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Complications Occurring (complications + occurring)
Selected AbstractsTotal Duodenectomy with Enteric Duct Drainage: A Rescue Operation for Duodenal Complications Occurring after Pancreas TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 3 2010U. Boggi Duodenal graft complications (DGC) occur frequently after pancreas transplantation but rarely cause graft loss. Graft pancreatectomy, however, may be required when DGC compromise recipient's safety. We herein report on two patients with otherwise untreatable DGC in whom the entire pancreas was salvaged by means of total duodenectomy with enteric drainage of both pancreatic ducts. The first patient developed recurrent episodes of enteric bleeding, requiring hospitalization and blood transfusions, starting 21 months after transplantation. The disease causing hemorrhage could not be defined, despite extensive investigations, but the donor duodenum was eventually identified as the site of bleeding. The second patient was referred to us with a duodenal stump leak, 5 months after transplantation. Two previous surgeries had failed to seal the leak, despite opening a diverting stoma above the duodenal graft. Thirty-nine and 16 months after total duodenectomy with dual duct drainage, respectively, both patients are insulin-independent and free from abdominal complaints. Magnetic resonance pancreatography shows normal ducts both basal and after intravenous injection of secretin. The two cases presented herein show that when DGC jeopardize pancreas function or recipient safety, total duodenectomy with enteric duct drainage may become an option. [source] Standing oral extraction of cheek teeth in 100 horses (1998-2003)EQUINE VETERINARY JOURNAL, Issue 2 2005P. M. DIXON Summary Reasons for performing study: Extraction of cheek teeth (CT) by the conventional repulsion technique requires general anaesthesia and carries a high rate of post operative complications. Consequently, an alternative method of extraction, i.e. orally in standing horses, was evaluated. Hypothesis: The need for and risks of general anaesthesia could be avoided and post extraction sequelae reduced by performing extractions orally in standing horses. Methods: One hundred mainly younger horses (median age 8, range 2-18 years) with firmly attached CT that required extraction because of apical infections, displacements, diastemata, idiopathic fractures and the presence of supernumerary CT had the affected teeth (n = 111) extracted orally under standing sedation. Follow-up information was obtained for all cases, a median of 16 months later. Results: Oral extraction was successful in 89 horses and unsuccessful in 11 due to damage to the CT clinical crown (n = 9) during extraction, for behavioural reasons (n = 1) and because the apex of a partly extracted CT fell back into the alveolus following sectioning (n = 1). Predispositions to extraction-related CT fractures were present in 5 of the 9 cases, i.e. advanced dental caries (n = 2) and pre-existing ,idiopathic' fractures (n = 3). The iatrogenically fractured CT were later repulsed under standing sedation (n = 3) and under general anaesthesia (n = 6). Eighty-one of the remaining 89 horses had successful oral CT extraction with no or minimal intra- or post operative complications occurring. Post operative complications in the other 8 cases included post extraction alveolar sequestration (n = 3), alveolar sequestration and localised osteomyelitis (n = 1), localised osteomyelitis (n = 1), incorporation of alveolar packing material into alveolar granulation tissue (n = 1), and nasal discharge due to continued intranasal presence of purulent food material (n = 1) and to ongoing sinusitis (n = 1). The above sequelae were treated successfully in all cases, with general anaesthesia required in just one case. Following oral extraction, significantly (P<0.001) fewer post operative problems developed in 54 horses with apically infected CT in comparison with 71 previous cases that had repulsion of apically infected CT at our clinic. Conclusions and potential relevance: Oral extraction of cheek teeth is a successful technique in the majority of younger horses with firmly attached CT and greatly reduces the post operative sequelae, compared with CT repulsion. Additionally, the costs and risks of general anaesthesia are avoided. Further experience and refinement in the described protocol could potentially increase the success of this procedure and also reduce the incidence of post operative sequelae. [source] Sickle Cell Trait Mimicking Multiple Inflicted Injuries in a 5-Year-Old BoyJOURNAL OF FORENSIC SCIENCES, Issue 5 2009Charis Kepron M.D. Abstract:, Sickle cell disease (SCD) and sickle cell trait (SCT) can be associated with sudden unexpected death in the pediatric population, usually due to pulmonary complications occurring within the acute chest syndrome (ACS). Musculoskeletal complications can occur and are classically limited to bone infarcts. The occurrence of bone pathology centered upon the epiphyseal growth plate in SCD/SCT is extremely rare, and multiple such injuries in a single patient have not been previously reported. Herein, we describe a case of sudden unexpected death in a 5-year-old child with undiagnosed SCT due to the ACS, with widespread epiphyseal and periosteal bone lesions mimicking multiple inflicted injuries at autopsy. This case highlights the importance of clinicopathological correlation and is the first to describe SCT pathology as a mimic of nonaccidental injury. [source] Ramus or Chin Grafts for Maxillary Sinus Inlay and Local Onlay Augmentation: Comparison of Donor Site Morbidity and ComplicationsCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003Jaime Clavero DDS ABSTRACT Background: The placement of endosseous implants in edentulous areas is frequently limited by inadequate bone volume of the residual ridge. Local bone grafts from the mandible are a convenient source of autogenous bone for alveolar reconstruction prior to implant placement. Purpose: The aim of the present study was to document and compare the morbidity and the frequency of complications occurring at two intraoral donor sites: the mandibular symphysis and the mandibular ramus. Material and Methods: This study reviewed 53 consecutively treated patients:29 with autogenous bone grafts from the mandibular symphysis and 24 with mandibular ramus bone grafts. Each patient received a questionnaire 18 months after surgery regarding problems that may have occurred during the postoperative period. Results: In the patients in whom bone was harvested from the mandibular ramus, there were fewer postoperative symptoms immediately after the operation than with mandibular symphysis harvesting. Twenty-two of the 29 patients with symphysis grafts experienced decreased sensitivity in the skin innervated by the mental nerve 1 month after the operation. Five of the 24 patients with ramus grafts experienced decreased sensitivity in the vestibular mucosa corresponding to the innervation of the buccal nerve. Eighteen months after the surgery, 15 of the 29 patients in the symphysis group still had some decreased sensitivity and presented with permanent altered sensation. Only one of the patients grafted from the mandibular ramus presented with permanent altered sensation in the posterior vestibular area. No major complication occurred in the donor sites in any of the 53 patients. Conclusion: The results of this study favored the use of the ascending mandibular ramus as an intraoral donor site for bone grafting. [source] | ||||||||||