A&A practice
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Case Reports
Anterior Cutaneous Nerve Entrapment Syndrome Caused by a Fixation Device: A Case Report.
Anterior cutaneous nerve entrapment syndrome (ACNES) is characterized by abdominal wall neuralgia. We report an 85-year-old woman with ACNES caused by a fixation device during the bipolar hip arthroplasty. ⋯ A positive Carnett's sign means the abdominal pain originates from the abdominal wall and is useful in diagnosing ACNES. Thus, physicians should examine Carnett's sign to differentiate ACNES in patients with abdominal pain developing after an operation.
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Case Reports
Expiratory Central Airway Collapse and Dynamic Hyperinflation During Peroral Endoscopic Myotomy: A Case Report.
In tracheobronchomalacia, the structural weakening of the airway results in altered ventilatory mechanics. This case report describes a patient with known tracheobronchomalacia who experienced expiratory central airway collapse and dynamic pulmonary hyperinflation during peroral endoscopic myotomy (POEM) to treat symptomatic achalasia. We discuss the physiological considerations and potential complications of a POEM procedure with superimposed tracheobronchomalacia and present perioperative strategies for the prevention and management of this potentially deleterious combination. Although tracheobronchomalacia was a known condition in our patient, it is likely an underdiagnosed condition that may first present intraoperatively.
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Case Reports
Dorsal Root Ganglion Stimulation for the Management of Inflammatory Bowel Disease: A Case Report.
This case report presents the successful use of dorsal root ganglion stimulation (DRGS) in a 30-year-old female patient with Crohn's disease. Despite extensive treatments, the patient experienced chronic abdominal pain, diarrhea, bloating, cramping, fatigue, and other debilitating symptoms. After a successful DRGS trial with leads placed on the right T6 and T10, she was implanted with a permanent system. At 18 months she continues to experience significant improvement in symptoms, including reduced abdominal pain, decreased defecation frequency, better stool consistency, less pain with eating and bowel evacuation, and enhanced quality of life.
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Case Reports
Surgical Repair of Ventricular Septal Defect Following Transcatheter Aortic Valve Implantation: A Case Report.
This case report describes the rare occurrence of a ventricular septal defect (VSD) after transcatheter aortic valve implantation (TAVI) in an 88-year-old male patient with aortic stenosis and other comorbidities. Initially asymptomatic, the patient was discharged but readmitted 2 weeks later with decompensated heart failure. ⋯ A bovine pericardial patch was successfully used for repair. This case highlights the importance of vigilant post-TAVI monitoring and individualized treatment for TAVI-related complications.
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Case Reports
High-Degree Heart Block During Noncardiac Surgery Soon After Transcatheter Aortic Valve Replacement: A Case Report.
Patients undergoing transcatheter aortic valve replacement (TAVR) as a bridge to noncardiac surgery have improved outcomes. Older clinical trials concluded no increased risk of performing noncardiac surgery within 30 days of the TAVR procedure. ⋯ We present a patient who received a TAVR and suffered associated complications during subsequent surgery. We further discuss preventative measures and perioperative considerations for this patient population.