Pub Date : 2024-06-12DOI: 10.15388/lietchirur.2024.23(2).6
Ljubinka Damjanoska Krstikj, Ana Rajkovska Kimovska, Roza Krsteska, Mare Stevkovska
Introduction. Congenital deformities of the outer ear are common; reported incidence are from 1:6000 to 1:6830 newborns. Multitude of corrective procedures are described in the literature. Purpose of the case study. The adequate surgical treatment of the congenital constricted ear remains a challenge. Selected tailor made approach should be employed on case by case basis, thus, in this study we present our case of moderate constricted ear and the used surgical procedures done under general anesthesia, as well as the outcome of the treatment. Case report. A 6 year old girl presented in pediatric and plastic surgery department with complaint of right ear deformity from birth and additional psychological effects such as increased difficulty in social integration and lack of self- confidence. On clinical examination, we considered as constricted ear grade IIB by Tanzel. Two separate procedures under general anesthesia were done. In the first procedure, advancement of the helix and otoplasty was performed; an effective expansion, of about 1 cm in the length of the pinna was obtained. In the second procedure, about 0.5 cm expansion of the helix was performed, and also the breadth of the pinna. Conclusion. In our case, combination of Mustardé suture, helix advancement and helix cartilage graft in moderate constricted ear were a useful surgical option, producing aesthetically good results in a simple and effective way.
{"title":"Correction of Constricted Ear – Case Report","authors":"Ljubinka Damjanoska Krstikj, Ana Rajkovska Kimovska, Roza Krsteska, Mare Stevkovska","doi":"10.15388/lietchirur.2024.23(2).6","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(2).6","url":null,"abstract":"Introduction. Congenital deformities of the outer ear are common; reported incidence are from 1:6000 to 1:6830 newborns. Multitude of corrective procedures are described in the literature. Purpose of the case study. The adequate surgical treatment of the congenital constricted ear remains a challenge. Selected tailor made approach should be employed on case by case basis, thus, in this study we present our case of moderate constricted ear and the used surgical procedures done under general anesthesia, as well as the outcome of the treatment. Case report. A 6 year old girl presented in pediatric and plastic surgery department with complaint of right ear deformity from birth and additional psychological effects such as increased difficulty in social integration and lack of self- confidence. On clinical examination, we considered as constricted ear grade IIB by Tanzel. Two separate procedures under general anesthesia were done. In the first procedure, advancement of the helix and otoplasty was performed; an effective expansion, of about 1 cm in the length of the pinna was obtained. In the second procedure, about 0.5 cm expansion of the helix was performed, and also the breadth of the pinna. Conclusion. In our case, combination of Mustardé suture, helix advancement and helix cartilage graft in moderate constricted ear were a useful surgical option, producing aesthetically good results in a simple and effective way.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"24 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.15388/lietchirur.2024.23(2).4
E. Kildušis, G. Brimas
Objective. Adequate bowel preparation is essential for diagnostic, screening, surveillance, and therapeutic colonoscopy. 3D virtual reality (3D-VR) has the characteristics of depth, interactivity and visuality and is widely used in medicine, so it can be used for patient education and training. The aim of our study is to determine the impact of using 3D virtual reality video for patients education on bowel preparation before colonoscopy. Materials and methods. A prospective, blind, randomized clinical trial was launched at the Republican Vilnius University Hospital (RVUL) on 07.03.2021, which included 50 outpatients who had indications for colonoscopy until 28.02.2022. Patients were randomly assigned to control and experimental groups. The first group was given the bowel preparation information in the standard form used by RVUL – in writing, and the second – in a 3D virtual reality video. The content of the information provided to both groups was the same. The quality of bowel preparation was assessed based on the Boston and Ottawa bowel preparation scales. Results. Of the 50 outpatients who participated in the study, 26 were assigned to the control group, 24 to the study group. The patients of both groups were identical in terms of sex, age, body mass index, comorbidities. The mean (SD) BBPS score was statistically significantly lower in the control group compared to the 3D-VR video group (5.96(±1) vs. 7.58(±1.47); p < 0.001). The mean (SD) scores of OBPS were higher in the control group (6.58(±2.44) than in the study group 1.83(±2.32); p < 0.001). The rate of adequate bowel preparation in the 3D-VR video group was higher than in the control group (18(69.23%) vs. 23(95.83%); the difference was statistically significant (p = 0.024)). The rate of terminal ileum intubation in the control group was 50% compared to 83.33% in the 3D-VR video group (p = 0.02).The mean (SD) colonoscopy time was statistically significantly shorter in the 3D-VR video group 23.04(±3.66) minutes and 16.5(±4.28) minutes, p = <0.001. Conclusions. Patients who were informed by 3D-VR method before colonoscopy had statistically significantly better bowel preparation, as well as reduced procedure time and possibly increased detection rates of polyps and adenomas.
