Infectious complications of AVG require prompt surgical or radiological intervention to save life or access. The need to excise an infected graft completely is sometimes counterbalanced by the compelling need to provide vascular access for hemodialysis in a patient with limited access options.
Lipoma is a rare cause of ulnar nerve compression in Guyon's canal. All four previously reported cases from 2000 to 2009 have been accurately diagnosed on MRI. We present a case report where the MRI and surgical findings differed and a summary of the previous cases in the literature. We conclude that although MRI remains the best investigation for this condition, it is not always accurate and clinical findings still provide the best basis for surgical treatment.
Introduction: Closuring complex major abdominal hernias risks abdominal compartment syndrome. Components separation (CS) allows midline closure in most cases. This poster outlines our experience including postoperative quality of life (QoL) and the evolution of a triple mesh technique. Method: Retrospective case notes review and structured telephone interview of patients undergoing CS between October 2005 and May 2010 at Derriford Hospital. Results: 50 patients underwent CS; 41 underwent telephone follow-up (82%). Median follow-up was 29 months (range 3.2 -57.6). 29 Patients were men; median age was 60 and BMI 33.8 (range 20-48.1). Wound complications affected 16(38%); the majority settling with conservative management. There was 1 recurrence of original hernia and 2 subsequent parastomal hernias. One patient developed a hernia related to the lateral release. Since developing the triple onlay technique there have been no recurrences. The series has one death related to small bowel ischaemia. 36(88%) of patients reported improved QoL; (95%) were happy to recommend the procedure to a friend. Conclusion: CS is associated with low mortality (2%); minimal long term morbidity and improved QoL. Triple mesh technique results in a low recurrence rate. We recommend CS with a triple onlay mesh for repairing complex major abdominal wall defects.
Endologix, Irvine, Calif) was deployed with adequate overlap with the proximal cuff (Fig, B and C). The patient then underwent laparotomy for an extended left hemicolectomy and transverse colostomy.Results: We noted prompt postoperative improvement in sepsis and hemodynamic status. Serial postoperative imaging up to 9 months has shown near-resolution of periaortic inflammatory changes and widely patent aortic and left renal artery repairs. Suppressive oral antibiotics are maintained.Conclusions: Chimney endovascular aortic repair is a viable option for emergent repair of secondary aortoenteric fistula in a select group of high-risk patients.
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