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7 "Complications"
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Review article
Basic knowledge of endoscopic retrograde cholangiopancreatography
Jung Wook Lee
Kosin Med J. 2023;38(4):241-251.   Published online December 26, 2023
DOI: https://doi.org/10.7180/kmj.23.151
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  • 6 Download
Abstract PDFPubReader   ePub   
Endoscopic retrograde cholangiopancreatography (ERCP) was first performed in the late 1960s. Due to advancements in instruments, devices, and techniques, ERCP has played an important role in the management and diagnosis of pancreatobiliary disorders. However, ERCP is accompanied by the risk of various complications even if performed by an expert. The incidence of ERCP complications is approximately 4% to 10%, while the incidence of fatal complications, such as death, is less than 0.5%. To prevent adverse events, experts performing ERCP must recognize and address ERCP-related complications and understand the various techniques. In this review, we summarize the complications and techniques of ERCP.
Case reports
Perioperative cutaneous complications in an elderly patient due to inappropriate use of a forced-air warming device and underbody blanket: a case report
Myounghun Kim, Soo Jee Lee, Beomseok Choi, Geunho Lee, Seunghee Ki
Kosin Med J. 2023;38(4):288-292.   Published online December 6, 2023
DOI: https://doi.org/10.7180/kmj.23.136
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Abstract PDFPubReader   ePub   
Forced-air warming is commonly utilized to prevent perioperative hypothermia. Underbody warming blankets are often employed to secure a larger area for patient warming. While forced-air warming systems are generally regarded as safe, improper usage poses a risk of cutaneous complications. Additionally, the influence of underbody blankets on cutaneous complications remains uncertain. We present a case of cutaneous complications resulting from the improper utilization of a forced-air warming device and an underbody blanket. A 79-year-old man presented to the hospital for robotic proctectomy under general anesthesia. The surgery lasted for 7 hours, and the forced-air warming device with underbody blanket operated continuously for 5 hours intraoperatively. The surgery was completed without any incidents. However, first-degree burns on the patient’s back, along with superficial decubitus ulcers on his right scapula, were observed after surgery. To prevent cutaneous complications, clinicians must adhere to the manufacturer's guidelines when utilizing a forced-air warming system. Compared to overbody blankets, underbody blankets have limitations in monitoring cutaneous responses. Ensuring patient safety requires selecting an appropriate blanket for scheduled operations.
The Importance of Lamina Size Measurement and Proper Implants Selection before Laminoplasty : Two Case Reports
Dong Hwan Kim, Su Hun Lee, Dong Ha Kim, Kyoung Hyup Nam, In Ho Han, Byung Kwan Choi
Kosin Med J. 2021;36(2):169-174.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.169
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Abstract PDFPubReader   ePub   

Open door laminoplasty using plates is a safe and effective procedure for multi-level cord compression. To achieve stable laminar arch, various types of plate have been developed and used. Now, we introduce two rare complications related to the laminar shelf of plate.

In the first case, we used the wider laminar shelf plate because the elevated lamina did not fit well into the usual laminar shelf. During follow-up, cord compression due to laminar shelf was observed.

And in the second case, the laminar shelf of plate did not fit into the elevated lamina, so we inserted it with a little bit of force. But the patient’s symptom was not improved. On CT image, the inner cortical bone of the lamina was fractured.

To prevent these complications, surgeons need to consider the thickness of the lamina and the size of the laminar shelf before surgery.

A double-knotted pulmonary artery catheter with large loop in the right internal jugular vein: A case report
Kyoung Sub Yoon, Jung A Kim, Jeong In Hong, Jeong Ho Kim, Sang Yoong Park, So Ron Choi
Kosin Med J. 2018;33(2):240-244.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.240
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Abstract PDFPubReader   ePub   

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.

Knot Formation at Removal of an Epidural Catheter Placed Against Insertion Resistance Encountered at the Entrance of the Epidural Space
Byung Tae Kil, Bong Il Kim, Jong Hae Kim
Kosin Med J. 2016;31(2):184-190.   Published online January 20, 2016
DOI: https://doi.org/10.7180/kmj.2016.31.2.184
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Abstract PDFPubReader   ePub   
Abstract

Knotting of an epidural catheter occurs very rarely with an estimated incidence of 0.0015%. We present a case of an epidural catheter knot formed at removal of an epidural catheter following a forceful insertion of the catheter against resistance met at the entrance of the epidural space during threading of the catheter through Tuohy needle placed uneventfully in a 65 year-old male patient undergoing epidural anesthesia. During removal of the epidural catheter, significant resistance was encountered on traction and it was found that approximately 1.5 ㎝ portion of the catheter had been retained within the patient's subcutaneous tissue. Firm traction was employed to withdraw the catheter against the resistance. The catheter was pulled out uneventfully from the patient. A knot estimated to be formed during removal of the catheter was observed at 0.6 ㎝ proximal to the catheter tip. No complications and side effects were noted until the patient's discharge.

Original article
Catheter Fracture of a Totally Implantable Venous Device Due to Pinch Off Syndrome in Breast Cancer: A Case Report
Yoonseok Kim
Kosin Med J. 2016;31(2):167-172.   Published online January 20, 2016
DOI: https://doi.org/10.7180/kmj.2016.31.2.167
  • 961 View
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  • 1 Citations
Abstract PDFPubReader   ePub   
Abstract

Totally implantable venous devices are used in medical care for parenteral nutrition, vascular access, administrating chemotherapeutic agents and so on. Although the large variety of catheter complications, catheter fracture is a rare but serious complication. The pinch off syndrome is caused by the compression of the catheter between the clavicle and first rib, and may lead to fracture and possible dislocation of the catheter. We report here the case history of a patient with metastatic breast cancer who developed a rare complication of subclavian catheter fracture as a consequence of pinch off syndrome.

Citations

Citations to this article as recorded by  
  • Pinch-off syndrome ou syndrome de la Pince Costo-Claviculaire
    E.A. Allassane, M. El Hammoumi, M. Bhairis, F. El Oueriachi, E.H. Kabiri
    Revue de Pneumologie Clinique.2018; 74(6): 492.     CrossRef
Case report
Percutaneous coronary stenting in guide-induced aortocoronary dissection
Jung Ho Heo
Kosin Med J. 2007;22(1):296-300.   Published online June 30, 2007
  • 263 View
  • 2 Download
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KMJ : Kosin Medical Journal