Complications of extracorporeal shock-wave lithotripsy are rare, with an incidence of symptomatic perinephric hematoma ranging from 0.2% to 0.66%. A 59-year-old man had massive symptomatic retroperitoneal and intra-abdominal bleeding 24 hours after lithotripsy. The hemorrhage was managed successfully by conservative measures, which consisted of packed red blood cells and fresh ...

Subcutaneous emphysema is an unusual complication of bronchiolitis. The investigators describe a patient with bronchiolitis who developed extensive subcutaneous emphysema. Despite an alarming appearance, the patient recovered with symptomatic care and observation. Review of the literature shows a multitude of causes of subcutaneous emphysema. The vast majority of cases resolve ...

Coumadin is a coumarin anticoagulant that induces a state similar to vitamin K deficiency and is routinely used for chronic oral anticoagulation. Intramural hematoma of the bowel is a rare complication of anticoagulant therapy. In this paper, we describe such a case of an anticoagulated patient who had complaints of ...

The nonsurgical approach for the management of blunt hepatic injuries is appropriate for a select subset of patients. An acceptable number of complications of the biliary tract and intraparenchymal hematomas have been reported. Delayed hepatic hemorrhage has been described, however, scant data are available in the literature to dictate management ...

A case of volvulus of a Roux-en-Y hepaticojejunostomy causing recurrent ascending cholangitis is reported. This rare complication of biliary reconstruction was diagnosed preoperatively by percutaneous transhepatic cholangiogram, and successfully treated by resection of the involved segment. The impaired myoelectric activity of the isolated Roux limb may contribute to this pathology.

A severe case of separation of the symphysis pubis during labor and delivery is reported, which included severe pain and unusual complications of urinary outflow incontinence and fecal incontinence that gradually resolved with conservative treatment. The incidence of symphysis pubis separation is reported to be between 1:600 and 1:3400 obstetric ...

Serious diagnostic and therapeutic dilemmas may arise when preeclampsia complicates pregnancy in a myasthenic patient. Four cases of such an association were previously reported in the English-language medical literature and the fifth one is reported here. Based on the literature review and our own case, the problems that may arise ...

BACKGROUND AND OBJECTIVES: Local, not systemic, complications associated with intravenous regional sympathetic block (IVRS) are very rare. The authors report the complication that occurred in a 70-year-old man who sustained an injury of the left thumb. METHODS: The second IVRS using reserpine and lidocaine, 1 week after the first IVRS, ...

Pneumothorax is a rare complication of pneumoperitoneum. We report a case of spontaneous bilateral pneumothorax during laparoscopic cholecystectomy. The history, pathogenesis, and therapeutic options of this unusual occurrence are discussed. Because laparoscopic operations have become increasingly popular in recent years, we call attention to this rare but potentially life-threatening complication.

Large or impacted bile duct stones can be difficult to manage with endoscopic and laparoscopic techniques. Electrohydraulic lithotripsy (EHL) seems to be ideally suited for these difficult cases. We report our experience and review the literature. Adjunctive use of EHL was attempted in seven patients with complicated stones. In six, ...

Penile prostheses are a well-established form of therapy for erectile dysfunction. We report our experience with 333 cases using the Mentor Alpha I inflatable penile prosthesis. With a follow-up period of 15.4 months, there were 25 (7.5%) complications with 15 (4.5%) major complications that required reoperation. We also review the ...

The transconjunctival approach to lower eyelid blepharoplasty is becoming increasingly popular. From 200 transconjunctival blepharoplasties performed between 1984 and 1991, 40 randomly selected cases were reviewed to identify the complications associated with this technique. This represents the largest reported series (to our knowledge) in the English-language otolaryngology head and neck ...

Chickenpox is a common contagious disease of childhood. Infection with varicella-zoster virus generally follows a benign course, but complications may occur. We report the case of a child with chickenpox who developed diffuse cerebritis with significant dehydration, azotemia, elevations in transaminases, and coagulopathy. The neurologic complications of varicella-zoster infection are ...

PURPOSE: To discuss the forms of cocaine that are available and their methods of administration and to review the medical complications of cocaine abuse. DATA SOURCES: Pertinent articles were identified through a MEDLINE search of the English-language literature from 1986 to 1992 and through a manual search of bibliographies of ...

Complications encountered with retained or embolized foreign bodies (FB) are mainly reported in association with invasive intravascular monitoring or diagnostic devices. Retrieval of these large FB is recommended. On the other hand, the embolization of hypodermic needle fragments in the intravenous drug abuser is infrequently reported. The natural history and ...

A case of severe bradycardia with junctional escape immediately following sublingual nitroglycerin is described. Bradycardia is a rare, but well-documented, complication of nitroglycerin and is often reported in the setting of myocardial ischemia or infarction. This particular case reported was complicated by the presence of an angiographically documented congenital coronary ...