{"title":"The Impact of an Educational 3D Virtual Reality Video Method on Bowel Preparation for Colonoscopy: First Results","authors":"E. Kildušis, G. Brimas","doi":"10.15388/lietchirur.2024.23(2).4","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(2).4","url":null,"abstract":"Objective. Adequate bowel preparation is essential for diagnostic, screening, surveillance, and therapeutic colonoscopy. 3D virtual reality (3D-VR) has the characteristics of depth, interactivity and visuality and is widely used in medicine, so it can be used for patient education and training. The aim of our study is to determine the impact of using 3D virtual reality video for patients education on bowel preparation before colonoscopy. Materials and methods. A prospective, blind, randomized clinical trial was launched at the Republican Vilnius University Hospital (RVUL) on 07.03.2021, which included 50 outpatients who had indications for colonoscopy until 28.02.2022. Patients were randomly assigned to control and experimental groups. The first group was given the bowel preparation information in the standard form used by RVUL – in writing, and the second – in a 3D virtual reality video. The content of the information provided to both groups was the same. The quality of bowel preparation was assessed based on the Boston and Ottawa bowel preparation scales. Results. Of the 50 outpatients who participated in the study, 26 were assigned to the control group, 24 to the study group. The patients of both groups were identical in terms of sex, age, body mass index, comorbidities. The mean (SD) BBPS score was statistically significantly lower in the control group compared to the 3D-VR video group (5.96(±1) vs. 7.58(±1.47); p < 0.001). The mean (SD) scores of OBPS were higher in the control group (6.58(±2.44) than in the study group 1.83(±2.32); p < 0.001). The rate of adequate bowel preparation in the 3D-VR video group was higher than in the control group (18(69.23%) vs. 23(95.83%); the difference was statistically significant (p = 0.024)). The rate of terminal ileum intubation in the control group was 50% compared to 83.33% in the 3D-VR video group (p = 0.02).The mean (SD) colonoscopy time was statistically significantly shorter in the 3D-VR video group 23.04(±3.66) minutes and 16.5(±4.28) minutes, p = <0.001. Conclusions. Patients who were informed by 3D-VR method before colonoscopy had statistically significantly better bowel preparation, as well as reduced procedure time and possibly increased detection rates of polyps and adenomas.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"104 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.15388/lietchirur.2024.23(2).5
Cenk Ozkan, Serhan Yilmaz, Osman Sibic
The epigastric hernia sac usually contains preperitoneal fat tissue, omentum, and intestines, but the presence of liver tissue is extremely rare. Epigastric hernia is a type of hernia in the midline of the abdominal wall between the umbilicus and the xiphoid process. It may be asymptomatic in some patients and cause complaints such as pain and nausea in most patients, but serious complications such as incarceration and strangulation are rare. In the present case, a 74-year-old woman was examined and found to have an irreduced omentum, transverse colon and liver tissue inside the hernia sac. She underwent an open procedure with onlay mesh-assisted hernia repair. Rare but serious complications, such as liver tissue incarceration, should be considered in epigastric hernia patients.
