Removal of partially extruded steel coils.
The authors use a snare for the antegrade extraction of coils which have become partially extruded during therapeutic embolization.
Biomedical subjects
Publications and source records attributed to M Herrera.
The authors use a snare for the antegrade extraction of coils which have become partially extruded during therapeutic embolization.
Recently the technique of percutaneous nephrostomy has been modified to allow the percutaneous extraction of urinary calculi. This communication describes experience with the percutaneous extraction of 63 calculi from the urinary tract. An overall success rate of 87%, a low incidence of complications (about 3%), a fast recovery, and sooner return to work are obtained. Several technical variants including grasping, fragmentation, flushing, and removal under direct vision have been used. In most cases, a combination of the different techniques has to be used in one patient. Essential to the technique is the introduction of large dilators into the kidney.
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Six cases of intramural duodenal hematoma in children less than seven years old are presented. A review of the literature found 143 cases in patients under 15 years. The etiology is traumatic in most cases, although they have also been described in patients with Schönlein-Henoch purpura or coagulation diseases. Contrast X-rays are fundamental elements for diagnosis. The "spring" sign is very valuable. Patients were conservatively treated, although three of them where operated, one for a hepatic rupture and the two other for presumed appendicitis and intussusception respectively. In none was the hematoma drained. Clinical course was excellent and oral tolerance was achieved between three and seven days. Based on this experience and that obtained in the review of the literature, conservative treatment is recommended for intramural duodenal hematomas, when other associated problems needing a laparotomy have been excluded.
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11 cases of retroperitoneal iliac abscesses are reported in patients under seven years of age. Causes have been: sepsis in 2 cases, lumbar traumatism in 1, perforation of the iliac vein in 1, pararenal abscess in 1, following debridement of iliac adenitis in one child and by appendicular mass in another case. The etiology was unknown in the remaining cases. Gram positive germs such as Staphylococcus and Streptococcus predominated in the exudate cultures. The most important clinical manifestations have been: fever, painful mobilization of the psoas, pain in the iliac fossa, limping and antiallergic scoliosis. Among radiological findings obliteration of the psoas line, mass in the iliac fossa, ureteral displacement and vesical compression were the most outstanding. Breathing x-rays and echography were diagnostic procedures in our cases. Diagnosis and differential diagnosis are commented, together with treatment. Authors consider that surgical debridement and drainage and administration of antibiotics are the ideal therapeutical procedures in these processes.
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Thirty one cases of pharyngeal pseudodiverticulum have been reported in the literature; twenty nine were diagnosed during the neonatal period. Respiratory distress, increased oral secretions, difficulty with feeding and the impossibility of passing a nasogastric catheter were the most common symptoms and/or signs. Pneumomediastinum, pneumothorax, cervical emphysema and ectopic location of a feeding catheter, alone or in combination, were identified in the chest roentgenograms of 16 patients. Esophagography and/or endoscopy were the diagnostic methods of choice. The exact location of the perforation was identified in 18 patients. Most of the perforations were in either the posterior pharyngeal wall or in the pyriform sinuses. The survival rate was as good amongst the medically treated patients as in those who underwent surgery.
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