Surgical and radiologic anatomy : SRA
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Case Reports
Azygos lobe without azygos vein as a sign of previous iatrogenic pneumothorax: two case reports.
A spontaneous pneumothorax appears to be rarely seen in patients with an azygos lobe, although this normal variant is incidentally found on CT and chest X-ray. The displacement of the azygos vein from the azygos lobe to the paramediastinal position indicates previous pneumothorax. ⋯ Documentation of an azygos lobe without azygos vein is highly suggestive of a previous pneumothorax. This observation may indicate an iatrogenic cause, because of the possible protective effect of an azygos lobe to the occurrence of spontaneous pneumothorax.
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Comparative Study
Comparison of fresh and Thiel's embalmed cadavers according to the suitability for ultrasound-guided regional anesthesia of the cervical region.
Ultrasound-guided punctures are a new technique in anesthesia. However, training in these techniques requires conditions resembling real life as far as possible for learning purposes. Several models are available, but none associates realistic anatomy and lifelike sensations of the passage of fascias. The aim of our study was to compare fresh and Thiel's embalmed cadavers for ultrasound-guided punctures. ⋯ Cadavers embalmed according to Thiel's method should be recommended for ultrasound-guided punctures as a realistic and lifelike model.
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Cricoid pressure occludes the esophagus (E) by compressing it between the cricoid cartilage (CC) and the body of the sixth cervical vertebra (C6). This technique is used to prevent passive regurgitation during the induction of anesthesia in patients at high risk for regurgitation. Failures of this technique had been described and a possible displacement of the E relative to the CC had been reported, but there is no study about displacement during antero-posterior movements of the head. ⋯ In our study, it can be seen that the E is clearly displaced with regard to the CC, that this displacement is favored by extension. Only 2/13 patients have an "over than 3 mm" displacement in extension whereas 5/13 in flexion. So, even if there are more displacements in extension, they are inferior to 3 mm and may not be considered as significant considering the occlusion of E. According to our results, the extension position of the head produces more displacement of the E but should preserve the containment of the cricoid pressure if we consider the thickness of the E wall.
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The aim of this study was to define the sonographic evaluation and morphometric measurements of the suprascapular notch. ⋯ Suprascapular notch measurements and the visualization of the anatomical neighborhood, which may be beneficial for the suprascapular nerve blockade procedure, can be successfully performed by the use of high-frequency ultrasound imaging.
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Cervical disc nucleoplasty is a significant and clinically demonstrated innovation in percutaneous disc decompression in case of non-herniated disc protrusions or prolpase. It allows a percutaneous decompression via a 19-gauge needle under utilization of the Coblation technique and under C-arm control. Until now the patients suffering of a cervicobrachialgia in cause of a disc prolapse had only the therapeutical solution between conservative treatment and monosegmental spondylodesis or disc prosthesis of the mentioned motion segment. ⋯ The percutaneous decompression of the cervical disc protrusion with the Perc DC-Spine Wand by using the Coblation mode is a quick and safe procedure. Furthermore, one may state a persistent pain relief in the follow-up time up to 2 years after the percutaneous decompression of the disc.