• Title/Summary/Keyword: Clinical complication

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Intussusception after Colonoscopy: A Case Report and Review of Literature

  • Hassan, Wan Amir Wan;Teoh, William
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.591-595
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    • 2018
  • Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

Lumbar Interbody Fusion Outcomes in Degenerative Lumbar Disease : Comparison of Results between Patients Over and Under 65 Years of Age

  • Jo, Dae-Jean;Jun, Jae-Kyun;Kim, Ki-Tack;Kim, Sung-Min
    • Journal of Korean Neurosurgical Society
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    • v.48 no.5
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    • pp.412-418
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    • 2010
  • Objective : To evaluate the clinical and radiological outcomes of lumbar interbody fusion and its correlation with various factors (e.g., age, comorbidities, fusion level, bone quality) in patients over and under 65 years of age who underwent lumbar fusion surgery for degenerative lumbar disease. Methods : One-hundred-thirty-three patients with lumbar degenerative disease underwent lumbar fusion surgery between June 2006 and June 2007 and were followed for more than one year. Forty-eight (361%) were older than 65 years of age (group A) and 85 (63.9%) were under 65 years of age (group B). Diagnosis, comorbidities, length of hospital stay, and perioperative complications were recorded. The analysis of clinical outcomes was based on the visual analogue scale (VAS). Radiological results were evaluated using plain radiographs. Clinical outcomes, radiological outcomes, length of hospital stay, and complication rates were analyzed in relation to lumbar fusion level, the number of comorbidities, bone mineral density (BMD), and age. Results : The mean age of the patients was 61.2 years (range, 33-86 years) and the mean BMD was -2.2 (range, -4.8 to -2.8). The mean length of hospital stay was 15.0 days (range, 5-60 days) and the mean follow-up was 23.0 months (range, 18-30 months). Eighty-five (64.0%) patients had more than one preoperative comorbidities. Perioperative complications occurred in 27 of 133 patients (20.3%). The incidence of overall complication was 22.9% in group A, and 18.8% in group B but there was no statistical difference between the two groups. The mean VAS scores for the back and leg were significantly decreased in both groups (p < 0.05), and bony fusion was achieved in 125 of 133 patients (94.0%). There was no significant difference in bony union rates between groups A and B (91.7% in group A vs. 95.3% in group B, p = 0.398). In group A. perioperative complications were more common with the increase in fusion level (p = 0.027). Perioperative complications in both groups A (p = 0.035) and B (p = 0.044) increased with an increasing number of comorbidities. Conclusion : Elderly patients with comorbidities are at a high risk for complications and adverse outcomes after lumbar spine surgery. In our study, clinical outcomes, fusion rates, and perioperative complication rates in older patients were comparable with those in younger populations. The number of comorbidities and the extent of fusion level were significant factors in predicting the occurrence of postoperative complications. However, proper perioperative general supportive care with a thorough fusion strategy during the operation could improve the overall postoperative outcomes in lumbar fusion surgery for elderly patients.

The Clinical Analysis of Cardiac Valve Surgery (심장판막증의 외과적 치료)

  • Min, Yong-Il;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.20 no.3
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    • pp.557-564
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    • 1987
  • From September 1980 to July 1986, 135 cases of cardiac valve surgery were performed under the cardiopulmonary bypass. Out of 135 cases, single valve surgery was 114 cases including open mitral commissurotomy 17, mitral annuloplasty 2, mitral valve replacement 85, and aortic valve replacement 10 and double valve surgery was 21 cases. There were 68 males and 67 females ranging from 9 to 57 years of age. Early death within 30 days after operation was 17 cases [12.6%] and caused of death were ventricular arrhythmia 5, low cardiac output syndrome 4, excessive bleeding 3, pulmonary complication 2, and so on. Among 118 early survivors, 5 cases [5.1%] of late death were developed over a period of 2 to 72 months, and main cause of death was fatal bleeding complication associated with anticoagulation therapy. Symptomatically, 91.8% of patients were in NYHA functional class I or II at the end of the follow-up.

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22 Bochdaleck*s Hernia in Infant - A Clinical Review - (영아 Bochdalek 탈장의 임상적 고찰)

  • Lee, Seong-Cheol;Seong, Suk-Hwan
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.825-828
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    • 1987
  • Authors carried out a retrospective study in 22 infants with Bochdaleck`s hernia who were operated upon, the results are; 1] the male to female ratio was 2:1 and the incidence of left side was threefold prevalent than right, 2] the chief complaint of those who were operated upon in neonatal period was dyspnea and diagnosis was possible by chest A-P, 3] primary repair was possible except one patient in whom a prosthesis was used. 4] complication occurred in 41% and pulmonary complication was most common including 5 pneumothorax, 5] mortality rate was 14%, the deaths occurred in infants who were operated upon within 48 hours of life and the lesion was left without sac, the defect was larger than average and all died within 72 hours after operation.

