Pub Date : 2022-05-02DOI: 10.15388/lietchirur.2022.21.60
Gabrielė Launikonytė, Klaudija Korsakaitė, D. Bužinskienė
The purpose of this literature review is to discuss the most effective gestational trophoblastic disease diagnostic and treatment methods. Also, to introduce some of the novel treatment options currently being explored. A comprehensive research was carried out on scientific databases of MEDLINE and PubMed over the time period of 2014 to 2021. According to literature sources initial gestational trophoblastic disease diagnosis is multimodal: encompassing clinical features, quantitative human chorionic gonadotropin titers and pelvic ultrasonography. Pelvic magnetic resonance imaging, body computed tomography, chest radiography and angiography are the methods usually used for overall disease staging and metastases detection. The best treatment method is designated with reference to individual features of the patient and the disease. Conventional treatment consists of hysterectomy and chemotherapy; however, the use of new methods, such as directed enzyme prodrug therapy is also being attempted to cure metastasized and/or resistant gestational trophoblastic neoplasias. Most women with gestational trophoblastic disease can be successfully managed with preservation of reproductive function due to early diagnosis in the first trimester of pregnancy. It is important to identify gestational trophoblastic disease promptly and adjust specific treatment for every patient properly to minimize various complications.
{"title":"Trophoblastic Disease: Review of the Literature","authors":"Gabrielė Launikonytė, Klaudija Korsakaitė, D. Bužinskienė","doi":"10.15388/lietchirur.2022.21.60","DOIUrl":"https://doi.org/10.15388/lietchirur.2022.21.60","url":null,"abstract":"The purpose of this literature review is to discuss the most effective gestational trophoblastic disease diagnostic and treatment methods. Also, to introduce some of the novel treatment options currently being explored. A comprehensive research was carried out on scientific databases of MEDLINE and PubMed over the time period of 2014 to 2021. According to literature sources initial gestational trophoblastic disease diagnosis is multimodal: encompassing clinical features, quantitative human chorionic gonadotropin titers and pelvic ultrasonography. Pelvic magnetic resonance imaging, body computed tomography, chest radiography and angiography are the methods usually used for overall disease staging and metastases detection. The best treatment method is designated with reference to individual features of the patient and the disease. Conventional treatment consists of hysterectomy and chemotherapy; however, the use of new methods, such as directed enzyme prodrug therapy is also being attempted to cure metastasized and/or resistant gestational trophoblastic neoplasias. Most women with gestational trophoblastic disease can be successfully managed with preservation of reproductive function due to early diagnosis in the first trimester of pregnancy. It is important to identify gestational trophoblastic disease promptly and adjust specific treatment for every patient properly to minimize various complications.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47887912","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 : 2022-05-02DOI: 10.15388/lietchirur.2022.21.64
N. Samalavicius
The Lithuanian Society of Coloproctologists X triennial meeting with International Conference Mayo Clinic days in Vilnius, Lithuanian–Turkish session and The International Society of University Colon and Rectal Surgeons Session. Vilnius, May 12 - 13, 2022.
{"title":"Xth Triennial Meeting of the Lithuanian Society of Coloproctologists","authors":"N. Samalavicius","doi":"10.15388/lietchirur.2022.21.64","DOIUrl":"https://doi.org/10.15388/lietchirur.2022.21.64","url":null,"abstract":"The Lithuanian Society of Coloproctologists X triennial meeting with International Conference Mayo Clinic days in Vilnius, Lithuanian–Turkish session and The International Society of University Colon and Rectal Surgeons Session. Vilnius, May 12 - 13, 2022.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46822847","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 : 2022-05-02DOI: 10.15388/lietchirur.2022.21.61
Ye. A. Kvasnevskyi, M. Kashtalian, O. Gerasimenko, Oleksandr A Kvasnevskyi
The purpose of the study. To increase the effectiveness of surgical care for the wounded with combat trauma of the colon by studying of ballistic, morphological and functional features of the gunshot wounds. Patients and methods. A study of surgical treatment of 83 wounded with combat injuries of the colon, received in the area of anti-terrorist operation in the period from 2014–2018. For comparative analysis of treatment results, two clinical groups were formed: comparison and main. The comparison group included 42 wounded who were treated from April 2014 to February 2015 (the first and second periods of ATO), who used traditional surgical tactics. The main group included 41 wounded who were treated from March 2015 to 2018. Results. Analysis of the distribution of wounded with combat trauma by type of wound / injury revealed that the vast majority of them in both groups had shrapnel wounds – 49 (59.1%). There were 30 (36.1%) victims with bullet wounds, and 4 (4.8%) with closed injuries. The wounded patients with the battle trauma of the thick bowel by type of injury had missile wounds as a rule – 49 (59.1%). There were 30 (36.1%) patients with bullet wounds, and 4 (4.8%) with closed injuries. Most of the injuries were combined – 58 (69.9%), and with only abdominal injuries – 25 (30.1%), mostly multiple – 21 (25.3%). The great majority of the thick bowel injuries belonged to sigmoid – 32 (38.6%) and transverse colon – 21 (25.3%), which is explained by relatively large size of these parts of the intestine. Conclusions. The choice of surgical tactics and scope of surgical interventions on damaged organs and structures took into account the results of experimental study of mechanogenesis and pathomorphology of gunshot wounds of the colon, obtained in bench studies by modeling gunshot wounds on “thoracoabdominal ballistic material”.
