Acute or chronic blood loss from pseudoaneurysms of the splanchnic artery in chronic pancreatitis poses diagnostic and management challenges. Arteriographic examination offers both diagnostic and therapeutic options, with success rates of 76%-100% for both modalities. In cases of failure of embolization, repeat embolization is also an option. Surgical intervention is advocated for rebleeding and failure of embolization. Evidence-based guidelines regarding the optimal treatment modality for this condition are lacking. There has been a reported case of dislodgement of coil into the stomach through a gastropseudocystic fistula. We report the case of a migrating steel-wire coil through the gastrointestinal tract and splenic artery pseudoaneurysm. We highlight the potential complications of pseudoaneurysm and other available therapeutic management options.
Calcium sulphate beads are increasingly being used in the management of prosthetic joint infections (PJI). Traditionally their use was limited to a void or dead space-filling combined with other additives such as Hydroxyapatite. Over the last decade, they have been developed to act more frequently as an antibiotics delivery system. Stimulan, a bio-absorbable form of Calcium sulfate, theoretically has an increased risk of hypercalcemia. Over the last few years, there have been published case reports which report it as an isolated cause of iatrogenic hypercalcemia. The sparsity of literature on this topic makes it difficult for surgeons to decide on the use of Calcium sulphate beads in patients with hypercalcemia predisposition in conditions like autoimmune disorders, sarcoidosis, malignancy, granulomatous diseases, heterotopic ossification, and hyperparathyroidism. The study was performed to assess the risk of hypercalcemia in patients after Calcium sulphate beads implantation in PJI. Two reviewers searched relevant literature in 3 online databases using cochrane methodology for systematic reviews. Studies reporting complications with the use of calcium sulphate beads in prosthetic joints were included. Studies reporting on less than five patients and studies reporting use in any other surgeries were excluded. The search of databases resulted in a total of 96 articles. After screening, a total of four articles were deemed suitable to be included in the analysis. A total of 1049 patients underwent calcium sulfate beads implantation, out of which 44 (4.2%) reported hypercalcemia with 41 (3.91%) transient in nature and 3 (0.28%) required management, including one with ICU admission. The result of this systematic review shows that calcium sulphate beads are safe and effective against PJI. There is a significant risk of transient hypercalcemia in susceptible patients and a low risk of symptomatic hypercalcemia.
Background: The kidneys filtration waste and excess water from your blood as urine. CKD when the GFR of the patient less than 15ml/min. ESKD is the final stage of CKD. HD is a common renal replacement therapy for ESRD patients. CKD may have many effects on nervous system and manifest as headache, seizure and DDS etc. Seizure is one of the complication of HD. Seizures are changes in the brain’s electrical activity. The study was conducted to assess the occurrence of seizure in hemodialysis patient and to analyze the possible causes of seizure in renal failure patient during hemodialysis. Methods and Materials: In this cross-sectional study, collected 202 samples for assessing the causes of seizures in patients on HD. In this study the selected ESRD patients with different types of seizures and causes which leads to HAS. To evaluate the occurrence of seizures in hemodialysis patients, individuals were thoroughly examined. Results: Among total of 202 hemodialysis patients, 16 patients were found suffered with seizures. Out of 16 patients, 14 patients were agreed to participate in the current study. The finding of this study showed that there are many causes of HAS but some are the most shown in this study. This study revealed that hypoglycemia, hypocalcemia (hyperparathyroidism), uremic encephalopathy, hyponatremia and use of erythropoietin for the cure of anemia in the dialysis patients are the most common causes of seizures seen. Conclusion: Some neurologic manifestations such as seizure, headache and developmental delay in patients with ESRD are seen. HAS is an important complication of HD. Moreover, treated properly in these cases for decrease of morbidity and mortality and there treatment should be told to medical professionals. Keywords: Hemodialysis, ESRD, Incidence, Seizures
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