Search results for "Ostomy"

Re: End Cutaneous Ureterostomy for the Management of Severe Hydronephrosis

2007

Ethical issues: invasive ventilation in amyotrophic lateral sclerosis.

2012

The first man was a school headmaster. By his eye-gaze system he is able to order coins to enlarge his 10-year collection. His grandchildren extort presents from him in exchange for help. The second was a prefect and even now insists that the flowers in the garden represent the national flag. In spite of his gastrostomy, he still likes to sip his espresso from porcelain cups. The ventilation circuit 24/7 has not changed his custom to read the newspapers and listen to classical music in the living room. That girl is a young mum. She is fed by a tube, but she always makes her little child laugh with the dialectal phrases that she writes on the screen. The surgeon, every day in his electric wh…

Endoscopic Treatment of Intracranial Arachnoid Cysts: A Retrospective Analysis of a 25-Year Experience.

2020

Background Since the development of neuroendoscopy, pure endoscopic fenestration for intracranial arachnoid cysts (ACs) became more and more popular and is actually preferred by many neurosurgeons. Objective To explore their techniques and experiences with endoscopic treatment of intracranial ACs over a 25-yr period. Methods A total of 95 endoscopic procedures in 87 patients with 88 intracranial ACs performed at the authors' departments between February 1993 and October 2018 were retrospectively analyzed. Particular respect was given to surgical technique, complications, patients' outcome, and radiological benefit in relation to cyst location. Results Patients' ages ranged from 23 d to 81 y…

Confocal Laser Endomicroscopy and Chromoendoscopy - A New Option of Surveillance in Patients with Ureterosigmoidostomy or Rectosigmoid Pouch

2010

Purpose In patients with bladder exstrophy-epispadias-complex (BEEC) or in selected patients with bladder loss for other reasons, ureterosigmoidostomy (USIG) & rectosigmoid pouch (Mainz Pouch (MZP) II) has been used at our institution. This diversion carries a lifelong risk for secondary malignancies. Therefore annual colonoscopy is recommended. Identification of potentially malignant structures can be challenging, and biopsies are taken in doubt, with the risk of injuring the ureterocolic implantation site. Using confocal laser endomicroscopy (CLE) and chromoendoscopy, the uretero-intestinal anastomosis is better visualized compared to conventional colonoscopy, and target biopsies could be…

Multiple Congenital Colonic Stenosis: A Rare Gastrointestinal Malformation

2016

Congenital colonic stenosis is a rare pediatric condition. Since 1968, only 16 cases have been reported in the literature. To the authors’ knowledge, multiple congenital colonic stenosis has not been previously reported in the literature. We report the case of a 2-month-old male, presented at our Neonatal Intensive Care Unit with a suspicion of intestinal malrotation. Clinical examination revealed persistent abdominal distension. During the enema examination, the contrast medium appeared to fill the lumen of the colon up to three stenotic segments and could not proceed further. Intraoperatively we confirmed the presence of four types of colonic atresia, located in the ascending, transverse,…

Anatomical basis for the interposition of a gastric pouch between the ileum and the anus after total proctocolectomy.

2003

After a total proctocolectomy, ileoanal continuity is achieved by an ileal pouch–anal anastomosis. This anastomosis is not possible when the ileum cannot reach the anus. To avoid definitive ileostomy in this circumstance, we devised a gastric pouch, taken from the left half of the vertical portion of the stomach, vascularized by the right gastroepiploic pedicle, then interposed it between the ileum and the anus. The aim of this anatomical study on seven cadavers was to estimate the capacity of this gastric pouch to reach the anus. The distance between the caudal edge of the pubic symphysis and the apex of the pouch was measured. It is accepted that an ileal pouch always reaches the anus wit…

Endoscopic management of gastric outlet obstruction disease

2019

Gastric outlet obstruction (GOO) is a clinical syndrome characterized by a variety of symptoms. It may be caused by motor disorders and by benign or malignant mechanical disease. Endoscopic management of benign disease is mainly based on balloon dilation, augmented by the use of covered self-expanding metal stents (SEMS) in refractory disease. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used as an alternative method, although more studies with longer follow up are needed before it can be considered as a recommended therapy. Surgery remains the last resort. Endoscopic management of malignant GOO is based on SEMS placement as an alternative to palliative surgery, b…

Vaginal Reconstruction Using the Bladder and/or Rectal Walls in Patients with Radiation-Induced Fistulas

2000

Abstract Objective. In irreparable or recurrent vesicovaginal fistulas and cloacal defects following high-dose irradiation therapy for gynecological malignancies, urinary diversion is the last resort to achieve a socially acceptable solution. In a select group of young and tumor-free patients, additional vaginal reconstruction may be indicated. Multiple operative procedures are available, but the results are often disappointing in the previously irradiated area. Materials and methods. In six such patients with large radiogenic vesicovaginal defects ( n = 5) or a cloacal fistula ( n = 1), a continent reservoir using the transverse colon with an umbilical stoma was performed. At the end of th…

Spinal anaesthesia in a patient with post-spine surgery dural ectasia.

2013

Dural sac ectasia is a very infrequent anatomical abnormality, usually caused by connective tissue diseases, as Marfan syndrome. Very few cases have been described being a consequence of a previous spine surgical procedure. We describe the case of an elderly patient who should be operated on twice due to sub-occlusive colon disease. Surgery was performed under spinal anaesthesia. A dural sac ectasia was suspected after the first procedure and the abdominal X-ray was reviewed. The characteristics of the anatomical alteration and the course of both anaesthetic procedures were described. X-ray and CT images were provided.

CRT-727 Percutaneous Balloon Atrial Septostomy for Direct Left Heart Decompression in Patients on Extra Corporeal Membrane Oxygenation

2014

Severe myocardial dysfunction and added afterload from the Extra Corporeal Membrane Oxygenation (ECMO) arterial cannula may lead to significant rise in left ventricular (LV) end-diastolic and left atrial (LA) pressures. This may result in ischemia, lower likelihood of ventricular recovery and hence