• Title/Summary/Keyword: Chronic rupture

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Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage

  • An, Jee Young;Lee, Jae Sin;Kim, Dong Ryul;Jang, Jae Young;Jung, Hwa Young;Park, Jong Ho;Jin, Sue Sin
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.109-113
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    • 2018
  • A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

Cranial Tibial Wedge Osteotomy for Treatment of Concomitant Cranial Cruciate Ligament Rupture and Medial Patellar Luxation Using Patient-Specific Surgical Guide in an Immature Cat

  • Ho-Hyun Kwak;Su-Hwan Koh;Jun-Hyung Kim;Heung-Myong Woo
    • Journal of Veterinary Clinics
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    • v.41 no.4
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    • pp.228-233
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    • 2024
  • A 7-month-old, 5.2 kg spayed female Norwegian Forest cat was referred for chronic, non-weight-bearing lameness in the left pelvic limb that has been present since 3 months old and has not responded to medical conservative therapy. Based on orthopedic and radiographic examination, concomitant cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL) of the left hind limb were diagnosed. In this case, cranial tibial wedge osteotomy (CTWO) was adopted to overcome side effect of performing other osteotomy techniques such as impairing the growth plates in the proximal tibia. Additionally, patient-specific surgical guides were applied to improve surgical accuracy. The patient showed an improvement in weight-bearing scores and gait condition during follow-up periods without complications. In our case, CTWO combined with corrective surgery for MPL can be used to treat concomitant CCLR and MPL without damaged on the growth plates and shows good clinical outcomes in an immature cat. Furthermore, the use of a surgical guide facilitates surgical procedures that minimize surgical error and increase surgical precision. This case study suggests that CTWO assisted by patient-specific surgical guides may be a viable surgical option for treating an immature cat with concomitant CCLR and MPL.

Complete Rupture of the Origins of Rectus Femoris Occurred During Relay Race - A Case Report - (릴레이 경주 중에 발생한 대퇴직근 기시부의 완전 파열 - 증례보고 -)

  • Jeon, Seung-Ju;Jeon, Ho-Seung;Moon, Chan-Sam;Noh, Haeng-Kee;Ha, Seung-Joo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.151-155
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    • 2008
  • During sports activity, rectus femoris muscle can be commonly injured as the quadriceps contracts forcefully to extend the knee and flex the hip, and rectus femoris muscle has a high percentage of type II muscle fibers which enable it to produce rapid forceful activity and the muscle is the only biarticular muscle of the quadriceps. Avulsion fractures by the traction of rectus femoris from the anterior inferior iliac spine in children are often reported. Rarely, complete rupture of proximal musculotendinous junction of rectus femoris muscle in adult may occurs by chronic repetitive stimulation and may mimic soft tissue neoplasm in the case of no history of antecedent trauma. However, there has been no report of acute complete rupture of origins of the rectus femoris muscle during relay race till now. So, we report a case of acute complete rupture of origins of the rectus femoris muscle occurred during relay race in middle-aged man, diagnosed by magnetic resonance image and treated by surgical repair with review of current literature.

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Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서)

  • Chang, Sang-Bum
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

Surgical Outcome of Reconstruction of Neglected Chronic Achilles Tendon Ruptures (진구성 만성 아킬레스 건 파열의 수술적 치료의 결과)

  • Sung, Ki-Sun;Heo, Jae-Won
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.109-114
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    • 2010
  • Purpose: The purpose of this study was to report the surgical outcome of reconstruction of neglected chronic Achilles tendon ruptures with various methods including Achilles tendon allograft. Materials and Methods: Between October 2003 and November 2008, 8 consecutive neglected chronic Achilles tendon ruptures with the defect gap of more than 4 cm underwent surgical reconstruction including V-Y advancement, gastrocnemius fascial turn-down flap, flexor hallucis longus transfer and Achilles tendon allograft. There were 7 males and 1 female who were evaluated at more than 18 months after surgery. At the time of followup, all patients were assessed with regard to postoperative complications, their self-reported level of satisfaction, the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale, 10 repetitive single heel rise, single leg hopping test, and ankle range of motion. Results: The AOFAS score increased from average 71.4 (50-87) to 96.4 (86-100). All patients were able to perform 10-repetitive single heel raise and single leg hopping at the latest follow up. No patient experienced wound complications and deep infection. Six patients were rated as 'excellent' and the other two as 'good'. Conclusion: Neglected chronic Achilles tendon ruptures could be successfully treated with careful selection of the reconstruction method according to the amount of defect gap. With an extensive defect, Achilles tendon allograft can be a good option when the reconstruction is not feasible otherwise.