{"title":"Incarcereted Epigastric Hernia with Liver Content: a Case Report","authors":"Cenk Ozkan, Serhan Yilmaz, Osman Sibic","doi":"10.15388/lietchirur.2024.23(2).5","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(2).5","url":null,"abstract":"The epigastric hernia sac usually contains preperitoneal fat tissue, omentum, and intestines, but the presence of liver tissue is extremely rare. Epigastric hernia is a type of hernia in the midline of the abdominal wall between the umbilicus and the xiphoid process. It may be asymptomatic in some patients and cause complaints such as pain and nausea in most patients, but serious complications such as incarceration and strangulation are rare. In the present case, a 74-year-old woman was examined and found to have an irreduced omentum, transverse colon and liver tissue inside the hernia sac. She underwent an open procedure with onlay mesh-assisted hernia repair. Rare but serious complications, such as liver tissue incarceration, should be considered in epigastric hernia patients.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"36 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-12DOI: 10.15388/lietchirur.2024.23(2).3
Amjaad Alkhezzi, S. Salati, Lamees AlSulaim, Mohammad Ahmed Elmuttalut, Yasir Ahmed Alsalamah
Giant gallstones are rare occurrences and measure 5 cm in any one dimension. They present unique set of features and complications. Due to their rarity, we conducted this systematic review to investigate the profile of patients with giant gallstones applying seven variables. For this study, we used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After an initial search of 111 peer reviewed articles from reliable sources, we included 29 articles for this study enrolling 30 patients with mean age of 66.7 years. Majority (97%) were symptomatic, reporting with cholecysto-enteric fistula/gallstone ileus (33%), acute cholecystitis (30%) and chronic dyspepsia (24%). The management options adopted included open cholecystectomy (48%), laparoscopic cholecystectomy (33%), endoscopic lithotripsy (6%) and conservative management (6%).
{"title":"Giant Gallstones – a Systematic Review","authors":"Amjaad Alkhezzi, S. Salati, Lamees AlSulaim, Mohammad Ahmed Elmuttalut, Yasir Ahmed Alsalamah","doi":"10.15388/lietchirur.2024.23(2).3","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(2).3","url":null,"abstract":"Giant gallstones are rare occurrences and measure 5 cm in any one dimension. They present unique set of features and complications. Due to their rarity, we conducted this systematic review to investigate the profile of patients with giant gallstones applying seven variables. For this study, we used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After an initial search of 111 peer reviewed articles from reliable sources, we included 29 articles for this study enrolling 30 patients with mean age of 66.7 years. Majority (97%) were symptomatic, reporting with cholecysto-enteric fistula/gallstone ileus (33%), acute cholecystitis (30%) and chronic dyspepsia (24%). The management options adopted included open cholecystectomy (48%), laparoscopic cholecystectomy (33%), endoscopic lithotripsy (6%) and conservative management (6%).","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"21 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141354310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Colorectal cancer (CRC) ranks as the third leading cause of cancerrelated mortality worldwide. Recent years have witnessed an increase in the incidence of CRC. The main reasons are ageing population, increased consumption of processed food, obesity, genetic predispositions. Aim. To review the latest scientific developments and novel factors on the epidemiology, etiology, pathogenesis of colon cancer, focusing on the influence of genetics and epigenetics, risk factors, and the advancement of prevention and treatment methods. Material and methods. The research method is a literature review. Publications were searched in the PubMed database using the following keywords and their combinations in English: colon cancer, colorectal cancer, management, prevalence, causes, risk factors, genetic and epigenetic changes. Selection criteria for publications: scientific articles in English relevant to the research topic and 90% of articles published in the last 10 years (2014–2024). Results. Using theoretical analysis methods, 72 publications were selected that met the inclusion criteria. Our findings emphasize the central role of genetic mutations (particularly in APC, TP53, KRAS and MMR) and epigenetic alterations, such as DNA methylation and histone modification, in the pathogenesis of colorectal cancer. These genetic and epigenetic factors drive the progression from benign polyps to malignant carcinomas, with environmental, lifestyle, and chronic disease factors also playing a critical role. In particular, diet, physical inactivity, smoking and alcohol significantly increase risk, especially in men and those over 50. Innovations such as CRISPR/Cas9 offer new avenues for targeted treatments, while advances in vaccines and liquid biopsy techniques are improving immune response activation and disease monitoring. In addition, diets rich in fiber, antioxidants and healthy fats, as well as the use of probiotics and NSAIDs, are key to reducing cancer risk through their anti-inflammatory effects and promoting gut health. Conclussions. This review highlights the significant impact of genetic and epigenetic factors on colorectal cancer (CRC) development, in addition to the role of lifestyle and environmental exposures. It highlights the potential of CRISPR/Cas9, immunotherapies, and liquid biopsies in pioneering personalized CRC treatments and early detection. Advances in prevention and technology promise a new era of personalized, effective CRC management strategies.
