Ventriculoatrial shunts are the alternative treatments when it is impossible to use ventriculoperitoneal shunts. Limited indication for ventriculoatrial shunt is due to the possibility of very serious complications inherent with this procedure. We present a case report of a young patient who suffered from disconnection of an atrial catheter from the valve after an accidental blow to his neck. The atrial catheter was dislocated to the heart and pulmonary artery and it was extracted through the femoral vein in the groin area using an endovascular technique. The procedure went without complications. A new atrial catheter was introduced under ultrasonic guidance during surgical revision.
- Klíčová slova
- atrial catheter, hydrocephalus, rare complication, ventriculoatrial shunt,
- MeSH
- arteria pulmonalis * chirurgie MeSH
- dospělí MeSH
- lidé MeSH
- migrace cizích těles chirurgie diagnostické zobrazování MeSH
- shunty pro odvod mozkomíšního moku škodlivé účinky MeSH
- srdeční síně chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Obesity has become a worldwide problem with a growing incidence, posing a risk to health, especially for cardiovascular disease, diabetes, certain types of cancer, depres-sive syndrome, and others. The methods of obesity treatment are still expanding, in addition to diet and exercise measures, pharmacological, endoscopic and surgical treatment is possible. One of the commonly performed bariatric surgical procedures is the Roux-en-Y gastric bypass, which combines restrictive and malabsorptive effects. As part of the development of new methods, the banded gastric bypass using the Fobi ring has been introduced. Its advantage is greater efficiency in reducing and maintaining -weight. One of the described complications is the migration of the Fobi ring, which can be addressed endoscopically today.
- Klíčová slova
- endoscopy, gastric bypass, obesity,
- MeSH
- lidé MeSH
- migrace cizích těles chirurgie MeSH
- morbidní obezita chirurgie MeSH
- žaludeční bypass * metody škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Electrode migration is the most common complication of spinal cord stimulation (SCS). The problem of longitudinal migration has already been solved, but lateral migration remains the most common current complication. The present article describes new electrodes fixation opportunities for the reduction of lateral migration in SCS. The pig was chosen as an animal model to illustrate a new protocol of electrode fixation for the control of lateral and longitudinal migration. The displacement of the electrode was measured using two different optical methods: the digital image stereo-correlation and the digital image processing methods. Fixation with two anchors has always considerably reduced electrode displacement and when fixation is done with two anchors and a loop then lateral migration is reduced by 62.5 % and longitudinal migration is reduced by 94.1 %. It was shown that the results are significantly different at the alpha=0.001 significance level. Based on a statistical evaluation it is possible to state that the differences between experimental results obtained for three different protocols of lead fixation are statistically significant and we can recommend the new fixation method for common practice.
- MeSH
- implantované elektrody normy MeSH
- migrace cizích těles diagnóza prevence a kontrola MeSH
- modely u zvířat * MeSH
- počítačové zpracování obrazu metody MeSH
- prasata MeSH
- zvířata MeSH
- Check Tag
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Varicose veins of lower extremities represent a common medical condition with minimally invasive percutaneous endovenous ablation techniques as a treatment of choice. A very rare complication is a catheter migration in the deep venous system. In the literature only 7 cases have been published so far, with only 2 cases with migration to the systemic circulation and heart involvement. In this paper we present an interesting case report from the perspective of a thoracic surgeon with the finding of a laser ablation catheter remnant in the left pleural cavity during thoracoscopic exploration for a spontaneous hemothorax in a 47-year old male patient after collapse. A similar complication affecting the pleural cavity has not been published before. In this paper we discuss possible routes of the cathether migration into the left pleural cavity, impending complications when a part of the catheter is left behind in the body and the means of prevention of these serious potentially fatal complications even after many years following the initial treatment.
