Isolated Post-Shunt Metopic Synostosis and Neural Tube Defects.
Arnold-Chiari Malformation/complications/*surgery; Craniosynostoses/*etiology; Female; Humans; Hydrocephalus/complications/congenital/*surgery; Infant; Meningomyelocele/complications/*surgery; Newborn; Postoperative Complications/*etiology; Slit Ventricle Syndrome/etiology; Third Ventricle; Ventriculoperitoneal Shunt/*adverse effects
BACKGROUND: Craniosynostosis is an uncommon complication after shunting procedures for congenital hydrocephalus. We report a case of a child with myelomeningocele and normocephaly at the time of birth. She underwent ventricular shunting for Chiari malformation and hydrocephalus at 3 days of age. An immediate postoperative CT scan confirmed all sutures were open. Serial CT scans document an open metopic suture at 2 months, closed metopic suture at 5 months, and trigonocephaly at 11 months with concomitant slit ventricle syndrome, and collapsed lateral and third ventricles. METHODS: An Ovid MEDLINE search within the dates of 1948 through 2017, using the keywords "synostosis AND shunt" was carried out. A tabulation of all patients and their respective synostosis patterns were recorded. RESULTS: We identified 8 case series and 2 case reports during 43 years (1966-2017). Seventy-eight patients with 79 suture synostosis patterns were identified (one patient underwent a second cranial reconstruction for identification of a separate, newly formed synostosis). Eighteen (30.5%) cases were associated with a neural tube defect (NTD). Patients with NTD and secondary craniosynostosis had on average earlier age of shunt placement (P = 0.001), craniosynostosis presentation (P = 0.146), and cranioplasty (P = 0.325) than secondary craniosynostosis patients without NTD. CONCLUSIONS: Ventricular shunt drainage in treating hydrocephalus rarely may lead to early synostosis and cranial deformity, especially in patients with NTDs. Early shunt placement poses significant risk in patients with NTD. Close follow-up may be necessary to evaluate overdrainage and cranial deformity after shunting procedures.
Abouhassan William; Chao John Kuang; Murthy Ananth S
The Journal of craniofacial surgery
2018
2018-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/SCS.0000000000004507" target="_blank" rel="noreferrer noopener">10.1097/SCS.0000000000004507</a>
The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture.
Humans; Incidence; Postoperative Complications/*etiology; *carpal tunnel; *CRPS; *Dupuytren contracture; Carpal Tunnel Syndrome/complications/*surgery; Complex Regional Pain Syndromes/*etiology; Dupuytren Contracture/complications/*surgery; Fasciotomy
BACKGROUND: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. METHODS: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Of the literature reviewed, only 4 studies met the defined criteria for use in the study. Data from the 4 studies were pooled, and the incidence of recurrence and complications, specifically CRPS, was noted. RESULTS: The rate of CRPS was found to be 10.4% in the simultaneous treatment group versus 4.1% in the fasciectomy-only group. This rate is nearly half the 8.3% rate of CRPS found in a randomized trial of patients undergoing carpal tunnel release. CONCLUSIONS: Our analysis demonstrates a marginal increase in the occurrence of CRPS by adding the carpal tunnel release to patients in need of fasciectomy, contradicting the original reports demonstrating a much higher rate of CRPS. This indicates that no clear clinical risk is associated with simultaneous surgical treatment of DC and CTS. In some patients, simultaneous surgical management of DC and CTS can be accomplished safely with minimal increased risk of CRPS type 1.
Buller Mitchell; Schulz Steven; Kasdan Morton; Wilhelmi Bradon J
Hand (New York, N.Y.)
2018
2018-07
<a href="http://doi.org/10.1177/1558944717718345" target="_blank" rel="noreferrer noopener">10.1177/1558944717718345</a>
Entero mesh vaginal fistula secondary to abdominal sacral colpopexy.
*Surgical Mesh; Abdomen; Female; Gynecologic Surgical Procedures; Humans; Intestinal Fistula/*etiology; Intestine; Middle Aged; Postoperative Complications/*etiology; Sacrum; Small; Uterine Prolapse/surgery; Vaginal Fistula/*etiology
BACKGROUND: Abdominal sacral colpopexy is a popular method for resupporting the vaginal apex. Bleeding and infection are the most common complications. We report a complication resulting in a small bowel fistula. CASE: A 48-year-old woman developed a chronic vaginal discharge 4-6 months after routine abdominal sacral colpopexy in which a velour mesh remained exposed in the pelvis. Conservative measures failed to control the intermittent copious discharge from the upper vaginal vault where the mesh was visualized. At laparotomy, an entero mesh vaginal fistula was discovered. Excellent long-term results were obtained by removal of the mesh along with resection of the involved small intestine. CONCLUSION: At the time of abdominal sacral colpopexy, we recommend that mesh not remain exposed in the pelvis.
Hopkins Michael P; Rooney Christopher
Obstetrics and gynecology
2004
2004-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/01.AOG.0000127940.45774.b4" target="_blank" rel="noreferrer noopener">10.1097/01.AOG.0000127940.45774.b4</a>
Discussion: Use of Acellular Dermal Matrix in Postmastectomy Breast Reconstruction: Are All Acellular Dermal Matrices Created Equal?
*Acellular Dermis; *Collagen; Breast Implantation/*methods; Female; Humans; Postoperative Complications/*etiology
Wagner Douglas S
Plastic and reconstructive surgery
2015
2015-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/PRS.0000000000001625" target="_blank" rel="noreferrer noopener">10.1097/PRS.0000000000001625</a>