Fractures of the bilateral distal radius and scaphoid: a case report

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PERCUTANEOUS TREATMENT OF BILE LEAKAGE AFTER LIVING DONOR LIVER TRANSPLANTATION

Guven, Koray/0000-0001-8572-1998WOS: 000492145900003Objective: Biliary leakage (BL) is one of the most frequent complications following living donor liver transplantation (LDLT). Radiological methods are important in diagnosis and treatment. Although endoscopic approaches are considered as the first-line treatment option in BL, nowadays, increasing experience is strengthening the role of interventional radiological approaches. in our article, we aim to analyze our experience in the diagnosis and treatment of BLs developed after LDLT. Material and methods: Between January 2015 and December 2018, 361 LDLT cases performed consecutive at our center were analyzed retrospectively. the leakage diagnosis and location was demonstrated by magnetic resonance cholangiopancreatography (MRCP) with hepatobiliary excreted contrast agent gadoxetate disodium in patients with suspected leakage. BLs were treated by endoscopic, interventional radiological, surgical or conservative approaches. Results: of the total 361 cases, 27 (7.4%) had BL. Twenty six (96%) of the BL were anastomotic and 1 (3,7%) was incision surface leakage. One patient (3.7%) was treated by endoscopic sphincterotomy methods, 23 (85,1%) patients by interventional radiological approaches, two patients (7.4%) by surgery and 1 patient (3,7%) by conservative approaches. There were no minor and major complications during interventional radiological procedures. After the procedure, minor complications (mild cholangitic attack) in 4 (17.4%), mild edematous pancreatitis in 2 (8,6%) developed in 6 (26%) patients. Conclusion: Endoscopic treatment approaches may be complicated in patients with multiple anastomosis of biliary tract after LDLT. Although interventional radiological approaches require experience, they can be performed as an alternative treatment method

Necrotizing pancreatitis after transcatheter arterial chemoembolization for hepatocellular carcinoma

A patient who developed necrotizing pancreatitis after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is presented. A 55-year-old man had been followed for chronic hepatitis B infection for 10 years at another institution. He presented with multiple masses in the right lobe of the liver and a metastasis in the left adrenal gland. He was referred after a percutaneous liver biopsy which revealed a moderately differentiated HCC. He was,treated by TACE. At the third session of TACE, the right hepatic artery was found to be thrombosed; however, angiography also demonstrated collateral feeder vessels (arising from the pancreaticoduodenal artery) which were used for treatment. He developed necrotizing pancreatitis, possibly due to regurgitation of the chemotherapeutic agents to the pancreas. He recovered without complications with imipenem-cilastatin prophylaxis. Acute pancreatitis is a rare but severe complication of TACE. Selective catheterization of the tumor vessels is the established standard in TACE. A careful risk-benefit analysis is mandatory in patients with abnormal collateral vessels. Treatment of acute necrotizing pancreatitis (ANP) after TACE is the same as the accepted approach to ANP due to other causes

Cystic echinococcal liver disease: New insights into an old disease and an algorithm for therapy planning

Human cystic echinococcosis (CE) continues to be a major health problem in developing countries. A review of current literature discloses four alternatives for the management of active CE, consisting of surgery, percutaneous treatment (PT), chemotherapy, and follow-up without intervention, but no clear guidelines for directing patients to the different management options. Palliation of symptoms or prevention of complications is the main rationale for the treatment of CE. Surgery has long been considered as the gold standard treatment. However, a meta-analysis comparing the clinical outcomes of patients treated with PT with those of a control group treated with surgery found PT to be more effective, safer, and cheaper. Medical therapy is considered to be ineffective when the criterion of success is defined as the disappearance of the lesion. However, medical therapy seems to be effective when the goal of therapy is defined as the prevention of complications in asymptomatic patients. We propose an algorithm for therapy planning in CE where the first line of therapy for patients with active lesions is PT. Patients with lesions unsuitable for PT are directed to surgery if they are symptomatic, have complicated lesions or have lesions that are prone to rupture. Asymptomatic patients with uncomplicated lesions are directed to medical therapy. Medical therapy failures are redirected to surgery

Atypical lung involvement in a patient with systemic juvenile xanthogranuloma

Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis characterized by xanthoma-like cutaneous lesions. It is a benign condition that is generally asymptomatic. Visceral involvement is uncommon, but when present may occur in various locations and in different combinations. Pulmonary involvement has been reported as bilateral, multiple micro- or macronodular lesions. We present a 10-year-old boy with systemic (skin, lung, liver and kidney) JXG who showed lung involvement with mainly an interstitial pattern. Bilateral multiple micronodules in both lungs and mediastinal adenopathy were also present

STAPHYLOCOCCUS AUREUS: RISK FACTORS FOR ORONASAL TRANSMISSION AND DENTAL ASPECT

Staphylococcus aureus is a major cause of surgical wounds and infections associated with indwelling medical devices; it is found particularly on the nasal membranes and skin. Naso-oral transmission of S. aureus is an important risk factor for development of oral and dental infections. Although prophylactic and postoperative antibiotics are given to patients after oral surgery operations, most strains of S. aureus are reported to be resistant to penicillin. After the 1960s, methicillin was replaced by newer penicillin-type antibiotic that were not affected by beta-lactamase, and the resistant S. aureus strains became known as methicillin resistant S. aureus (MRSA)

An unusual cause of diffuse ascites in an infant: colonic duplication associated with bladder duplication

Colonic duplication is usually asymptomatic; however, when it is symptomatic, patients with this anomaly may present with bleeding, constipation, or manifestations of obstruction, perforation, or malignancy. We report the case of a sixteen-month-old boy who presented with diffuse ascites, and had complete colonic duplication and bladder duplication. Duplication of the colon associated with bladder duplication is a rare entity with only a few cases reported in the medical literature. In addition, it is an extremely rare cause of ascites