- Klíčová slova
- VATS, complications, endovenous laser ablation, hemothorax, varicose veins of lower extremities,
- MeSH
- hemotorax * etiologie MeSH
- katetrizační ablace * MeSH
- laserová terapie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- migrace cizích těles * komplikace MeSH
- pánev MeSH
- varixy * terapie MeSH
- vena saphena MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- dospělí MeSH
- kardiochirurgické výkony metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- migrace cizích těles chirurgie MeSH
- podpůrné srdeční systémy * MeSH
- pooperační komplikace chirurgie MeSH
- selhání protézy * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- kazuistiky MeSH
OBJECTIVE: Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans-vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials). DESIGN: Review. SETTING: Department of Obstetrics and Gynecology, Regional hospital Mladá Boleslav a.s., Mladá Boleslav. METHODS: Overview of the results of recent studies published in the Czech and English language in recent years. RESULTS: Pelvic organ prolapse repair with vaginal mesh has generally lower count of relapse especially in patients with wide genital hiatal area and with major levator ani avulsion. The spectrum of complications differs from classical techniques because of the presence of synthetic nonabsorbable material. Some of the specific complications we did not encounter during classical operations include vaginal mesh erosion, infection of mesh associated with chronic pelvic pain, dyspareunia, protrusion of the mesh into the closest organs or the rejection and progressive extrusion of the mesh. CONCLUSION: Primary enthusiasm has now been replaced with worries of major complications. Future tasks should therefore be aimed at minimizing the rate of complications associated with transvaginal meshes. Except using well-known and safe materials and providing specialized training of physicians for each mesh implantation technique, other precautions outlined in this article should help, such as a closer specification of indication for the application of transvaginal mesh.
- Klíčová slova
- complications risk factors., efficacy, recurrence, transvaginal mesh,
- MeSH
- chirurgické síťky * MeSH
- chronická bolest epidemiologie MeSH
- dyspareunie epidemiologie MeSH
- gynekologické chirurgické výkony metody MeSH
- infekce chirurgické rány epidemiologie MeSH
- infekce spojené s protézou epidemiologie MeSH
- lidé MeSH
- migrace cizích těles epidemiologie MeSH
- pánevní bolest epidemiologie MeSH
- pooperační komplikace epidemiologie MeSH
- prolaps pánevních orgánů chirurgie MeSH
- recidiva MeSH
- vagina chirurgie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Our case study presents a case of foreign body migration through the vascular system of the human body. The following paper is a comprehensive overview of different diagnostic approaches, extraction indications, common ways in which a foreign body can migrate via the vascular system and possible complications caused by the migration or extraction of the foreign body.
- Klíčová slova
- foreign object - extraction migration.,
- MeSH
- arteria pulmonalis * MeSH
- lidé MeSH
- migrace cizích těles komplikace diagnóza terapie MeSH
- následné studie MeSH
- počítačová rentgenová tomografie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
PURPOSE: The aim of the study was evaluation and comparison of rotational stability and the effect of multifocal toric intraocular lens rotation (T-MIOL) at visual quality of two types of intraocular lens AcrySof IQ ReSTOR Toric SND1Tx (Alcon Laboratories, Inc.) and AT LISA toric 909M (Carl Zeiss Meditec AG). There was evaluated a pseudophakic dysphotopsia based on patients subjective feelings as well as the independence on glasses and overall satisfaction with the visual quality after T-MIOLs were implanted. METHODS: The retrospective study included 68 eyes (100 %) of 34 patients, who underwent an uncomplicated cataract surgery with multifocal toric intraocular lens was implanted. 68 eyes were divided into two groups. Group A consisted of 48 eyes (70,6 %) with AcrySof IQ ReSTOR Toric SND1Tx and group B included 20 eyes (29,4 %) with AT LISA toric 909M multifocal toric intraocular lenses were implanted. The T-MIOL position, planned axis and misalignment were evaluated one week and 6 months after surgery. Surgical lens reposition was indicated in case of worsening visual quality due to T-MIOL rotation from its planned position. RESULTS: In the group of 68 eyes, the mean uncorrected distance visual acuity (UDVA) before surgery was 0,08 (n = 48) in group A and 0,09 (n = 20) in group B. The mean UDVA after T-MIOL were implanted improved to 0,83 ± 0,06 (n = 48) in group A and 0,75 ± 0,08 (n = 20) in group B. The mean UDVA in patients before T-MIOL surgical rotation was 0,57 ± 0,03 (n = 5) in group A and 0,59 ± 0,08 (n = 5) in group B. At six months after T-MIOL surgical rotation, the uncorrected distance visual acuity was 1,0 in both groups (p = 0.70). The surgical rotation of T MIOL was performed in 10 eyes (14,7 %) of 68 eyes (p = 0.48), in group A (n = 48) in 5 eyes (10,4 %) and in group B (n = 20) in 5 eyes (25,0 %). Mean deviation from the planned axis was 8,2 ± 1,78 degrees in group A and 13,4 ± 3,04 degrees in group B. At six months postoperatively, the T-MIOL rotational stability showed less than 5 degrees for all surgically rotated lenses in both groups. Mean cylinder decreased in all patients from -2,92 ± 1,85Dcyl to -0.85 ± 0.61Dcyl after surgery. The mean spherical equivalent for all patients decreased from 0,56 ± 4,75D to 0,06 ± 1,33D after surgery. Presence of disturbing fotic phenomenon had reported 11 (32.4 %) of 34 patients, 9 of them they were subsequently indicated T-MIOL reposition. All 34 patients were able to perform normal daily tasks independently on spectacle correction. At six months after surgery, there was very high satisfaction with the quality of postoperative vision in both groups. CONCLUSION: Implantation of toric multifocal intraocular lens, both of AcrySof ReSTOR Toric SND1Tx (Alcon Laboratories, Inc.) and AT LISA toric 909M (Zeiss Meditec AG Carl) in cataract patients is safe and effective method to correct corneal astigmatism and maintain the visual multifocality. Early surgical T-MIOL reposition should be performed to put the T-MIOL to planned axis in steepest meridian if unwanted lens rotation is identified. KEY WORDS: cataract surgery, toric multifocal intraocular lens, rotation, rotational stability, quality of vision.
