scholarly journals The Postoperative Pancreas Imaging

2020 ◽  
Vol 3 (01) ◽  
pp. 087-098
Author(s):  
Ahmed Taher ◽  
Bilal Mujtaba ◽  
Nisha S. Ramani ◽  
Asif Patel ◽  
Ajaykumar C. Morani
Keyword(s):  
Surgical Techniques ◽  
Mortality Rates ◽  
Early Postoperative Period ◽  
Imaging Findings ◽  
Postoperative Assessment ◽  
Postsurgical Complications ◽  
Postoperative Intensive Care ◽  
Computed Tomography Scans ◽  
Hospital Stays ◽  
Postoperative Findings

Abstract Recent advances in the surgical techniques and postoperative intensive care have led to a decrease in the mortality rates after major pancreatic procedures, which now ranges from 1 to 3%. However, the morbidity rates are still high, resulting in longer hospital stays and greater cost. Imaging plays a fundamental role in the postoperative assessment. Specially, multidetector computed tomography scans (MDCT) is the modality of choice in the postoperative settings. Early diagnosis of the postoperative complications and differentiating them from being normal or expected postoperative findings is crucial to offer the best possible care for patients and to decrease the morbidity and mortality associated with surgery. In this article, we will briefly review the normal pancreatic anatomy, discuss the main types of pancreatic surgeries, and illustrate the imaging findings during the early postoperative period and of the main postsurgical complications in both acute and chronic postoperative settings.

Postoperative Imaging of Ulnar Wrist Pain

2021 ◽  
Vol 25 (02) ◽  
pp. 329-345
Author(s):  
Luis Cerezal ◽  
Eva Llopis ◽  
Ana Canga ◽  
Francisco Del Piñal
Keyword(s):  
Surgical Techniques ◽  
Soft Tissue Injuries ◽  
Clinical Problem ◽  
Wrist Pain ◽  
Resonance Imaging ◽  
Postoperative Evaluation ◽  
Postsurgical Complications ◽  
Ulnar Wrist Pain ◽  
Magnetic Resonance Imaging Mri ◽  
Critical Aspects

AbstractUlnar wrist pain, caused by a broad spectrum of bone and soft tissue injuries, is the most common clinical condition of the wrist. Multiple surgical techniques and their variants in the treatment of these injuries are constantly evolving. Postoperative evaluation of the wrist for many surgeons is limited to serial clinical and radiographic monitoring. However, imaging methods such as ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and arthrographic techniques (arthrographic CT and arthrographic MRI) play a fundamental role in diagnosing and managing postsurgical complications.The several critical aspects in evaluating the postsurgical wrist imaging spectrum are familiarity with the surgical techniques, knowledge of the original clinical problem, understanding the strength and limitations of the different radiologic modalities, and effective communication between surgeon and radiologist.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

Evaluation and Surgical Treatment of Congenital Craniofacial Deformities

Neurosurgery ◽  
1978 ◽  
Vol 2 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Jack E. Maniscalco ◽  
Mutaz B. Habal
Keyword(s):  
United States ◽  
Congenital Malformations ◽  
Surgical Techniques ◽  
Neurological Impairment ◽  
The United States ◽  
Mortality Rates ◽  
Craniofacial Surgery ◽  
Brain Malformation ◽  
Working Together ◽  
Method Of Evaluation

Abstract The field of craniofacial surgery has rapidly developed over the last decade in the United States and abroad. Congenital malformations heretofore considered hopeless are now being corrected by a team of specialists working together in the cranial-facial junction. The evaluation of patients for craniofacial surgery must include consideration of associated neurological impairment, and in certain syndromes the incidence of brain malformation and mental retardation are extremely high. The method of evaluation and the various surgical techniques are presented. Mortality rates from this surgery have ranged from 0 to 5%, according to the severity of the deformities.

Postoperative Assessment of Incisor Dental Implants Using Cone-Beam Computed Tomography

2010 ◽  
Vol 36 (5) ◽  
pp. 377-384 ◽  
Author(s):  
Munetaka Naitoh ◽  
Hiromitsu Nabeshima ◽  
Hisashi Hayashi ◽  
Takehiko Nakayama ◽  
Kenichi Kurita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Dental Implants ◽  
Cone Beam Computed Tomography ◽  
Bone Grafts ◽  
Cone Beam ◽  
Postoperative Assessment ◽  
Labial Side ◽  
Bone To Implant Contact ◽  
The Mean ◽  
Postoperative Findings

Abstract The bone configuration surrounding anterior dental implants was postoperatively assessed using cone-beam computed tomography (CBCT). In 21 patients with a mean age of 41.5 years, 36 implants placed in the incisor region were postoperatively evaluated using CBCT. The rate of bone-to-implant contact (%) was calculated. The mean rate of bone-to-implant contact on the labial side was 78.3% with and 65.3% without bone grafts. The postoperative findings of incisor implants could be assessed using CBCT.

