Medicine
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The imaging finding of omental cake has been demonstrated in other modalities, such as computed tomography, magnetic resonance imaging, and ultrasonography. However, to the best of our knowledge, the image presentation of omental cake on a routine kidney-ureter-bladder film has not been reported before in the literature. We presented a unique case of a 61-year-old woman, with known advanced cecal colon mucinous adenocarcinoma, presented to our institution with abdominal fullness, poor appetite, and decreased stool passage for 20 days. ⋯ The imaging finding in plain radiograph corresponds to the findings in other imaging modalities, including abdominal sonography and computed tomography. The patient underwent subtotal colectomy and ileostomy during later courses of chemotherapy due to adhesion ileus and possible intraabdominal abscess, and pathologic study confirmed the diagnosis of cecal mucinous adenocarcinoma and peritoneal carcinomatosis. Although the image finding of omental cake on plain radiograph has never been described, this image finding is unique and should be recognized, as it may suggest the presence of omental cake when first identified in the emergency department from patients with abdominal distension and warrant further evaluation to evaluate the underlying cause.
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Observational Study
Initial and Middle-Term Outcome of Treatment for Spontaneous Isolated Dissection of Superior Mesenteric Artery.
Symptomatic isolated dissection of the superior mesenteric artery (SIDSMA) represents an extremely rare condition. Although various treatments including conservative treatment, endovascular stenting (ES), and surgical repair are currently available, consensus treatment guideline is absent due to scarce of SIDSMA cases. Thus, we present our experience in the treatment of SIDSMA at our single center. ⋯ All patients were free from new aneurysmal formation of SMA and all stents remained patent. For SIDSMA without peritonitis, conservative treatment can be provided with reasonable success rate, while ES may serve as an effective alternative once conservative treatment fails. For SIDSMA with peritonitis, open surgery remains the treatment of choice by resection of necrotic intestine and revasculization.
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Observational Study
Increased Risk of Acute Coronary Syndrome in Patients With Diverticular Disease: A Nationwide Population-Based Study.
Diverticular disease and acute coronary syndrome (ACS) are common disorders that share several risk factors. Few researchers have evaluated the association between diverticular disease and ACS. We aimed to assess the risk of ACS in patients with diverticular disease. ⋯ The adjusted HRs of ACS in patients with diverticular disease additionally increased from 1.97 (95% CI, 1.73-2.23) in patients with 1 comorbidity to 5.51 (95% CI, 3.88-7.84) in those with ≥5 comorbidities. This large population-based retrospective study revealed an association between diverticular disease and ACS. Further research is warranted to determine the exact mechanism of the link between these diseases.
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The aim of this study is to report our 39 patients treated with anterior debridement and autologous iliac bone grafting with or without anterior instrumentation, which is the presumed treatment of choice for thoracic or lumbar spondylodiscitis. Our patients underwent surgical treatment of spondylodiscitis using anterior debridement and autologous iliac bone grafting with or without anterior instrumentation and were analyzed with a mean follow-up of 8 years (range, 2-11 years). Kaneda 2-rod system instrumentation was used in 12 patients, in total. ⋯ Imaging-documented fusion was achieved in 23 of 27 patients in the graft group (85% fusion rate) and 11 of 12 patients in the graft + Kaneda instrumentation group (91% fusion rate). There was no instrumentation failure, loosening, or graft-related complication such as slippage or fracture of the graft. This approach demonstrated a good recovery rate of neurological functions and a high fusion rate.
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The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation. One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. ⋯ Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.