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Complications of Tracheal and Bronchial Foreign Bodies (기관 및 기관지이물의 합병증)

  • 강일태;신기철;김종선;김홍기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1982.05a
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    • pp.8.3-8
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    • 1982
  • A clinical analysis of complications was done in 72 cases of tracheal & bronchial foreign bodies who had been treated in this department in the past 5 years (1977-1981). Complications were developed in 58 cases (80.6%). A total number of complications was 93 from 58 patients with average complication rate of 1.6 per case. There were emphysema in 22 cases, atelectasis in 5 cases, pneumonia in one case and combined complication in 24 cases. We had four fatal cases in our series. It is our intent to present the result of this analysis with literature review and to stress the importance of early detection & early managent.

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A Case of Cerebral Infarction Complicated by Mycoplasma pneumoniae Pneumonia (Mycoplasma pneumoniae 폐렴에 합병된 뇌경색 1례)

  • Cheon, Kyoung Whoon;Kang, Won Sik;Son, Byeong Hee;Kim, Sung Won
    • Clinical and Experimental Pediatrics
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    • v.45 no.5
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    • pp.673-678
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    • 2002
  • Mycoplasma pneumoniae is the most common pathogen of the respiratory tract among schoolaged children and young adults. The incidence of CNS complication is reported as 0.1-7% of Mycoplasma pneumoniae infections. We experienced a case of cerebral infarction complicated by Mycoplasma pneumoniae, and reviewed the literature about the CNS complication of Mycoplasma pneumoniae infection.

Bisphosphonate related osteonecrosis of the jaws: report of two cases

  • Han, Jin-Woo
    • Imaging Science in Dentistry
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    • v.41 no.3
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    • pp.129-134
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    • 2011
  • Bisphosphonates are compounds used to treat osteoporosis and malignant bone metastasis. Despite the benefits related to the use of these medications, osteonecrosis of the jaws is a significant complication in a subset of patients receiving these drugs. This complication occurs either spontaneously or after a simple dento-alveolar surgery. Recently there were two patients who showed the features of bisphosphonate related osteonecrosis of the jaws (BRONJ) in Gangneung-Wonju National University Dental Hospital. The patients revealed the clinical and radiological features of classical osteomyelitis. This report presents two cases of BRONJ which were examined by plain radiography and computed tomography.

Clinical Analysis of the Laryngo-Tracheal Stenosis (후두 및 기관협착증의 임상적 고찰)

  • 김영호;최은창;최재영;홍원표
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.261-269
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    • 1997
  • When performing an endotracheal intubation or tracheotomy to an unconscious patient in emergent situations, one should consider the possibility of later complication of laryngo-tracheal stenosis which can result in difficulties in decannulation. Laryngo-tracheal stenosis is a bothersome problem developing as a complication of treatment by tracheotomy with a cuffed tube and long-term endotracheal intubation with assisted ventilation. One hundred twenty-three cases of laryngo-tracheal stenosis patients during the four yew period from May 1992 to April 1996 were restrospectively reviewed according to several parameters such as the duration of intubation, site of stenosis, treatment modality and, site of tracheostoma. The present report is an analysis of these materials to search for the possible etiologic factors and its proper preventive methods. It was desirable that the endotracheal intubation should be limited within 20 days at most. Tracheotomy performed by non-otolaryngologists has a tendency to be on a higher level of trachea. Technical precautions should be taken into consideration when doing a tracheotomy. The success rate of decannulation of tracheal T-tube was 78.8% and it required average 11 months.

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The clinical Experience of Tracheal Stenosis (기관협착의 임상적 고찰)

  • 명창률
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.136-139
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    • 1994
  • Tracheal stenosis is relatively common complication after tracheal intubation or tracheostomy for a long time. We experienced 10 cases of tracheal stenosis with various causes, prolonged intubation or tracheostomy caused the tracheal stenosis in seven, one after advanced cancer of the lung, one after inhalation burn, and the other was palliative management for tracheal stenosis by Gianturco type tracheal stent. We tried to correct this stenosis applying three tracheal stent and one Montgomery T-tube as a palliative approach, but failed in two, one restenosis due to regrowing of granulation tissue with scarring or another metastatic spread of cancer to systemic organs after 3 months of placing the stent. Tracheal circumferential resection and end to end anastomosis were done in seven, and obtained one postoperative complication as subglottic stenosis was followed by Montgomery T-tube and reoperation later. With the brief review of references, we report the cases.

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A Hybrid Intervention for Post-infarction Papillary Muscle Rupture with Severe Mitral Regurgitation: A Case Report

  • Nakamae, Kosuke;Oshitomi, Takashi;Uesugi, Hideyuki
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.239-242
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    • 2022
  • Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.