Chylothorax complicating pulmonary resections is exceptional and management of this complication remains controversial. We report a case of chylothorax after a right pneumonectomy and radical subcarinal nodal dissection. Successful nonoperative management consisted of controlled tube drainage, fasting, and total parenteral nutritional support for a period of 2 weeks. A review ...

The incidence of complications from arthroscopic surgery is low. Between 1978 and 1991, 8500 arthroscopies were performed by the two senior authors (J.N. and D.R.A.D.). Several significant complications were recorded, and these are presented to show how they occurred, and how our practice of arthroscopy was subsequently modified. There were ...

A case of active peptic ulcer disease in a primigravida at 29 weeks' gestation is presented, with a literature review. This particular case was complicated by gastric outlet obstruction, a complication which has not been previously reported in the obstetric literature. Although an uncommon diagnosis in pregnancy, the investigations for ...

The intracolonic bypass has been used both experimentally and clinically to avoid high-risk primary colonic anastomosis in the face of peritonitis. Experimental and clinical data have established the Coloshield as safe, with few clinical complications reported. This is a review of the literature and a case report of a complication ...

For nearly a century, physicians and laypersons have attempted to repair, reconstruct, and embellish the human body in numerous ways by injecting various oils beneath the skin. Soon after Gersuny's first reported subcutaneous injection of oil, the local and systemic complications became apparent. Despite this, the practice of oil injections ...

Utilization of Kirschner wires for bone and joint fixation is potentially complicated by migration of the wire from the fixation site over time. However, a review of the literature disclosed few reports of this complication. We describe such a case in order to emphasize the potential danger of the migration ...

Parapneumonic effusions are relatively common sequelae of pneumonias. Occasionally, parapneumonic effusions will lead to empyemas. If these fluid collections are not aggressively drained in a timely manner, they will become loculated, placing the patient at risk for septic complications. Two cases of parapneumonic empyemas with delayed drainage eventually requiring thoracotomy ...

Pseudarthrosis is a well known, late complication of ankylosing spondylitis associated with extensive discovertebral junction destruction and fracture of the posterior elements. In contrast, the term "Pseudopseudarthrosis" is published in the recent literature to portray similar roentgenologic findings of discovertebral destruction but without bony break of the posterior arch. In ...

A rare iatrogenic complication of subclavian vein catheterization for hemodialysis is massive hydrothorax. A case is presented that illustrates the need for adherence to a standard procedure of prompt roentgenologic examination in conjunction with catheterization, and emphasizes the importance of the autopsy as a means of quality assurance.

Double-compartment hydrocephalus, a rare shunt complication, is caused by occlusion of the aqueduct and the fourth ventricular outlets after shunting of the lateral ventricles. Dilation of the fourth ventricle causes brain-stem dysfunction and cerebellar signs. A case of double-compartment hydrocephalus presenting with opisthotonus is presented, and the relevant literature is ...

Compartment syndrome is a rare but serious complication of vascular reconstruction. It most commonly occurs following revascularization of an acutely ischemic extremity. This case of compartmental syndrome following bypass surgery for chronic arterial insufficiency is therefore exceedingly unusual. A review of the literature reveals only a few cases with similar ...

Hydrocephalus can occur in conjunction with large acoustic neuromas. Cerebral tentorial herniation and brainstem compression can be a complication of surgical excision. Three cases of hydrocephalus and acoustic neuroma are presented and therapeutic options are discussed. Ventriculoperitoneal shunting 1 to 2 weeks before translabyrinthine or suboccipital excision of acoustic neuroma ...

Droplets of oil-based contrast medium were unexpectedly seen within the head of a 14-year-old girl being investigated for headache. The contrast had been inadvertently introduced during an attempted amniofetogram whilst the patient was in utero. As far as the author is aware, this complication of amniography and its late sequel ...

Because transesophageal echocardiography is invasive, it has the potential for serious complications. Limitations occur because of the restricted transducer mobility within transducers for special situations. Pitfalls (potential erroneous diagnoses resulting from misinterpretation of normal and abnormal anatomy) are prevalent with this new technology. This report critically reviews transesophageal echocardiography and ...

Retrospectively 120 anaesthetic complications with potential medicolegal consequences were reviewed. Seven deaths occurred. Eighty percent of the complications were potentially avoidable. Of the complications 4.4% resulted in major morbidity and 82.3% in intermediate morbidity. Dental injuries were reported with an annual frequency of six. The use of pulse oximetry and/or ...

A case of neutrophilic dermatosis (ND) complicated by cryofibrinogenemia (CFGN) and myelodysplastic syndrome (MDS) is reported. Although the patient presented pancytopenia, the skin lesions were compatible with those of ND from the clinical and histopathological findings. Further, immunofluorescence technique revealed cryofibrinogen (CFG) deposits on the walls of the blood vessels ...

