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Puncture perfusion method was described for elimination of blood and tissue fluid in the scanning electron microscope specimens. It was also demonstrated that the puncture perfusion is of excellent use in cleaning the small samples including the human biopsy samples, which are hardly washed by the vascular cannulation.
The renal pelvis of ten patients with ileal or colonic conduit was punctured with a 22G spinal needle under fluoroscopic guidance. Renal pelvic urine was obtained from nine patients. Two patients temporarily developed gross hematuria as a complication due to this procedure. The obtained renal pelvic urine was investigated bacteriologically. Direct renal pelvic puncture was concluded to be a useful and safe technique for locating urinary tract infection. Reflux of infected urine into the renal pelvis did not occur in any of the nine patients who had no obstruction of the ileal or colonic conduit.
We described a case of spondylodiscitis L3 L4, in a 3 year old child that appeared 3 weeks after a lumbar puncture. The infectious agent responsible wasn't found. The child recovered without sequelae with an antistaphylococcis treatment. The mecanism by inoculation has been described after surgery of the inter-vertebral disc but also after spinal anesthesis. The bone complications of the lumbar puncture are exceptionally rare but elementary aseptic precautions must not be overlooked in order minimise the infection.
Spinal anesthesia is a frequently used technique for surgery of the lower extremities. A complication of this form of regional anesthesia is post-lumbar puncture headache. Rapid diagnosis and treatment are essential in preventing prolonged disability and neurologic sequelae. Two case reports are presented, followed by a review of the literature concerning etiology, diagnosis, and treatment of post-lumbar puncture headache.
With the widespread acceptance of ultrasonography and computed tomography for the evaluation of renal masses, the role of guided renal cyst puncture in the evaluation of a suspected renal cyst has undergone revision in recent years. In this article, the authors review the technique, interpretation, and complications of diagnostic cyst puncture and attempt to define its current diagnostic and therapeutic indications.
This statement for physicians redefines the use and importance of lumbar puncture to suspected stroke mechanisms. It also identifies neurologic conditions in which newer imaging techniques are safer and more effective diagnostic tools than lumbar puncture.
Seventy patients admitted to the Auckland hospitals suffering from acute subarachnoid haemorrhage without major neurological deficits underwent diagnostic lumbar puncture. No patients showed immediate deterioration. Where the clinical indication exists and the circumstances require, lumbar puncture continues to be an appropriate investigation in establishing the diagnosis of subarachnoid haemorrhage.
One case of pyogenic splenic abscess, diagnosed and treated by several ultrasonically guided fine needle punctures, is presented. This noninvasive procedure provided a definitive therapy preserving the spleen. Evacuating fine needle puncture seems to be an alternative therapy of splenic abscess, especially in patients with reduced operability.
Ultrasonically guided puncture of the prostate was carried out in 10 patients with prostatic disease. Biopsy of the aiming portion of the prostate was performed with more certainty and safety by this method than the conventional blind procedure. In the 15 cases having the suspicion of seminal vesicle disorder, the seminal vesicle was punctured under ultrasound control. By this procedure, the seminal vesicle fluid was safely and accurately obtained.
We report on a patient with long-standing sterility, who became pregnant only after laparoscopic puncture of the follicle in spite of all possible diagnostic and therapeutic procedures being applied. The methods so far used for stimulation of ovulation are discussed and the puncture of the ovary is proposed as new possibility in the treatment of sterility.