18F-FDG PET: early postoperative period of oro-maxillo-facial flaps

2003 ◽  
Vol 42 (05) ◽  
pp. 210-214 ◽  
Author(s):  
G. Schultes ◽  
G. Wolf ◽  
Y. Yamashita ◽  
E. Sorantin ◽  
H. Kärcher ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Clinical Course ◽  
Early Postoperative Period ◽  
Point Scale ◽  
Tissue Component ◽  
Large Defect ◽  
Postoperative Assessment ◽  
Facial Surgery ◽  
Fdg Pet Scan

Summary: Aim: We addressed the feasibility of FDG-PET to differentiate between viability and non-viability in the immediate postoperative assessment of flaps (autologous microvascular anastomosed pedicled flaps) in oro-maxillo-facial surgery. Methods: 3-7 days after surgery, FDG-PET was done in 38 patients who had received flaps for reconstruction of the mandible after partial resection. The studies were done on a dedicated full ring PET-scanner (ECAT EXACT HR+, Siemens/CTI). Acquisition started between 60 and 80 min post injection. The findings of the soft tissue component of the flaps were grouped using a three point scale: (I) no defect, (II) small defects, (III) one large defect. The results of PET were compared with the clinical course for at least 3 months. Results: “No defect” on the FDG-PET study identified viability of the flap and predicted normal clinical follow-up (22/38 patients). “Small defects” visualized areas of decreased perfusion and decreased glucose metabolism indicating risk of non-viability (13/38 patients); adapting the postsurgical management led to delayed but uncomplicated healing of the flaps in these patients. “One large defect” demonstrated early necrosis of the flap (3/38 patients). After removal and replacement of this necrotic portion of the flap the second FDG-PET scan of these 3 patients demonstrated the uncomplicated post-operative healing. Conclusion: FDG-PET facilitated the assessment of viability and non viability of flaps in the immediate postsurgical period, and demonstrated the usefulness of FDG-PET for postoperative care and prognosis.

scholarly journals Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Cartilage ◽  
2019 ◽  
pp. 194760351987085 ◽  
Author(s):  
Anthony Fiegen ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Jonathan D. Barlow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Glenohumeral Joint ◽  
Meta Analysis ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Cartilage Defects ◽  
Imaging Findings ◽  
Level Of Evidence ◽  
Patient Reported

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

scholarly journals Necrotizing Encephalitis Caused by Disseminated Aspergillus Infection after Orthotopic Liver Transplantation

2015 ◽  
Vol 9 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Luis E. Barrera-Herrera ◽  
Alonso Vera ◽  
Johanna Álvarez ◽  
Rocio Lopez
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Fungal Infections ◽  
Periodic Acid ◽  
Surgical Techniques ◽  
Mortality Rates ◽  
Variceal Hemorrhage ◽  
Early Recovery ◽  
Periodic Acid Schiff ◽  
Aspergillus Infection

Liver transplantation is the only available treatment for some patients with end-stage liver disease. Despite reduction in mortality rates due to advances related to surgical techniques, intensive medical management and immunosuppressive therapy, invasive fungal infections remain a serious complication in orthotopic liver transplantation. We report the case of an 18-year-old male diagnosed with autoimmune cirrhosis in 2009 who was assessed and listed for liver transplantation for massive variceal hemorrhage. One year after listing a successful orthotopic liver transplantation was performed. Uneventful early recovery was achieved; however, he developed pulmonary and neurological Aspergillus infection 23 and 40 days after surgery, respectively. Antibiotic therapy with voriconazole and amphotericin was started early, with no major response. Neuroimaging revealed multiple right frontal and right parietal lesions with perilesional edema; surgical management of the brain abscesses was performed. A biopsy with periodic acid-Schiff and Gomori stains revealed areas with mycotic microorganisms morphologically consistent with Aspergillus, later confirmed by culture. The patient developed necrotizing encephalitis secondary to aspergillosis and died. Necrotizing encephalitis as a clinical presentation of Aspergillus infection in an orthotopic liver transplant is not common, and even with adequate management, early diagnosis and prompt antifungal treatment, mortality rates remain high.

scholarly journals A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Cuneyt Kucur ◽  
Isa Ozbay ◽  
Fatih Oghan ◽  
Nadir Yildirim ◽  
Zuhal Zeybek Sivas ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Present Report ◽  
Rare Complication ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Common Disease ◽  
Limited Data ◽  
Horner Syndrome ◽  
Tonsil Surgery ◽  
The Right

Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.

scholarly journals Modeling Meropenem Treatment, Alone and in Combination with Daptomycin, for KPC-Producing Klebsiella pneumoniae Strains with Unusually Low Carbapenem MICs

2016 ◽  
Vol 60 (8) ◽  
pp. 5047-5050 ◽  
Author(s):  
P. Gagetti ◽  
F. Pasteran ◽  
M. P. Martinez ◽  
M. Fatouraei ◽  
J. Gu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Therapeutic Strategy ◽  
Mortality Rates ◽  
Pharmacodynamic Model ◽  
Gram Negative Bacteria ◽  
Content Type ◽  
Serious Infections ◽  
Hospital Stays ◽  
Kill Curve ◽  
Prolonged Hospital

ABSTRACTKlebsiella pneumoniaestrains producingK. pneumoniaecarbapenemase (KPC) cause serious infections in debilitated and immunocompromised patients and are associated with prolonged hospital stays and increased mortality rates. Daptomycin is a lipopeptide used againstStaphylococcus aureusinfection and considered inactive against Gram-negative bacteria. We investigated the effectiveness of a daptomycin-meropenem combination by synergy kill curve and a pharmacokinetic/pharmacodynamic model. The combination may represent a novel therapeutic strategy against infections caused by KPC-producingK. pneumoniaestrains.

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