-
The Panzer Heart: A Surgical Challenge
Ciss Amadou Gabriel,
Gandji E.Wilfried,
Diop Momar Sokhna,
Ba Papa Salmane,
Leye Mohamed,
Sene Etienne Birame,
Diatta Souleymane,
Gaye Magaye,
Dieng Papa Adama,
N’diaye Assane,
N’diaye Mouhamadou
Issue:
Volume 4, Issue 6, December 2016
Pages:
126-129
Received:
10 September 2016
Accepted:
11 October 2016
Published:
7 November 2016
DOI:
10.11648/j.js.20160406.11
Downloads:
Views:
Abstract: Introduction constrictive pericarditis is an inflammation of pericardium, they develops progressive fibrotic, calcified the pericardium and compressed the myocardium. The aim of this study is to present a case of massive calcified pericardium and to describe the difficult of surgery. Method A 30–year-old woman was admitted in cardiovascular hospital after 7 years of dyspnea, weakness, fatigue, ascites and palpitation. She had been diagnosed with on tuberculosis 8 years before and had complied with anti-tuberculosis chemotherapy. Treatment consists of 4 drugs therapy (rifampicin, isoniazid, pyrazinamide and ethambutol) for 2 months followed by 2 drugs (rifampicin, isoniazid) for 4 months with adjuvant treatment including vitamin B. Clinical examination showed symptoms of right heart congestion including congestive liver; ascites dilated jugular vein and leg edema. Chest radiography showed massive pericardial calcific deposits encircling the left and the right ventricle. Two dimensional echocardiography revealed severe pericardial calcification with right systolic ventricular dysfunction, dilatation fright atrium and inferior vena cava. Chest thoracic scanner was performed and precise the topography of calcification. Right cardiac catheterism was not performed. Abdominal ultrasound showed ascites and cardiac-like liver. The transaminases were high. Result A subtotal pericardiectomy was performed through a median sternotomy without cardiopulmonary bypass (CPB).The anterior, lateral and inferior pericardium was resected between the right and left phrenic nerve using the ultrasonic scalpel. Massive calcified are as were first irrigated with hot physiologic serum, in order to fracture the plaque and dissect it from myocardium without coronary lesion. Our patient was discharged to the hospital 8 days later, electrocardiogram showed atrial fibrillation. After 3 months she no longer presents dyspnea and ascites. Conclusion Surgical decompression of right cardiac cavities in massive calcified pericarditis induce increasing of right signs and restoration of the right ventricular function.
Abstract: Introduction constrictive pericarditis is an inflammation of pericardium, they develops progressive fibrotic, calcified the pericardium and compressed the myocardium. The aim of this study is to present a case of massive calcified pericardium and to describe the difficult of surgery. Method A 30–year-old woman was admitted in cardiovascular hospita...
Show More
-
Management over Penetrating Wound of the Chest in University Hospital of Conakry
Aissatou Taran Diallo,
Alpha Kabinet Camara,
Soriba Naby Camara,
Essaga Ayissi Alphonsine Martine,
Diallo Sara Boubacar,
Ismael Kaba,
Boubacar Djello Diallo,
Mariame Béavogui,
Mohamed Kaba Touré,
Diallo Biro
Issue:
Volume 4, Issue 6, December 2016
Pages:
130-133
Received:
1 October 2016
Accepted:
22 October 2016
Published:
23 November 2016
DOI:
10.11648/j.js.20160406.12
Downloads:
Views:
Abstract: Penetrating injuries to the chest present a frequent and challenging problem. The majority of these injuries can be managed non-operatively. The aim of this study were to determine the frequency of penetrating wounds of the chest, identifying wounding agents and circumstances of the trauma occurred, describe the diagnostic and therapeutic care at the University Hospital of Conakry. Methods As part of this study was the thoracic surgery department of the National Hospital Donka Hospital in Conakry. This was a retrospective descriptive study of a type of 4 years and 8 months, from 1 January 2010 to 30 August 2015 inclusive. It involved a chart review of patients admitted consecutively in the service for penetrating trauma of Thorax. The variables studied were epidemiological, diagnostic, and therapeutic. Results: We collected 98 cases of penetrating wounds of the chest during the study period, representing 21.16% of all thoracic pathologies treated in the service during the same period (n = 463). The male occupied 87% of cases (n = 85) and the female gender was 13% (13). The average age of patients of patients was 25 years with extremes of 04 and 60 years. The age between 21 and30 years is the most represented with 59.19% (n = 58). Pupils and students were most concerned with 31.63% (n = 31), followed by workers (23.46%, n = 23), street vendors (20.40%, n = 20) and drivers (15.30%, n = 30). The wounding agents were represented by stabbing with 67% (n = 66), firearms with 26% (n = 25), and impalement on perforating agents in 7% (n = 7%). The circumstances of occurrence recorded were armed criminal assault in 87.75% (n = 86), hunting accidents with 5.10% (n = 5), brawls with 4.08% (n = 4) and falls from height with 3.06% (n = 3). Conclusion Penetrating wounds of the chest are a current pathology by increased violence, insecurity and the misuse of firearms in major cities. The vital importance of intra thoracic organs is a medical and surgical emergency.
