwang, Shin;Jung, Dong-Hwan;Jwa, Eun-Kyoung;Kim, Yumi
    • Journal of Yeungnam Medical Science
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    • v.39 no.3
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    • pp.235-243
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    • 2022
  • Background: Intrahepatic cholangiocarcinoma (ICC) of the left liver often shows left-sided lymph node (LN) metastasis. If gastric lesser curvature is extensively dissected, it can induce an iatrogenic injury to the extragastric vagus nerve branches that control motility of the pyloric sphincter and lead to gastric stasis. To cope with such LN dissection-associated gastric stasis, we performed pyloroplasty preemptively. The objective of this study was to analyze our 20-year experience of preemptive pyloroplasty performed in 10 patients. Methods: We investigated clinical sequences of 10 patients with ICC who underwent preemptive pyloroplasty following left hepatectomy and extended left-sided LN dissection. Incidence of gastric stasis and oncological survival outcomes were analyzed. Results: All 10 patients were classified as stage IIIB due to T1-3N1M0 stage according to the 8th edition of American Joint Committee on Cancer staging system. The overall patient survival rate was 51.9% at 1 year, 25.9% at 2 years, and 0% at 3 years. Seven patients showed uneventful postoperative recovery after surgery. Two patients suffered from gastric stasis, which was successfully managed with supportive care. One patient suffered from overt gastric paresis, which was successfully managed with azithromycin administration for 1 month. Conclusion: We believe that preemptive pyloroplasty is an effective surgical option to prevent gastric stasis in patients undergoing extensive left-sided LN dissection. Azithromycin appears to be a potent prokinetic agent in gastroparesis.

Liver Abscess Caused by Klebsiella oxytoca with Hepatic Artery Pseudoaneurysm: A Case Report (Klebsiella oxytoca에 의한 간농양 내 거짓동맥류: 증례 보고)

  • Jae Young Lee;Hyoung Nam Lee;Woong Hee Lee;Hyeong Cheol Shin;Seung Soo Kim;Jeong Ah Hwang
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1448-1452
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    • 2020
  • Hepatic artery pseudoaneurysm is a rare but potentially life-threatening condition that usually occurs after trauma. Early recognition and prompt management are essential for preventing catastrophic consequences, such as hemoperitoneum. We report a rare case of liver abscess caused by Klebsiella oxytoca resulting in hepatic artery pseudoaneurysm without iatrogenic injury. The unique feature of the present case is that the abscess cavity itself became a pseudoaneurysm as a result of fistula formation with the hepatic artery. Vascular complications should be considered in patients with unfavorable clinical course even in the absence of iatrogenic injury. Endovascular treatment is safe and effective.

Iatrogenic Injuries to the Urinary Tract after Abdominal Surgery: 6 cases (복강 수술 후의 의인성 요로계 손상: 6례)

  • Byeon Ye-Eun;Lim Ji-Hey;Lee Sun-Tae;Chae Ho-Cheol;Jung Joo-Hyun;Choi Min-Cheol;Yoon Jung-Hee;Kweon Oh-Kyeong;Kim Wan-Hee
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.211-217
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    • 2006
  • Six patients (5 dogs, 1 cat) were referred with the complications of urinary tract injuries. Clinical signs were vomiting (4/6), oliguria (2/6) and anuria (3/6). Four females had been spayed, 1 male had cryptorchid orchiectomy and 1 male had been operated for removing calculi in the urethra. Both preoperative and intraoperative investigation were performed and they were confirmed as iatrogenic injuries in the urinary tract during surgery. Depending on the condition of the complications, urethral anastomosis, unilateral nephrectomy, ureteroneocystostomy, colonic urinary diversion, ureterourethral anastomosis, cystostomy and suture of the defect region were performed separately in individual cases. Postoperative observation revealed 50% (3 cases) survival rate of the patients.

Percutaneous Transhepatic Removal of Migrated Biliary Stent from a Chronic Biloma Cavity (만성 담즙종 공동 내로 이동한 담도 스텐트의 경피경간적 제거)

  • Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.442-447
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    • 2020
  • Iatrogenic foreign bodies are a challenging complication to both the interventional radiologist and patient, resulting in impaired quality of life and substantial financial cost. The case report describes a successful percutaneous transhepatic removal of an intra-abdominal foreign body. A 72-year-old man underwent surgery for placement of a retrievable covered stent for refractory bile leakage after left hemihepatectomy. Three days after placement, stent folding and migration into a chronic biloma cavity occurred via the bile leakage site. By using a balloon catheter technique, the folded stent could be straightened and repositioned into the bile duct to minimize stent-strut injury during retrieval. The interventional approach could be a valid treatment option for intra-abdominal foreign bodies, as well as intravascular foreign bodies. A thorough understanding of devices and techniques can provide the interventional radiologist with valuable information regarding procedural planning and the management of iatrogenic foreign bodies.

Urgent Endovascular Stent Graft Placement for Iatrogenic Subclavian Artery Rupture (의인성 쇄골하정맥 파열로 인한 응급 혈관내 스텐트 삽입)

  • Kang, Byung-Woo;BAE, Jun-ho;Chung, Jin-Wook;Jo, Byeong-Joo;Park, Jun-Gi;Nah, Deuk-Young
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.83-86
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    • 2015
  • Central venous cannulation is one of the most commonly performed procedures for critically ill patients in the emergency room. Serious complications like a rupture of subclavian artery may occur during this procedure. We report a case of successful stent graft deployment for iatrogenic ruptured subclavian artery after attempted right subclavian vein catheterization in a 31 year-old female patient with hypovolemic shock due to cervical os laceration during vaginal delivery.

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Clinical Study on Peripheral Facial Nerve Injury (외상성 안면마비 환자에 대한 임상적 고찰)

  • Kim, Min Jung;Song, Ji Yeon;Sung, Won Seok;Kim, Pil Kun;Ryu, Hee Kyoung;Park, Yeon Cheol;Seo, Byung Kwan;Woo, Hyun Su;Baek, Yong Hyeon;Park, Dong Suk
    • Journal of Acupuncture Research
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    • v.29 no.6
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    • pp.23-34
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    • 2012
  • Objectives : This study was performed to define clinical character of peripheral facial nerve injury. Methods : 36 patients was identified with peripheral facial nerve injury among 1128 patients who visited the Facial Palsy Center in Kyung Hee University Hospital at Gang-dong between January 2010 and November 2011. We reviewed the medical records including gender, age, cause, symptom, period of treatment, and axonal loss. Results : Most common cause of peripheral facial nerve injury was iatrogenic surgery, followed by direct trauma, neoplastic disorders. Patients with facial nerve injury commonly complain about facial palsy(ipsilateal or bilateral), followed by paresthesia, facial spasm, facial pain, auricular pain. Peripheral facial nerve injury group showed worse electrophysiological pattern and younger onset age compared with Bell's palsy group. Conclusion : This study was designed for 36 patients and further studies are necessary.