ABSRACTIntramural oesophageal dissection is a rare disorder, caused by the interposition of a divisive force between the mucosal and muscular layers of the oesophagus, leading to their separation. We present a case of intramural oesophageal dissection, secondary to the accidental iatrogenic intramural insertion of a nasogastric tube. We discuss the aetiologies, presentation, investigation and treatment of intramural oesophageal dissection, and make recommendations on the management of suspected oesophageal perforation with prophylactic nasogastric tube insertion. We also discuss other complications associated with nasogastric tube insertion, and how these may be avoided.
Significantly displaced intra-articular glenoid fractures treated nonoperatively have been found to have poor functional outcomes. For this reason, most are treated with open reduction and internal fixation. Conventional open techniques involve extensive exposure and soft tissue dissection. Moreover, visualization of the fracture and its reduction can also be difficult even with standard open techniques. We present a case of an Ideberg type III glenoid fracture treated with an arthroscopically assisted percutaneous screw fixation, using the coracoid as a reduction aide. This reduction technique is not previously reported in the literature. Arthroscopically assisted percutaneous glenoid fixation has showed promising early results in the literature. In our case, the fracture united and the patient returned to all his normal daily activities by 7 weeks postoperatively. This suggests arthroscopically assisted glenoid fixation provides good functional and radiological outcomes, without the need for extensive soft tissue dissection.
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