SJ LifeMag - шаблон joomla Новости

Clinical use of Amplatzer Vascular Plug in central and peripheral vascular system has been extensively described in the

literature. We present a case of occlusion of  left vertebral artery (LVA) performed by deploying an Amplatzer Vascular

Plug, in addition to microspheres plus coils for embolization of the deep cervical branches that feed a cervical metastasis

involving the left VA. After the endovascular intervention, the patient underwent surgical resection of the lesion.

The application of the device, the use of multiple embolic materials, as well as the angiographic and clinical

results of the procedure, were evaluated because not previously reported in the literature. 

Hence, we provide an updated literature review about clinical use of Amplatzer Vascular Plug in supra-aortic vessels.

Published in Embj

Munchausen syndrome is a complex type of abuse, which is often underdiagnosed or misdiagnosed in

clinical practice, and has harmful consequences for children. Its relationship with child abuse, of which it

is a variety, must be recognized in clinical and forensic practice. The authors report herein two observed

cases of different types of Münchausen syndrome by proxy (MSbP). The first, is the most severe form of

MSbP, with induced, true illness and related pathological symptoms into victim. The second case is a

moderate form, much more complex to detect, in which a perpetrator parent simulates and aggravates the

child‘s illness. Adequate training of health professionals and investigators is essential in revealing cases of

MSbP. Diagnosis must be based on the study of the different forms of "abuse" and the knowledge of

clinical protocols used to validate any suspected behaviour which could be potentially harmful to the

child. Moreover, a lack of training may lead to misleading interpretations of medical history interpretation

and fallacious conclusions. Our study aims to review the features that are to be considered in a suspected

case of MSbP, in accordance with a recently updated consensus statement by the Committee on Child

Abuse and Neglect from the American Academy of Pediatrics.

Published in Embj

The pseudo-aneurysm is an encapsulated hematoma of post-traumatic origin which is in communication with the lumen of the artery of relevance. We present a rare case of pseudo-aneurysm occurring after superior thyroid trans-esophageal echocardiography (TEE) and external cardioversion. Singular occurrence in otolaryngology, if not recognized early a pseudo-aneurysm can result in dramatic events such cataclysmic bleeding or acute occlusion of the upper airway .

Published in Embj
Published in Embj

 Retropharyngeal abscesses (RPA) are rare in adults. We report a case of a healthy adult with RPA presenting with clinical symptoms of acute thyroiditis. A 37-yr-old female presented with a painful mass in the anterior region of the neck, sore throat, mild fever and dysphagy for liquids and solids. Neck emergency US dis-closed normal thyroid ventrally displaced by a huge retropharyngeal hypoechoic mass. Direct laryngoscopy revealed erythema of the posterior pharyngeal wall with bulges (8 cm) preventing the correct visualization of the glottic plane. CT confirmed the pres-ence of retropharyngeal abscess and laryngoscopic drainage was performed. The pa-tient was discharged on 11th post-operative day, in good condition. The high mortality rate of retropharyngeal abscess is related to its association with invasion of contiguous structures and mediastinum: once mediastinitis occurs, mortality reaches 50%, even with antibiotic therapy. CT is fundamental for the diagnosis, but in many cases, as our, ultrasonography of the neck may play a pivotal role as quickly as possible. Surgi-cal treatment (intraoral incision and drainage) is the better definitive and resolutive treatment. The clinical diagnosis of retropharyngeal abscess in adult can be difficult because of the lacking and non specificity of clinical presentation.  It is recommended to collect accurate clinical history, careful examination of the head and neck and use of early ultrasound examination of the neck, which in real time can give precise indications to guide the diagnosis and therapy.  The management of a retropharyngeal abscess depends on the patient’s clinical condi-tion, moving from conservative treatment with steroids and antibiotics to reanimation and aggressive surgical drainage.

Published in Embj
Page 1 of 3