PURPOSE: To evaluate the anti-subsidence effect of suspensionplasty using abductor pollicis longus (APL) tendon in carpometacarpal (CMC) arthritis of the thumb. METHODS: From June 2009 to May 2016, hematoma distraction arthroplasty (HDA; group A, 10 cases) and HDA with suspensionplasty using APL tendon (group B, 7 cases) were performed in total 17 patients with CMC arthritis. The K-wire was fixed from 1st metacarpal to 2nd metacarpal in both group to maintain the empty space for 6 weeks until the fibrous tissue fill the space. We measured the preoperative trapezium space height with picture archiving and communication (PACS) system and compare the height with that was measured postoperatively. Additionally the subsidence rate checked sequentially with follow-up plain radiography. RESULTS: The subsidence ratios (subsidence/trapezium height) were average 33.2% in group A and 31.4% in group B. There is no statistical difference between two groups. Six weeks after pin removal almost of subsidence occurred, and then from 3 months after surgery to 6 months after surgery, few subsidence was occurred and it is average only 8% of total subsidence. The trial of distraction the empty space when perform the Kirschner wire (K-wire) fixation, it does not influence the prevention of subsidence. Between distraction height and subsidence, there was no statistical relevance. CONCLUSION: Although suspensionplasty was known as one of methods to prevent the subsidence, it is thought to be not very helpful method to prevent subsidence of thumb in CMC arthritis.
Arthritis* ; Arthroplasty ; Carpometacarpal Joints ; Follow-Up Studies ; Hematoma ; Humans ; Methods ; Radiography ; Tendons ; Thumb*

Central venous catheters provide long-term available vascular access. They are useful for central venous pressure monitoring, rapid fluid management, massive transfusion and direct cardiovascular medication, especially in operation. Central venous catheterization is usually performed by the landmark bedside technique without imaging guidance. The complications of central venous catheterization are frequent, which include malposition, pneumothorax, hemothorax, chylothorax, arterial puncture, hematoma, air embolism and infection. Malposition of a central venous catheter is not rare and may cause several complications such as malfunction of the catheter, default measurement of central venous pressure, catheter erosion, thrombophlebitis and cardiac tamponade. In this case, we report a malposition of central venous catheter with 9-Fr introducer sheath which is located in the right subclavian vein via ipsilateral internal jugular vein and the correction of this misplacement assisted by mobile type diagnostic X-ray apparatus (C-arm fluoroscope).
Cardiac Tamponade ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Central Venous Pressure ; Chylothorax ; Embolism, Air ; Hematoma ; Hemothorax ; Jugular Veins ; Pneumothorax ; Punctures ; Radiography* ; Subclavian Vein ; Thrombophlebitis

OBJECTIVETo explore the procedures of dynamic infusion cavernosometry and cavernosography (DICC) and their application in the diagnosis and classification of venous erectile dysfunction (VED).

METHODSThis study included 103 ED patients, aged 20 to 43 years, highly suspected of VED, with disease courses of 4 months to 6 years. DICC was performed and analyses were made on the results, especially the parameters of flow-to-maintain (FTM) and pressure decay (PD) in the corpus cavernosum.

RESULTSBased on the parameters of FTM and PD, 21 of the patients were normal, 5 were suspected of VED, 39 had mild VED, 25 had moderate VED, and 13 had severe VED. Penile subcutaneous hematoma was found in 4 of the patients, all recovered after 3 to 5 days, with no other complications.

CONCLUSIONDICC is a reliable, safe and minimally invasive method for the diagnosis and classification of VED.

Diagnostic Techniques, Urological ; adverse effects ; Hematoma ; etiology ; Humans ; Impotence, Vasculogenic ; classification ; diagnosis ; Male ; Penile Diseases ; etiology ; Penis ; blood supply ; diagnostic imaging ; Radiography ; Veins

MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.
Adult ; Female ; Hematoma/etiology ; Humans ; Limb Salvage ; Lower Extremity/anatomy & histology/radiography/*surgery ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Sarcoma/radiotherapy/*surgery ; Soft Tissue Infections/radiography/*surgery ; Soft Tissue Injuries/radiography/*surgery ; Soft Tissue Neoplasms/radiotherapy/*surgery ; Surgical Flaps/adverse effects