Tenodesis after Tendon Lengthening for Irreparable Tibialis Anterior Tendon Avulsion Injury: A Case Report (단순 건고정술이 불가능한 전경골건 견열 손상에 대한 건연장술 이후 건고정술: 증례 보고)

  • Su Whi, Chae;Jin Soo, Suh;Jun Young, Choi
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.4
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    • pp.183-186
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    • 2022
  • Anterior tibialis ruptures are a rare type of injury related to the foot and ankle. Specifically, chronic and non-traumatic ruptures are related to preexisting chronic tendinopathic conditions and anatomical factors. These ruptures may cause persistent pain and functional impairments if neglected. Chronic tibialis anterior ruptures are frequently diagnosed late because the symptoms are not distinct. In cases with chronic or non-traumatic tibialis anterior tendon ruptures, tendons often become irreparable. Hence, various surgical options have been introduced to address this issue. The current surgical treatment options are as follows: free sliding anterior tibialis graft, extensor hallucis longus tendon transfer, and reconstruction with an allograft tendon. To date, there have been few reports about the reconstruction technique using Z-plasty for irreparable tibialis anterior tendon ruptures. In this report, we present a rare case of the application of the tibialis anterior tendon reconstruction technique using Z-plasty and tenodesis for a middle-aged man with an irreparable avulsion injury rupture. We also present the management plan and prognostic outlook, as well as a subsequent review of the relevant literature.

Diaphragmatic Hernia and Eventration -A Report of 10 Cases- (횡격막탈장(橫隔膜脫臟) 및 횡격막이완증(橫隔膜弛緩症) -10례(例) 보고-)

  • Choi, S.S.;Lee, J.H.;Yoo, Y.S.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.328-335
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    • 1976
  • This case report included 4 cases of traumatic diaphragmatic hernias, 3 cases of non-traumatic diaphragmatic hernias, and 3 cases of eventration of the diaphragm. Among the traumatic hernias, one case was in immediate phase of traumatic diaphragmatic rupture by traffic accident, 2 cases were in intermediate phase with chronic respiratory or vague gastrointestinal symptoms after traffic accident, and the other was developed after an operation, decortication for a chronic empyema with severe pleural calcifications, damaging the diaphragm. Three cases of nontraumatic diaphragmatic hernia were presented, including 2 cases of probable Bochadlek's hernia (Parents refused operation) and a case of Morgagni's hernia with severe gastrointestinal symptoms. And three cases of eventration of the diaphragm with symptoms were also reported. Results of all treated cases were excellent.

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Spontaneous abdominal intramuscular hematoma in a non-dialysis chronic kidney disease patient under cilostazol therapy (투석하지 않는 만성신질환 환자에서 cilostazol 투여 중에 발생한 복벽의 자발성 근육내 혈종)

  • Kang, Seonghui;Yu, Hyung Min;Na, Ha Young;Ko, Young Kyung;Kwon, Se Woong;Lim, Chae Ho;Kim, Sun Woong;Jo, Young Il
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.139-143
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    • 2014
  • Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.

Spontaneous Hemomediastinum and Hemothorax Caused by a Ruptured Bronchial Artery Aneurysm

  • Seo, Yeon-Ho;Kwak, Jin-Young
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.314-317
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    • 2011
  • A bronchial artery aneurysm (BAA) is uncommon and usually associated with chronic inflammatory lung disease or a systemic vascular condition, which is rarely the etiology of mediastinal hemorrhage. A middle-aged person presented with spontaneous hemothorax and hemomediastinum. A diagnostic evaluation identified a bronchial artery aneurysm as the source. To prevent further rupture, we performed a bronchial artery embolization. In the absence of trauma or other causes for hemothorax and mediastinal hemorrhage, the possibility of a BAA should be considered. A bronchial artery aneurysm can be managed by interventional techniques as well as surgery.

Atypically Large Calcific Tendinitis of the Shoulder: A Case Report

  • Kim, Jin Wan;Moon, Kyu Pill;Kim, Kyung Taek;Hwang, Youn Soo;Park, Won Seok
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.241-244
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    • 2016
  • Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.