{"title":"Colon Cancer Genetic and Epigenetic Changes, Etiopathogenesis, Risk Factors, Treatment: Literature Review","authors":"Gabrielė Ūbaitė, Aurelija Remeikaitė, Justas Žilinskas","doi":"10.15388/lietchirur.2024.23(2).2","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(2).2","url":null,"abstract":"Background. Colorectal cancer (CRC) ranks as the third leading cause of cancerrelated mortality worldwide. Recent years have witnessed an increase in the incidence of CRC. The main reasons are ageing population, increased consumption of processed food, obesity, genetic predispositions. Aim. To review the latest scientific developments and novel factors on the epidemiology, etiology, pathogenesis of colon cancer, focusing on the influence of genetics and epigenetics, risk factors, and the advancement of prevention and treatment methods. Material and methods. The research method is a literature review. Publications were searched in the PubMed database using the following keywords and their combinations in English: colon cancer, colorectal cancer, management, prevalence, causes, risk factors, genetic and epigenetic changes. Selection criteria for publications: scientific articles in English relevant to the research topic and 90% of articles published in the last 10 years (2014–2024). Results. Using theoretical analysis methods, 72 publications were selected that met the inclusion criteria. Our findings emphasize the central role of genetic mutations (particularly in APC, TP53, KRAS and MMR) and epigenetic alterations, such as DNA methylation and histone modification, in the pathogenesis of colorectal cancer. These genetic and epigenetic factors drive the progression from benign polyps to malignant carcinomas, with environmental, lifestyle, and chronic disease factors also playing a critical role. In particular, diet, physical inactivity, smoking and alcohol significantly increase risk, especially in men and those over 50. Innovations such as CRISPR/Cas9 offer new avenues for targeted treatments, while advances in vaccines and liquid biopsy techniques are improving immune response activation and disease monitoring. In addition, diets rich in fiber, antioxidants and healthy fats, as well as the use of probiotics and NSAIDs, are key to reducing cancer risk through their anti-inflammatory effects and promoting gut health. Conclussions. This review highlights the significant impact of genetic and epigenetic factors on colorectal cancer (CRC) development, in addition to the role of lifestyle and environmental exposures. It highlights the potential of CRISPR/Cas9, immunotherapies, and liquid biopsies in pioneering personalized CRC treatments and early detection. Advances in prevention and technology promise a new era of personalized, effective CRC management strategies.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"141 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141351112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.15388/lietchirur.2024.23(1).4
A. Mitevski, Vladko Cvetanovski, Petar Markov, I. Milev
Introduction. Surgeons, using all available means for the treatment of the hemorrhoidal disease, must make compromises between the radicality of the potential surgical treatment (to prevent recurrence) and the maintenance of the postoperative functionality of the anorectum (avoiding stricture, anal fissures, incontinence, reduction of postoperative pain etc.). Materials and methods. All patients treated with the THD method using a system manufactured by THD S.p.A., Correggio, Italy, consisting of a proctoscope equipped with a Doppler probe and a light source was used to perform the operation. Results. Out of 100 operated patients, 64 (64%) were men and 36 (36%) were women. 54 patients had third degree hemorrhoidal disease, 32 had fourth degree, 7 patients had fourth degree hemorrhoidal disease with active bleeding and 7 patients had second degree hemorrhoidal disease with active bleeding. In the follow-up period, anal fissure formation in two patients and prolapse of a hemorrhoidal node in a treated patient with fourth-degree hemorrhoidal disease were noted. Discussion. It is estimated that more than 50% of the general population will experience at least one episode of symptomatic hemorrhoids during their lifetime. Morphological and hemodynamic changes that occur in patients with hemorrhoidal disease is the finding of an increased diameter of the terminal branches of the superior rectal artery that supplies the hemorrhoidal nodes. These branches are 10–11 in number, of which ligation of up to six is allowed for effective treatment with the THD method. Conclusion. If the THD technique is used according to the established standards, postoperative complications in patients in the form of fecal incontinence and chronic pain have not been described, which is also confirmed in our series. The absence of serious complications while addressing a hemorrhoidal disease at the level of the cause of its occurrence, makes the THD+mucopexy technique applicable in most cases. Correct manipulation of the instruments, precision in dearterization, mucopexy of the rectal mucosa and submucosa are imperative for achieving excellent results.