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
Arm ; Braces ; Dislocations* ; Elbow Joint ; Elbow* ; Hematoma* ; Humans ; Humerus ; Joint Capsule ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Radiography ; Range of Motion, Articular ; Reference Values ; Rupture ; Splints ; Young Adult

We report 2 cases of complicated spontaneous dissection of the celiac artery, which were successfully treated by a stent graft. The first patient was a 47-year-old man who presented with acute abdominal pain. CT scan showed ruptured saccular aneurysm with surrounding retroperitoneal hematoma. The second patient was a 57-year-old man with progressive dissecting aneurysm. Endovascular stent graft was placed in the celiac trunk to control bleeding, and to prevent rupture in each patient. Follow-up CT scans showed complete obliteration of a dissecting aneurysm.
Abdominal Pain/etiology/radiography ; Aneurysm, Dissecting/*therapy ; Aneurysm, Ruptured/prevention & control ; Celiac Artery/*injuries ; Hematoma/etiology/radiography ; Hemorrhage/etiology/radiography ; Humans ; Male ; Middle Aged ; Retroperitoneal Space ; Rupture, Spontaneous/therapy ; *Stents ; Tomography, X-Ray Computed/adverse effects

Spontaneous retroperitoneal hemorrhage is one of the most serious and often lethal complications of anticoagulation therapy. The clinical symptoms vary from femoral neuropathy to abdominal compartment syndrome or fatal hypovolemic shock. Of these symptoms, abdominal compartment syndrome is the most serious of all, because it leads to anuria, worsening of renal failure, a decrease in cardiac output, respiratory failure, and intestinal ischemia. We report a case of a spontaneous retroperitoneal hemorrhage in a 48-year-old female who had been receiving warfarin and aspirin for her artificial aortic valve. She presented with a sudden onset of lower abdominal pain, dizziness and a palpable abdominal mass after prolonged straining to defecate. Computed tomography demonstrated a huge retroperitoneal hematoma and active bleeding from the right internal iliac artery. After achieving successful bleeding control with transcatheter arterial embolization, surgical decompression of the hematoma was performed for management of the femoral neuropathy and the abdominal compartment syndrome. She recovered without any complications. We suggest that initial hemostasis by transcatheter arterial embolization followed by surgical decompression of hematoma is a safe, effective treatment method for a spontaneous retroperitoneal hemorrhage complicated with intractable pain, femoral neuropathy, or abdominal compartment syndrome.
Abdomen ; Anticoagulants/*adverse effects ; Compartment Syndromes/*etiology ; Female ; Gastrointestinal Hemorrhage/chemically induced/*congenital ; Hematoma/etiology/surgery ; Humans ; Iliac Artery/pathology/radiography ; Middle Aged ; Tomography, X-Ray Computed

We report herein a case of hyperacute onset of spontaneous cervical spinal subdural hematoma treated with methylprednisolone pulse therapy that showed good results. A 57-year-old man was admitted for posterior neck pain and paraparesis which occurred an hour ago. MRI revealed a ventral subdural hematoma distributed from the level of C1 down to T3, compressing the spinal cord. Conservative management with methylprednisolone pulse therapy was administered considering the patient's poor general condition. Although emergent surgical decompression is necessary in most cases of spinal subdural hematoma, conservative management with steroid therapy could be effective.
Cervical Vertebrae/pathology/radiography ; Glucocorticoids/administration & dosage/*therapeutic use ; Hematoma, Subdural, Spinal/*drug therapy/pathology/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone/administration & dosage/*therapeutic use ; Middle Aged ; Paraparesis/drug therapy/pathology/radiography ; Tomography, X-Ray Computed

After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.
Aged ; Hematoma ; diagnostic imaging ; etiology ; surgery ; Humans ; Kidney Diseases ; diagnostic imaging ; etiology ; surgery ; Male ; Radiography ; Renal Artery Obstruction ; complications ; diagnostic imaging ; surgery

Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.
Abdominal Wall ; Angiography ; Ascites/surgery ; Embolization, Therapeutic ; Epigastric Arteries/*injuries ; Female ; Hematoma/*etiology/radiography/therapy ; Humans ; Liver Cirrhosis/*diagnosis ; Middle Aged ; Paracentesis/*adverse effects ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/complications