Scrub typhus is still prevalent on Penghu Islands. We herein report a case in a pregnant woman who had been to Yi-Lan County in Taiwan. The patient responded well to Minocycline (Minocin) therapy without complication. Her newborn baby was found not complicated with the disease. The relative literature is reviewed.

Low-molecular-weight dextran is utilized by many microsurgeons after free tissue transfer for its beneficial effects on the microcirculation. While it is generally felt to have a low rate of complications, severe complications secondary to dextran's osmotic effects may occur. We report here on two cases in which therapy with low-molecular-weight ...

Dermal sinuses penetrating the dura are important in that they may be complicated by C.N.S. infection, and this complication can be prevented by early surgery. Although well recognised over the occiput and lumbar spine, nasal dermal sinuses extending intracranially are much rarer and have received little attention in the neurosurgical ...

Pharyngeal complications due to anterior cervical spine surgery (ACSS) are not rare. We describe the case of a traction diverticulum of the hypopharynx after ACSS, a complication that has not yet been reported. We discuss the possible mechanism. A review of the complications of ACSS that are of interest to ...

Intubation of the upper gastrointestinal tract with balloon catheters has a role in the diagnosis, treatment, and research of many gastrointestinal conditions. A potential complication of this procedure, albeit rare, is failure of the balloon to deflate, thereby preventing removal of the intestinal tube. We describe a case where this ...

An account is given of a fatal complication following the use of a pharyngostomy feeding tube. The literature on this topic is reviewed with regard to complications. Of the 671 patients that have been reported previously there have been no fatal or serious complications and minor complications were reported in ...

This prospective study was designed to determine the frequency and natural history of hydroureteronephrosis (HUN) after placement of an aortobifemoral vascular graft. A total of 30 patients were evaluated by the study protocol, which included: pre and postoperative biological kidney function tests, preoperative and early postoperative (14th day) intravenous pyelograms ...

The use of epinephrine auto-injectors for prehospital treatment of severe allergic reactions has become increasingly popular in recent years. Anxiety when patients are called on to use these spring-loaded devices may lead to complications. We present the case of a 28-year-old woman who accidentally injected epinephrine 1:1,000 solution 0.3 mL ...

The incidence of shunt nephritis has decreased over the past several years due to the increased use of ventriculoperitoneal (VP) shunts rather than the ventriculovascular systems for which this complication was originally reported in 1965. Despite this trend, the syndrome has been reported in cases of VP shunting and, for ...

We report the case of a 61 yr old male, who developed a severe right-to-left shunt through a patent foramen ovale, in the absence of elevated right-sided heart pressures, two months after a left-sided pneumonectomy. This is considered to be a rare complication after pneumonectomy. However, taking into account the ...

Oesophageal intramural pseudodiverticulosis is a rare condition that presents with dysphagia. The diagnosis is usually not apparent endoscopically and careful radiological evaluation is required. Previous reports suggest a benign course with good response of dysphagia to oesophageal dilatation and complications have not been described. Two cases are reported, one in ...

The pathology encountered at the craniovertebral junction is extensive. It includes congenital, developmental and acquired abnormalities which ultimately compromise the cervicomedullary junction. The pediatric age group is particularly vulnerable as the muscular support is not fully developed. Numerous surgical approaches have been developed to relieve compression, as well as to ...

Tick-borne encephalitis (TBE) is rarely seen in Britain. We report a case of TBE in a 44-year-old Swedish woman presenting to an accident and emergency department in London. The clinical features of the case, while in many ways typical, were nonspecific and led to difficulty in early diagnosis. The course ...

Complete duplication of vagina, cervix and uterus, with imperforate hemivagina and renal agenesis is a rare condition with less than 120 cases published. In those articles, urological complications are uncommon with only a 10% of the total. We report 2 cases of uterus didelphys with unilateral hematocolpos and ipsilateral renal ...

Complications arising from central venous cannulation include sepsis, thrombosis and trauma. Total parenteral nutrition via a Hickman catheter is an accepted therapeutic technique. Cases of catheter-related thrombus within the right atrium have been described, primarily in premature infants, although a recent case has been reported in an adult. We describe ...

Pleural effusions in patients with chronic liver disease are common and usually are of little consequence. Bilious pleural effusion can occur following percutaneous biopsy or cholangiography procedures if the pleura is traversed. This report emphasizes the role of biliary tract obstruction in the development of a bilious effusion and the ...

Although the initial reports of tracheoesophageal puncture after total laryngectomy reported little to no morbidity, subsequent studies with longer follow-up have reported a significant number of complications. We present the first reported case (to our knowledge) of prolapse of the posterior tracheal wall with diverticulum formation developing 6 years after ...

An unusual complication following transhiatal esophagectomy for lower esophageal carcinoma is reported in which extrapericardial tamponade and profound shock occurred secondary to a herniated section of omentum in the immediate postoperative period. The two-dimensional echocardiogram was nondiagnostic, but the diagnosis was confirmed during reexploration of the abdomen. Anatomic and pathophysiologic ...