{"title":"Experimental Study of Action Different Kinetic Energy on the Colon","authors":"Ye. A. Kvasnevskyi, M. Kashtalian, O. Gerasimenko, Oleksandr A Kvasnevskyi","doi":"10.15388/lietchirur.2022.21.61","DOIUrl":"https://doi.org/10.15388/lietchirur.2022.21.61","url":null,"abstract":"The purpose of the study. To increase the effectiveness of surgical care for the wounded with combat trauma of the colon by studying of ballistic, morphological and functional features of the gunshot wounds. Patients and methods. A study of surgical treatment of 83 wounded with combat injuries of the colon, received in the area of anti-terrorist operation in the period from 2014–2018. For comparative analysis of treatment results, two clinical groups were formed: comparison and main. The comparison group included 42 wounded who were treated from April 2014 to February 2015 (the first and second periods of ATO), who used traditional surgical tactics. The main group included 41 wounded who were treated from March 2015 to 2018. Results. Analysis of the distribution of wounded with combat trauma by type of wound / injury revealed that the vast majority of them in both groups had shrapnel wounds – 49 (59.1%). There were 30 (36.1%) victims with bullet wounds, and 4 (4.8%) with closed injuries. The wounded patients with the battle trauma of the thick bowel by type of injury had missile wounds as a rule – 49 (59.1%). There were 30 (36.1%) patients with bullet wounds, and 4 (4.8%) with closed injuries. Most of the injuries were combined – 58 (69.9%), and with only abdominal injuries – 25 (30.1%), mostly multiple – 21 (25.3%). The great majority of the thick bowel injuries belonged to sigmoid – 32 (38.6%) and transverse colon – 21 (25.3%), which is explained by relatively large size of these parts of the intestine. Conclusions. The choice of surgical tactics and scope of surgical interventions on damaged organs and structures took into account the results of experimental study of mechanogenesis and pathomorphology of gunshot wounds of the colon, obtained in bench studies by modeling gunshot wounds on “thoracoabdominal ballistic material”.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48421925","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 : 2022-04-27DOI: 10.15388/lietchirur.2022.21.57
Edvina Januškevičiūtė, Laura Kalakauskaitė, Ž. Visockienė
Background. Bilateral adrenal cortical hyperplasia (ACH) is one of the rare causes of adrenocorticotropic hormone (ACTH)-independent Cushing’s syndrome (CS), where lateralization of cortisol secretion and choice of treatment techniques are challenging. Percutaneous radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for benign and malignant tumors, but it is not commonly used to treat CS in bilateral ACH. Case description. A 79-year-old patient developed ACTH-independent CS with bilateral ACH. Adrenal venous sampling (AVS) showed right sided cortisol hypersecretion. Due to serious comorbidities it was decided to perform percutaneus RFA. The procedure was successful and without any complications. Hydrocortisone replacement therapy was given to manage adrenal insufficiency after the procedure. Conclusions. Percutaneous RFA is an effective minimally invasive procedure for the treatment of cortisol producing adrenal tumors. Reduction of symptoms caused by the disease has been observed after the procedure. It is also expected that hormone deficiency developed after the procedure will be transient.