Abstract: Penetrating injuries to the chest present a frequent and challenging problem. The majority of these injuries can be managed non-operatively. The aim of this study were to determine the frequency of penetrating wounds of the chest, identifying wounding agents and circumstances of the trauma occurred, describe the diagnostic and therapeutic care at t...
Show More
-
Choice of Lowest Instrumented Vertebras for Lenke I Adolescent Idiopathic Scoliosis Orthopedics
Zhisheng Ji,
Sida Chen,
Guowei Zhang,
Yuhao Yang,
Yaozhong Liang,
Hongsheng Lin
Issue:
Volume 4, Issue 6, December 2016
Pages:
134-140
Received:
22 December 2016
Accepted:
30 December 2016
Published:
21 January 2017
DOI:
10.11648/j.js.20160406.13
Downloads:
Views:
Abstract: To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospectively. All patients were divided into touched vertebra group (n=21 cases; 6 M and 15 F) and stable vertebra group (n=24 cases; 7 M and 17 F) according to the choice of different lowest instrumented vertebras. The indexes of the coronal and sagittal spinal imaging before and after operation as well as in the last follow-up were analyzed and SRS-22 questionnaire was performed to evaluate the curative effect. Through a 6-36-month follow-up visit, no significant difference was found in the pre-operative indexes (Cobb angle and pre-operative TS, SVA, TK and LL) of the coronal and sagittal spinal imaging between the two groups (P>0.05). Meanwhile, there was no statistical difference in the spinal coronal parameters (i.e., Cobb angle, TS, pre-operative thoracic-waist/waist scoliosis, pre-operative flexibility of thoracic scoliosis, correction rate and loss rate) after operation and in the last follow-up visit between the two groups (P>0.05). In touched vertebra group, the coronal spinal parameters (e.g., thoracic-waist/waist scoliosis) after operation and in the last follow-up visit were significantly higher than those of stable vertebra group (P<0.05) while there was no statistical difference in postoperative SVA between the two groups (P>0.05). In the aspect of fusion segments, the touched vertebra group saved one centrum relative to stable vertebra group (P<0.05). The postoperative SRS-22 scores for living quality of both groups were significantly decreased compared with the pre-operative, in which the score was decreased from the preoperative 51.0 to 29.0 in touched vertebra group and from 50.9 to 28.7 in stable vertebra group (both P<0.05), but both the pre- and post-operative scores were not significantly different between the two groups (P>0.05). In order to treat Lenke I AIS patients with posterior pedicle screw-rod orthopedics, touched vertebra should be used as lowest instrumented vertebra as it can not only obtain the similar therapeutic effect to stable vertebra, but also shorten the fixed segments.
Abstract: To discuss the impact of different lowest instrumented vertebras on the effect of posterior spinal pedicle screw-rod orthopedics for treatment of Lenke I adolescent idiopathic scoliosis. 45 patients with adolescent idiopathic scoliosis (AIS) who received posterior pedicle screw-rod orthopedics from July 2011 to September 2015 were analyzed retrospe...
Show More
-
Effect of Swallowing Function After ROI-C Anterior Cervical Interbody Fusion
Guowei Zhang,
Zhaohui Chen,
Qiuling Liu,
Zhisheng Ji,
Chunhai Lan,
Hongsheng Lin
Issue:
Volume 4, Issue 6, December 2016
Pages:
141-145
Received:
22 December 2016
Accepted:
3 January 2017
Published:
21 January 2017
DOI:
10.11648/j.js.20160406.14
Downloads:
Views:
Abstract: The difference of swallowing function between a new zero-notch anterior cervical interbody fusion device (ROI-C) and classical method with the plate using in anterior cervical decompression and fusion (ACDF) were discussed and analyzed. 57 cases in the First Affiliated Hospital of Jinan University from Feb 2013 to Mar 2016 who underwent ACDF were retrospectively reviewed. There were 33 cases in group using with ROI-C and 24 cases in group using with plate. The difference of dysphagia incidence and severity were analyzed by comparing with the image data before and after operation. The dysphagia correlative risk factors analyzed by logistic regression test were internal fixation material and thickness of 3-days post-operative prevertebral soft tissue (PST). When the PST (3-days post-operative) was larger than 10.44mm, the chance of developing postoperative was significantly greater. The thickness of 3-days post-operative PST in ROI-C group was significantly lower than that in plate group (P <0.05). The thickness of 3-days post-operative PST swelling width ROI-C group was significantly lower than that in plate group (P <0.05). The index of 3-days post-operative PST was lower but no significant in ROI-C group than that of group Plate (P >0.05). 3-days post-operation, the dysphagia incidence and severity were significantly lower in ROI-C group than that in plate group (P <0.05). The dysphagia correlative risk factors are internal fixation material and thickness of 3-days post-operative PST. When the 3-days post-operative PST larger than 10.44 mm, the chance of developing postoperative is significantly greater. Zero-notch ROI-C anterior cervical interbody fusion device is associated with less stimulations to esophagus, lower postoperative dysphagia incidence, milder severity of dysphagia and shorter period of dysphagia in ACDF.
Abstract: The difference of swallowing function between a new zero-notch anterior cervical interbody fusion device (ROI-C) and classical method with the plate using in anterior cervical decompression and fusion (ACDF) were discussed and analyzed. 57 cases in the First Affiliated Hospital of Jinan University from Feb 2013 to Mar 2016 who underwent ACDF were r...
Show More