{"title":"Transanal Hemorrhoidal Dearterialization (THD): A Single Center Experience on 100 Consecutive Cases","authors":"A. Mitevski, Vladko Cvetanovski, Petar Markov, I. Milev","doi":"10.15388/lietchirur.2024.23(1).4","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(1).4","url":null,"abstract":"Introduction. Surgeons, using all available means for the treatment of the hemorrhoidal disease, must make compromises between the radicality of the potential surgical treatment (to prevent recurrence) and the maintenance of the postoperative functionality of the anorectum (avoiding stricture, anal fissures, incontinence, reduction of postoperative pain etc.). Materials and methods. All patients treated with the THD method using a system manufactured by THD S.p.A., Correggio, Italy, consisting of a proctoscope equipped with a Doppler probe and a light source was used to perform the operation. Results. Out of 100 operated patients, 64 (64%) were men and 36 (36%) were women. 54 patients had third degree hemorrhoidal disease, 32 had fourth degree, 7 patients had fourth degree hemorrhoidal disease with active bleeding and 7 patients had second degree hemorrhoidal disease with active bleeding. In the follow-up period, anal fissure formation in two patients and prolapse of a hemorrhoidal node in a treated patient with fourth-degree hemorrhoidal disease were noted. Discussion. It is estimated that more than 50% of the general population will experience at least one episode of symptomatic hemorrhoids during their lifetime. Morphological and hemodynamic changes that occur in patients with hemorrhoidal disease is the finding of an increased diameter of the terminal branches of the superior rectal artery that supplies the hemorrhoidal nodes. These branches are 10–11 in number, of which ligation of up to six is allowed for effective treatment with the THD method. Conclusion. If the THD technique is used according to the established standards, postoperative complications in patients in the form of fecal incontinence and chronic pain have not been described, which is also confirmed in our series. The absence of serious complications while addressing a hemorrhoidal disease at the level of the cause of its occurrence, makes the THD+mucopexy technique applicable in most cases. Correct manipulation of the instruments, precision in dearterization, mucopexy of the rectal mucosa and submucosa are imperative for achieving excellent results.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"55 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140258416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.15388/lietchirur.2024.23(1).8
Kipras Sasnauskas, Robert Vrublevski, Povilas Masionis, Sigitas Ryliškis
Intrathoracic displacement of the humeral head is rarely documented due to high mortality of the trauma. As a result, there is no clear consensus about how such case should be approached. In this report we reviewed our successful case, and reviewed the literature. The patient arrived after car accident with a broken humerus and upon taking X-ray found to have the humeral head lodged in the chest cavity. After humeral head removal and arthroplasty, patient was discharged without complications. In literature several cases were found in which a patient usually suffers because of high energy trauma with arm typically in abducted position. In all cases treatment involves removing humeral fragment from chest and prosthetic arthroplasty of the glenohumeral joint. Although some authors suggest leaving humeral fragment in some cases while others suggest to always remove. Exact indications of such decision are unclear. Cases like this pose a high risk of neurological and circulatory complications, although no complications were observed in this case. Nevertheless, there have been too few similar cases described to establish a proper methodology.