{"title":"Challenges in Diagnosis and Treatment of Cushing Syndrome in Bilateral Macronodular Adrenal Hyperplasia","authors":"Edvina Januškevičiūtė, Laura Kalakauskaitė, Ž. Visockienė","doi":"10.15388/lietchirur.2022.21.57","DOIUrl":"https://doi.org/10.15388/lietchirur.2022.21.57","url":null,"abstract":"Background. Bilateral adrenal cortical hyperplasia (ACH) is one of the rare causes of adrenocorticotropic hormone (ACTH)-independent Cushing’s syndrome (CS), where lateralization of cortisol secretion and choice of treatment techniques are challenging. Percutaneous radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for benign and malignant tumors, but it is not commonly used to treat CS in bilateral ACH. Case description. A 79-year-old patient developed ACTH-independent CS with bilateral ACH. Adrenal venous sampling (AVS) showed right sided cortisol hypersecretion. Due to serious comorbidities it was decided to perform percutaneus RFA. The procedure was successful and without any complications. Hydrocortisone replacement therapy was given to manage adrenal insufficiency after the procedure. Conclusions. Percutaneous RFA is an effective minimally invasive procedure for the treatment of cortisol producing adrenal tumors. Reduction of symptoms caused by the disease has been observed after the procedure. It is also expected that hormone deficiency developed after the procedure will be transient.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49076145","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 : 2022-04-27DOI: 10.15388/lietchirur.2022.21.59
Rūta Aliulytė, Agnė Kavaliauskaitė, D. Venskutonis
Biliary ascariasis is a pathology caused by roundworms when parasites migrate from the jejunum into the bile ducts manifesting in typical clinical symptoms. Ascaris’ eggs mature in the soil, because of that ascariasis is mostly prevalent in tropical and subtropical regions due to poor hygiene, lack of clean drinking water, the consumption of contaminated food. Diagnosis of biliary ascariasis consists of blood and faecal examination, imaging tests, such as ultrasound, magnetic resonance imaging and endoscopic retrograde cholangiography. In this article, we present the case of a patient with biliary ascariasis, review of the epidemiology, life cycle, causes of the migration into the bile duct, clinical manifestations, diagnostic methods and treatment options.
{"title":"Biliary Ascariasis: Case Report","authors":"Rūta Aliulytė, Agnė Kavaliauskaitė, D. Venskutonis","doi":"10.15388/lietchirur.2022.21.59","DOIUrl":"https://doi.org/10.15388/lietchirur.2022.21.59","url":null,"abstract":"Biliary ascariasis is a pathology caused by roundworms when parasites migrate from the jejunum into the bile ducts manifesting in typical clinical symptoms. Ascaris’ eggs mature in the soil, because of that ascariasis is mostly prevalent in tropical and subtropical regions due to poor hygiene, lack of clean drinking water, the consumption of contaminated food. Diagnosis of biliary ascariasis consists of blood and faecal examination, imaging tests, such as ultrasound, magnetic resonance imaging and endoscopic retrograde cholangiography. In this article, we present the case of a patient with biliary ascariasis, review of the epidemiology, life cycle, causes of the migration into the bile duct, clinical manifestations, diagnostic methods and treatment options.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45946321","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 : 2021-12-30DOI: 10.15388/lietchirur.2021.20.49
Cemal Ulusoy, A. Nikolovski, Giray Yavuz, Tuba Saydam, Ali İlbey
Gastric bezoars are rare but well known intraluminal formations in the gastrointestinal system. Reports for gastric bezoar treatment include dissolution, endoscopic retrieval and surgery (open and laparoscopic). We are presenting a case of 32 years old male patient presented with giant gastric bezoar complicated with large ulcer. The patient was operated laparoscopically with success. Laparoscopic surgery is safe alternative to open surgery for giant gastric bezoars treatment.
{"title":"Laparoscopically Treated Giant Gastric Bezoar Complicated with Large Ulcer in Young Patient","authors":"Cemal Ulusoy, A. Nikolovski, Giray Yavuz, Tuba Saydam, Ali İlbey","doi":"10.15388/lietchirur.2021.20.49","DOIUrl":"https://doi.org/10.15388/lietchirur.2021.20.49","url":null,"abstract":"Gastric bezoars are rare but well known intraluminal formations in the gastrointestinal system. Reports for gastric bezoar treatment include dissolution, endoscopic retrieval and surgery (open and laparoscopic). We are presenting a case of 32 years old male patient presented with giant gastric bezoar complicated with large ulcer. The patient was operated laparoscopically with success. Laparoscopic surgery is safe alternative to open surgery for giant gastric bezoars treatment.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49632519","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 : 2021-12-30DOI: 10.15388/lietchirur.2021.20.46
Ž. Saladžinskas
The origins of higher education in Kaunas began in 1919, during a difficult period for the country, during the struggle for its independence. The young state of Lithuania laid the first foundations of higher education and sought to restore the health care system. The article presents a brief history of the establishment of a higher school in Kaunas, the establishment of higher medical courses and a university. One of the initiators of this work, along with other prominent Lithuanians, was the famous surgeon and public figure at the time Juozas Žemgulys. The emergence of the first departments of surgery at the then University of Lithuania in Kaunas and the beginning of their work is reviewed, the first supervisors Janis Dzirne, Hans Boit, Aleksandr Hagentorn are presented. They significantly contributed to the development of surgery in the country, helped to grow a new generation of Lithuanian surgeons.
