Asunto(s)
Cuerpos Extraños/diagnóstico por imagen , Traumatismos Penetrantes de la Cabeza/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Diagnóstico Diferencial , Cuerpos Extraños/cirugía , Vidrio , Traumatismos Penetrantes de la Cabeza/cirugía , Humanos , Masculino , Cuero Cabelludo/lesiones , Cráneo/lesiones , Índices de Gravedad del TraumaRESUMEN
OBJECTIVE: To describe a safe surgical technique for the management of refractory ascites. PATIENTS AND METHOD: Two preterminal patients with respiratory compromise caused by refractory ascites had the long saphenous vein transected at mid-thigh and anastomosed to the peritoneum in the region of the internal inguinal ring. This allowed direct drainage of the ascitic fluid into the vascular system (peritoneosaphenous shunt). RESULTS: The procedure was performed successfully on two patients. The first patient, with cirrhosis, was leading a normal lifestyle without diuretic use at 7 1/2 months' follow-up. The second patient, with cirrhosis and multifocal hepatoma, was fit enough for discharge without medication. CONCLUSION: The peritoneo-saphenous shunt deserves further evaluation as a novel and safe surgical technique for the management of refractory ascites.
Asunto(s)
Ascitis/cirugía , Derivación Peritoneovenosa , Humanos , Masculino , Persona de Mediana Edad , Vena Safena , Ultrasonografía DopplerAsunto(s)
Pie/irrigación sanguínea , Isquemia/etiología , Zapatos/efectos adversos , Humanos , Trote , MasculinoRESUMEN
A consecutive series of 30 patients admitted with non-meningococcal meningitis is presented. In all there was a history of preceding head injury. All 30 patients were investigated by direct coronal computed tomography (CT) scan to determine whether or not a site of fracture into a paranasal air sinus could be demonstrated. We postulated that such a fracture would correspond to the site of a dural tear. Direct coronal CT demonstrated a fracture in all patients, and this corresponded to the site of a dural tear at operation in every case in which an operation was carried out (28 out of the 30 patients). We propose that this method of investigation is superior to other techniques that have been, or are currently, employed in this clinical situation.
Asunto(s)
Duramadre/diagnóstico por imagen , Meningitis/etiología , Senos Paranasales/lesiones , Fracturas Craneales/complicaciones , Tomografía Computarizada por Rayos X/métodos , Rinorrea de Líquido Cefalorraquídeo/etiología , Duramadre/lesiones , Humanos , Meningitis/diagnóstico por imagen , Senos Paranasales/diagnóstico por imagen , Fracturas Craneales/diagnóstico por imagenRESUMEN
Pictorial analogies are a descriptive modality often employed to convey radiological (as well as clinical and pathological) appearances. Examples of this useful descriptive device abound and many anatomical terms take their origin from such analogies. The cauda equina (horse's tail) and the uvula (grape) are but two classic examples. A radiographic appearance resembling a 'winking ogre' on computed tomography of the lumbosacral junction is described. This appearance is encountered in cases scanned following myelography, where one of the (left or right) first sacral nerve roots is compressed by herniated disc material.
Asunto(s)
Región Lumbosacra/diagnóstico por imagen , Síndromes de Compresión Nerviosa/diagnóstico por imagen , Raíces Nerviosas Espinales , Tomografía Computarizada por Rayos X , Humanos , Región Lumbosacra/patologíaRESUMEN
Two fatal cases of poisoning by paracetamol are described. Both patients were heavy imbibers of alcohol and both had swallowed less paracetamol that that generally regarded as a lethal dose. The biochemistry of paracetamol hepatotoxicity is outlined and the increased susceptibility of alcoholic patients to the hepatotoxic effects of paracetamol is remarked upon. Recent trends in the treatment of acute paracetamol poisoning are mentioned.