肱骨头胸内移位的病例很少见，因为这种创伤的死亡率很高。因此，对于如何处理此类病例还没有明确的共识。在本报告中，我们回顾了自己的成功病例，并查阅了相关文献。患者因车祸导致肱骨骨折，在接受 X 光检查时发现肱骨头卡在胸腔内。切除肱骨头并进行关节置换术后，患者无并发症出院。在文献中发现了一些病例，患者通常因高能量创伤而导致手臂外展。在所有病例中，治疗方法都包括从胸腔中取出肱骨碎块，并对盂肱关节进行人工关节置换。尽管有些作者建议在某些病例中保留肱骨碎片，但也有一些作者建议始终切除肱骨碎片。这种决定的确切指征尚不明确。此类病例极易引发神经系统和循环系统并发症，但在本病例中并未观察到并发症。尽管如此，类似病例的描述还是太少，因此无法确定正确的方法。
{"title":"Intratorakalinis žastikaulio galvos išnirimas, esant politraumai: klinikinio atvejo aprašymas","authors":"Kipras Sasnauskas, Robert Vrublevski, Povilas Masionis, Sigitas Ryliškis","doi":"10.15388/lietchirur.2024.23(1).8","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(1).8","url":null,"abstract":"Intrathoracic displacement of the humeral head is rarely documented due to high mortality of the trauma. As a result, there is no clear consensus about how such case should be approached. In this report we reviewed our successful case, and reviewed the literature. The patient arrived after car accident with a broken humerus and upon taking X-ray found to have the humeral head lodged in the chest cavity. After humeral head removal and arthroplasty, patient was discharged without complications. In literature several cases were found in which a patient usually suffers because of high energy trauma with arm typically in abducted position. In all cases treatment involves removing humeral fragment from chest and prosthetic arthroplasty of the glenohumeral joint. Although some authors suggest leaving humeral fragment in some cases while others suggest to always remove. Exact indications of such decision are unclear. Cases like this pose a high risk of neurological and circulatory complications, although no complications were observed in this case. Nevertheless, there have been too few similar cases described to establish a proper methodology.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"52 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140259023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.15388/lietchirur.2024.23(1).5
Tomas Mačiulaitis, Aira Jucaityte, Mindaugas Minderis
Cheiralgia paresthetica (CP) is a distinctive clinical condition arising from the compression of the superficial branch of the radial nerve (SBR). Typically, CP manifests as a burning-type pain in the dorsal and radial aspect of the hand. Existing literature highlight various etiological factors contributing to this condition, including constriction of the wrist, as with tight wristwatches or handcuffs. Symptoms may also arise from blunt traumas, distal radius fractures, and iatrogenic causes. However, CP induced by a lipoma is an exceptionally rare phenomenon. In this context, we present a case exemplifying the diagnosis and management of lipoma-induced CP.
{"title":"Neįprastas klinikinis atvejis: lipomos sąlygota Cheiralgia paresthetica","authors":"Tomas Mačiulaitis, Aira Jucaityte, Mindaugas Minderis","doi":"10.15388/lietchirur.2024.23(1).5","DOIUrl":"https://doi.org/10.15388/lietchirur.2024.23(1).5","url":null,"abstract":"Cheiralgia paresthetica (CP) is a distinctive clinical condition arising from the compression of the superficial branch of the radial nerve (SBR). Typically, CP manifests as a burning-type pain in the dorsal and radial aspect of the hand. Existing literature highlight various etiological factors contributing to this condition, including constriction of the wrist, as with tight wristwatches or handcuffs. Symptoms may also arise from blunt traumas, distal radius fractures, and iatrogenic causes. However, CP induced by a lipoma is an exceptionally rare phenomenon. In this context, we present a case exemplifying the diagnosis and management of lipoma-induced CP.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"36 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140259619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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