{"title":"Welcoming the Centenary of the University of Lithuania in Kaunas: Higher Courses, the Beginning of the Development of Academic Surgery, it’s First Heads","authors":"Ž. Saladžinskas","doi":"10.15388/lietchirur.2021.20.46","DOIUrl":"https://doi.org/10.15388/lietchirur.2021.20.46","url":null,"abstract":"The origins of higher education in Kaunas began in 1919, during a difficult period for the country, during the struggle for its independence. The young state of Lithuania laid the first foundations of higher education and sought to restore the health care system. \u0000The article presents a brief history of the establishment of a higher school in Kaunas, the establishment of higher medical courses and a university. One of the initiators of this work, along with other prominent Lithuanians, was the famous surgeon and public figure at the time Juozas Žemgulys. \u0000The emergence of the first departments of surgery at the then University of Lithuania in Kaunas and the beginning of their work is reviewed, the first supervisors Janis Dzirne, Hans Boit, Aleksandr Hagentorn are presented. They significantly contributed to the development of surgery in the country, helped to grow a new generation of Lithuanian surgeons.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46247674","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 : 2021-12-30DOI: 10.15388/lietchirur.2021.20.47
E. Kildušis, G. Brimas
Background. To review and evaluate the influence of bowel preparation educational methods for colonoscopy used in world practice. Research material and methods. Scientific publications have been searched in PubMed, Cochrane Libraly, Google Scholar and SpringerLink databases since 2011 January 1 until 2020 May 10. The following keywords were used in the search: improving bowel preparation, cleansing, colonoscopy, education, enhanced, method, instruction, intervention, comparison, validated bowel preparation scale, adult participants. The specified inclusion and exclusion criteria were used in the selection of articles, and a detailed analysis of educational methods was performed. Results. This systematic review includes 21 articles, which assesses the various ways in which patients are educated before colonoscopy. The publications are divided into 3 groups: (1) patients in the study group educated in some way are compared with those in the control group who received standard instructions; (2) all patients received standard instructions, and the patients in the study group were additionally educated in some way and compared with the control group; (3) all patients received standard instructions, and patients in the study groups (there was more than one study group) were additionally educated in some way and the study groups were compared with each other. The main comparative results of the used bowel preparation for colonoscopy educational methods are presented. Conclusion. It is necessary to objectively (quantitatively, using standardized scales) evaluate the effectiveness of emerging patient bowel preparation before colonoscopy educational methods, to standardize patient training (education) protocols, so that it is possible to properly compare different forms of education.
{"title":"Influence of Educational Methods on Bowel Preparation for Coloncopy: Systematic Literature Review","authors":"E. Kildušis, G. Brimas","doi":"10.15388/lietchirur.2021.20.47","DOIUrl":"https://doi.org/10.15388/lietchirur.2021.20.47","url":null,"abstract":" Background. To review and evaluate the influence of bowel preparation educational methods for colonoscopy used in world practice. Research material and methods. Scientific publications have been searched in PubMed, Cochrane Libraly, Google Scholar and SpringerLink databases since 2011 January 1 until 2020 May 10. The following keywords were used in the search: improving bowel preparation, cleansing, colonoscopy, education, enhanced, method, instruction, intervention, comparison, validated bowel preparation scale, adult participants. The specified inclusion and exclusion criteria were used in the selection of articles, and a detailed analysis of educational methods was performed. Results. This systematic review includes 21 articles, which assesses the various ways in which patients are educated before colonoscopy. The publications are divided into 3 groups: (1) patients in the study group educated in some way are compared with those in the control group who received standard instructions; (2) all patients received standard instructions, and the patients in the study group were additionally educated in some way and compared with the control group; (3) all patients received standard instructions, and patients in the study groups (there was more than one study group) were additionally educated in some way and the study groups were compared with each other. The main comparative results of the used bowel preparation for colonoscopy educational methods are presented. Conclusion. It is necessary to objectively (quantitatively, using standardized scales) evaluate the effectiveness of emerging patient bowel preparation before colonoscopy educational methods, to standardize patient training (education) protocols, so that it is possible to properly compare different forms of education.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49619387","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 : 2021-12-30DOI: 10.15388/lietchirur.2021.20.48
Lukas Šalaševičius, Nijolė Savičienė, Rasa Alsytė, D. Gasiūnaitė, Giedrius Bernotavičius, O. Lapteva, K. Saniukas, Arūnas Vaitkevičius, R. Kvaščevičius, Vidūnas Daugelavičius, J. Šipylaitė, S. Ročka
Spinal deformity surgery is one of the most challenging surgeries that is only performed by highly professional multidisciplinary team in dedicated spinal centres. In the paper, the authors share and present the algorithm for safe and successful management of complex spinal disorders in Vilnius University Hospital Santaros Clinics.
