AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training ...AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.展开更多
RETAINED foreign bodies in the urinary tract after surgical or diagnostic procedure, named iatrogenic foreign bodies, are rarely reported, though the estimated incidence was as high as 1/1500 cases.1 Prompt and pro...RETAINED foreign bodies in the urinary tract after surgical or diagnostic procedure, named iatrogenic foreign bodies, are rarely reported, though the estimated incidence was as high as 1/1500 cases.1 Prompt and proper retrieval is required due to potential complications. We report a case of iatrogenic foreign body into the bladder.展开更多
Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue com...Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue complication rates. The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes. A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period. Methods： All patients undergoing syndesmotic fixa- tion for ankle fracture between May 2008 and October 2009 were retrospectively reviewed. Incidence of complications, secondary procedures, maintenance of syndesmotic reduc- tion and time spent on non-weight bearing were recorded. Family doctors were contacted for those treated with Tight- ropes to check for any complications managed elsewhere. Results： Thirty-five patients required syndesmoticfixation, in which 12 were treated with Tightropes. They were followed up in clinic for a mean of 12.4 weeks. Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered. There were no complications attributable to method of fixation. In this series, 12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures （19 were screw removals）. There was 1 case ofsyndesmotic diastasis. Screw removal resulted in 2 minor complications. Conclusion： Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge. We do not experience soft tissue complications reported elsewhere.展开更多
文摘AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.
文摘RETAINED foreign bodies in the urinary tract after surgical or diagnostic procedure, named iatrogenic foreign bodies, are rarely reported, though the estimated incidence was as high as 1/1500 cases.1 Prompt and proper retrieval is required due to potential complications. We report a case of iatrogenic foreign body into the bladder.
文摘Objective： Conventional fixation of syndesmotic injuries with screws remains problematic. A novel fibrewire device （Tightrope） has suggested advantages. However, small case series have reported high soft tissue complication rates. The purpose of our study was to quantify complication rates and further procedures in patients treated with Tightropes. A secondary objective was to determine incidence of complications and further procedures in those treated with syndesmotic screws over the same period. Methods： All patients undergoing syndesmotic fixa- tion for ankle fracture between May 2008 and October 2009 were retrospectively reviewed. Incidence of complications, secondary procedures, maintenance of syndesmotic reduc- tion and time spent on non-weight bearing were recorded. Family doctors were contacted for those treated with Tight- ropes to check for any complications managed elsewhere. Results： Thirty-five patients required syndesmoticfixation, in which 12 were treated with Tightropes. They were followed up in clinic for a mean of 12.4 weeks. Family doctors were contacted at mean 14.6 months after treatment to determine any complications suffered. There were no complications attributable to method of fixation. In this series, 12 patients underwent 13 procedures and no patient had recurrent diastasis at discharge; 23 patients treated with screw fixation underwent 45 procedures （19 were screw removals）. There was 1 case ofsyndesmotic diastasis. Screw removal resulted in 2 minor complications. Conclusion： Tightrope fixation provideds effective syndesmotic fixation that is maintained at discharge. We do not experience soft tissue complications reported elsewhere.