Pressure resistance of an experimental epidural blood patch was studied in vitro. Pieces of canine lumbar dura were perforated with a 19-gauge needle (n = 12) or a 25-gauge needle (n = 6) and kept between the intercommunicating chambers of a plexiglass apparatus. One chamber (epidural side) was filled with autologous blood and the other chamber (subdural side) was filled with autologous cerebrospinal fluid. Control studies consisted of dural specimens not exposed to blood on the epidural side (19-gauge, n = 8; 25-gauge, n = 4). After 30 min, the dura was removed and placed in saline for inspection. In blood-treated specimens small sheets of coagulated blood were found attached to the epidural side of the dura, and in eight of the twelve of 19-gauge puncture experiments and one of the six of the 25-gauge puncture experiments clotted blood was visible on the subdural side. The dura was then placed back into the chamber for pressure testing 30 min or 16-18 hr later. The subdural chamber was filled with saline and air was left in the epidural chamber. Pressure (1.5, 20, 30, 40, and 50 mm Hg) was applied by injecting additional saline into the subdural chamber. Each pressure level was maintained for 5 min. Saline leaked through the perforation in all control specimens at 1.5 mm Hg pressure. Four blood-treated specimens showed some leakage at 20 mm Hg. All dura specimens perforated with a 19-gauge needle leaked at 40 mm Hg, five of them only at the lowest score rate, 1-4 drops/5 min. One blood-patched dura perforated with a 25-gauge needle did not leak until the pressure reached 50 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)
Seventy five patients referred with a diagnosis of pneumonia underwent transtracheal puncture. In 76% of cases this examination led to discovery of an organism in infected patients. In 50% of cases, the bacteriological diagnosis was sufficiently accurately oriented by direct examination to permit rapid and effective treatment. There was virtually perfect agreement with the results of blood cultures when the latter were positive. The organisms most often responsible were Gram positive and above all the pneumococcus. These results led to narrow spectrum antibiotic treatment appropriate for the organism. This early treatment, based upon the results of tracheal puncture, was associated with a favourable course in 85% of cases, in particular in severely ill patients requiring intubation. No notable complications occurred.
A modified technique of puncture and catheterization of the femoral vessels in children and a detailed description of the stages of the examination are presented. An analysis of 350 angiographies with the use of the modified puncture and catheterization technique in children aged from 1 month to 15 years was carried out. Technical errors were noted in 16 children (4.3%) and complications in 3 (0.85%). The presented observations prove that the given modification of the catheterization technique is not a very traumatic one and allows to avoid many undesirable complications which may arise especially at the stage of mastering the described method.
A new technique for performing and teaching subclavian punctures based on the finding of a new landmark--a small tubercle on the medial aspect of the deltopectoral groove, is presented. This tubercle has been found to be easily palpable on 92% of individuals examined. With this new landmark and the technique described the novice can quickly master this procedure with very little difficulty. The author found that both clinicians inexperienced in subclavian puncture and nursing personnel performed the procedure successfully after the first or second trial.
Three fatal cases of the puncture of the vena subclavia are reported and medicolegal aspects of this emergency operation are discussed. Punctures of the vena subclavia--as an emergency operation--has no contraindications. Undesirable consequences, when the operation was carried out with due skills and in due circumstances--will not provide grounds for negligence.
The complications of angiography, arterial puncture and catheterisation in the context of iatrogenic arterial disease are extremely variable and they are related to the condition of the artery (healthy or pathological), the site of puncture and the type of catheterisation; their clinical manifestations and prognosis are therefore wide ranging. Three types of complications can be distinguished by their high incidence: --complications of the Seldinger method comprising 110 cases between 1967 and 1980; --complications of high translumbar aortography, including one rare complication which should be underlined because of the severity of the prognosis: septic rupture in two observations; --complications of angioplastic dilatation which are now well-recognised. Their character allows precise determination of the indications of this type of therapeutic angiographic procedure: from December 1979 to March 1982, 6 complications observed out of a total of 114 angioplasty performed. The relatively high incidence of iatrogenic complications explains the necessity of early diagnosis, ensuring a good surgical result.
A neonate was noted to have two depressed scars on the upper part of the back at birth that we believe resulted from midtrimester amniocentesis; no underlying injury was apparent. Scar formation from needle puncture occurs in an estimated 1% to 3% of the infants whose mothers have undergone midtrimester diagnostic amniocentesis. The scars most commonly are depressed, dimplelike, and measure 1 to 2 mm in diameter, although linear scarring may also occur. Single or multiple scars may be present, and, in seven of the 36 infants previously described in the literature, internal injuries also occurred as a result of the needle puncture.
Ventricular taps are performed either for diagnostic or for therapeutic purposes. They are not free of risks. A new technique is presented, in which the placement of the needle is echographically monitored. Fifteen punctures were done in five children. All punctures were successful at first attempt, and were uneventful.