{"title":"Protocol of Spinal Deformity Surgery and Anaesthesia in Children and Adult: Recommended Preoperative and Perioperative Diagnostic and Treatment Algorithm in Spinal Deformity Surgery","authors":"Lukas Šalaševičius, Nijolė Savičienė, Rasa Alsytė, D. Gasiūnaitė, Giedrius Bernotavičius, O. Lapteva, K. Saniukas, Arūnas Vaitkevičius, R. Kvaščevičius, Vidūnas Daugelavičius, J. Šipylaitė, S. Ročka","doi":"10.15388/lietchirur.2021.20.48","DOIUrl":"https://doi.org/10.15388/lietchirur.2021.20.48","url":null,"abstract":"Spinal deformity surgery is one of the most challenging surgeries that is only performed by highly professional multidisciplinary team in dedicated spinal centres. In the paper, the authors share and present the algorithm for safe and successful management of complex spinal disorders in Vilnius University Hospital Santaros Clinics.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44498119","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 : 2021-12-30DOI: 10.15388/lietchirur.2021.20.50
G. Ledas, D. Jocius, Juozas Jarašūnas, Žymantas Jagelavičius
Computed tomography-guided percutaneous core needle biopsy of the lung is an undoubtedly useful and well-established interventional radiological procedure for the diagnosis of indeterminate pulmonary lesions. Complications of percutaneous core needle biopsy, such as pneumothorax and hemoptysis are considered mild and self-resolving, however systemic air embolism is considered a potentially fatal complication. Systemic air embolism occurs when the air enters a pulmonary vein secondary to a percutaneous CT-guided lung biopsy and is expelled into systemic circulation. Systemic air embolism is extremely rare: incidence of clinically apparent SAE is estimated at 0.061–0.17%, while clinically silent systemic air embolism may be as high as 3.8–4.8%. This study reports a case of air embolism in the cerebral arteries that resulted from a complex CT-guided percutaneous core needle biopsy of the lung. The present case highlights the main mechanisms of this pathology, risk factors, importance of complete thoracic CT after procedure, as well as management of rare complications.
{"title":"Computed Tomography-Guided Percutaneous Lung Biopsy Complicated by Symptomatic Systemic Air Embolism: Case Report and Review of the Literature","authors":"G. Ledas, D. Jocius, Juozas Jarašūnas, Žymantas Jagelavičius","doi":"10.15388/lietchirur.2021.20.50","DOIUrl":"https://doi.org/10.15388/lietchirur.2021.20.50","url":null,"abstract":"Computed tomography-guided percutaneous core needle biopsy of the lung is an undoubtedly useful and well-established interventional radiological procedure for the diagnosis of indeterminate pulmonary lesions. Complications of percutaneous core needle biopsy, such as pneumothorax and hemoptysis are considered mild and self-resolving, however systemic air embolism is considered a potentially fatal complication. Systemic air embolism occurs when the air enters a pulmonary vein secondary to a percutaneous CT-guided lung biopsy and is expelled into systemic circulation. Systemic air embolism is extremely rare: incidence of clinically apparent SAE is estimated at 0.061–0.17%, while clinically silent systemic air embolism may be as high as 3.8–4.8%. This study reports a case of air embolism in the cerebral arteries that resulted from a complex CT-guided percutaneous core needle biopsy of the lung. The present case highlights the main mechanisms of this pathology, risk factors, importance of complete thoracic CT after procedure, as well as management of rare complications.","PeriodicalId":52926,"journal":{"name":"Lietuvos Chirurgija","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47714524","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：