Pseudo-achalasia: a complication of laparoscopic adjustable gastric banding

A 49-year-old woman presented with dyspepsia and nocturnal regurgitation. A laparoscopic adjustable gastric binding (LAGB) had been performed 6 years before presentation. An upper gastrointestinal barium contrast study was performed and revealed a marked dilatation and tortuous course of the esophagus as well as absence of peristalsis and delayed evacuation of the esophagus (Fig. A, B). The findings were compatible with an achalasia-like disorder. An esophageal manometry revealed a constant high LES pressure with aperistalsis, thus confirming the diagnosis of (pseudo-)achalasia. Consequently a complete band deflation was conducted and resulted in a complete resolution of the patient’s symptoms. Two weeks later the control contrast study showed a marked improvement of the delayed evacuation and a small regain of peristaltic function. The dilatation and “sigmoidlike” image of the esophagus remained unchanged (Fig. C)

Unexpected pyomyositis of right buttock

A 11-year-old boy was admitted to the emergency department complaining of pain in the right hip, fever and had developed a noticeable limp sinds one week. He had fallen on his buttock in the swimming pool a few weeks before. Physical examination revealed pain at the mobilisation of the right hip, without limitation of movement. The laboratory data showed increased value CRP (154 mg/l) and leukocytosis at 11300 WBC/µl

<i>Ureaplasma urealyticum</i> osteomyelitis of the greater trochanter in a patient with multiple sclerosis using ocrelizumab – a case report

Ocrelizumab – a monoclonal anti-CD20 antibody used in treatment of multiple sclerosis (MS) – marks significant progress in treating autoimmune diseases but raises susceptibility to opportunistic infections due to hypogammaglobulinemia. A young MS patient developed osteomyelitis from persistent Ureaplasma urealyticum urethritis, which was diagnosed with specialized polymerase chain reaction and resolved with targeted antibiotics. A multidisciplinary approach is crucial for managing such infections.</p

Paclitaxel drug-coated balloon angioplasty for the treatment of failing arteriovenous fistulas: a single-center experience

Objectives: To report our experience of angioplasty with Lutonix (Bard Peripheral Vascular, Inc., Tempe, AZ) drug-coated balloon (DCB) for the treatment of failing arteriovenous fistulas (AVF).Materials and methods: Retrospective, single-center analysis consisting of 14 patients treated with Lutonix paclitaxel DCBs in the period from July 2015 through April 2017. We analyzed technical success, clinical success, primary patency of the target lesion, primary patency of the dialysis circuit, and the rate of complications. Regular follow-up of AVF patency was realized by clinical examination and duplex ultrasonography. The Kaplan-Meier survival method was applied to determine the cumulative primary patency of the target lesion and the dialysis circuit.Results: Technical success was 100% and clinical success 92.9%. There were no major or minor complications. Cumulative target lesion primary patency after DCB was 69.2% at 6 months and 31.6% at 12 months. Cumulative vascular circuit primary patency was 61.5% at 6 months and 31.6% at 12 months.Conclusion: Compared to results reported in literature with plain old balloon angioplasty (POBA), Lutonix paclitaxel DCB angioplasty proved a short-term patency benefit in treatment of dialysis AVF stenosis.status: publishe