- MeSH
- astigmatismus patofyziologie MeSH
- fakoemulzifikace metody MeSH
- implantace nitrooční čočky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- multifokální intraokulární čočky * MeSH
- posunutí nitrooční čočky patofyziologie MeSH
- pseudofakie patofyziologie MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spokojenost pacientů MeSH
- zraková ostrost fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Chest pain in young adults is usually self-limited and of benign etiology. However, rare causes of chest pain must be considered in patients for whom initial diagnostic tests are negative, particularly if unusual risk factors are identified. The authors present a rare case describing a 27-year-old male intravenous drug user who developed transient chest pain most likely secondary to pericardial irritation caused by a needle fragment that embolized from a peripheral vein to his right ventricle. The current literature on intracardiac needles and similar foreign bodies is discussed, providing insight to the epidemiology, complications, and treatment of such patients.
- Klíčová slova
- Chest pain, Drug user, Needle embolism, Right ventricle,
- MeSH
- bolesti na hrudi diagnóza etiologie MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- embolie diagnóza etiologie MeSH
- jehly škodlivé účinky MeSH
- lidé MeSH
- migrace cizích těles komplikace diagnóza MeSH
- srdeční komory zranění MeSH
- výsledek terapie MeSH
- žilní tromboembolie diagnóza etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Percutaneous endoscopic gastrostomy (PEG) is a widely used method of nutrition delivery for patients with long-term insufficiency of oral intake. The PEG complication rate varies from 0.4% to 22.5% of cases, with minor complications being three times more frequent. Buried bumper syndrome (BBS) is a severe complication of this method, in which the internal fixation device migrates alongside the tract of the stoma outside the stomach. Excessive compression of tissue between the external and internal fixation device of the gastrostomy tube is considered the main etiological factor leading to BBS. Incidence of BBS is estimated at around 1% (0.3%-2.4%). Inability to insert, loss of patency and leakage around the PEG tube are considered to be a typical symptomatic triad. Gastroscopy is indicated in all cases in which BBS is suspected. The depth of disc migration in relation to the lamina muscularis propria of the stomach is critical for further therapy and can be estimated by endoscopic or transabdominal ultrasound. BBS can be complicated by gastrointestinal bleeding, perforation, peritonitis, intra-abdominal and abdominal wall abscesses, or phlegmon, and these complications can lead to fatal outcomes. The most important preventive measure is adequate positioning of the external bolster. A conservative approach should be applied only in patients with high operative risk and dismal prognosis. Choice of the method of release is based on the type of the PEG set and depth of disc migration. A disc retained inside the stomach and completely covered by the overgrowing tissue can be released using some type of endoscopic dissection technique (needle knife, argon plasma coagulation, or papillotome through the cannula). Proper patient selection and dissection of the overgrowing tissue are the major determinants for successful endoscopic therapy. A disc localized out of the stomach (lamina muscularis propria) should be treated by a surgeon.
- Klíčová slova
- Buried bumper syndrome, Complication, Endoscopy, Enteral nutrition, Percutaneous endoscopic gastrostomy,
- MeSH
- design vybavení MeSH
- enterální výživa škodlivé účinky přístrojové vybavení metody MeSH
- gastroskopie škodlivé účinky přístrojové vybavení MeSH
- gastrostomie škodlivé účinky přístrojové vybavení metody MeSH
- lidé MeSH
- migrace cizích těles diagnostické zobrazování etiologie terapie MeSH
- odstranění implantátu MeSH
- rizikové faktory MeSH
- selhání zařízení MeSH
- výsledek terapie MeSH
- zaváděcí katétry škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
