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Case Reports in Clinical Medicine 2020年第8期9卷 223-227页

作者： Gang Yang Shaojun Yang Junjie Lv Chenbing Wang Department of Neurosurgery Zhuji Affiliated Hospital of Shaoxing University Shaoxing China

Background: Patients with severe hypertensive brainstem hemorrhages have poor prognoses if they only receive conservative medical management. In contrast, aggressive operative interventions may decrease the morbidity and mortality in such patients. These operative treatments include craniotomy for evacuation of the hematoma, stereotactic positioning, and neuronavigational-guided hemorrhage puncture and drainage. Here, we report a novel and relatively simple procedure to achieve satisfactory outcomes in a patient with a brainstem pontine hemorrhage. Case Presentation: A 53-year-old man who was diagnosed with brainstem pontine hemorrhage. On hospital day 6, he underwent CT-guided, virtual stereotactic puncture and catheter drainage of this brainstem pontine hemorrhage. Medical treatments were continued after this procedure. On postoperative day 16 (hospital day 22), the patient was discharged from the hospital, awake and able to answer questions appropriately. Muscle strengths were grades V and IV for the left and right extremities, respectively. The patient was continued with active rehabilitation and achieved a Barthel index of 85 points at one month after the percutaneous drainage procedure. Conclusion: CT-guided, virtual stereotactic percutaneous transcranial puncture and catheter drainage for brainstem pontine hemorrhages has obvious potential advantages and offers a possible alternative to achieve the best outcomes with minimal operative trauma compared to open microcraniotomy.

关键词： Computed Tomography-Guided Stereotactic catheter drainage Pontine Hemorrhage

Computed tomography-guided catheter drainage with urokinase and ozone in management of empyema

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World Journal of Radiology 2017年第4期9卷 212-216页

作者： Bing Li Chuan Liu Yang Li Han-Feng Yang Yong Du Chuan Zhang Hou-Jun Zheng Xiao-Xue Xu Sichuan Key Laboratory of Medical Imaging Department of RadiologyAffiliated Hospital of North Sichuan Medical CollegeNanchong 637000Sichuan ProvinceChina

AIM To retrospectively compare the outcomes of catheter drainage,urokinase and ozone in management of *** Retrospective study included 209 patients(111 males and 98 females; age range 19 to 72 years) who were diagnosed with *** patients were divided into 3 groups based on the therapy instituted: catheter drainage only(group I); catheter drainage and urokinase(group II); catheter drainage,urokinase and ozone(group III).drainage was considered successful if empyema was resolved with closure of cavity,clinical symptoms were resolved,and need for any further surgical procedure was *** rate,length of stay(LOS),need for further surgery and hospital costs were compared between the three groups using the Kruskall-Wallis nonparametric test,with P catheters were placed successfully under CT ***-three patients were treated with catheters alone(group I),64 with catheters and urokinase(group II),and 82 with catheters,urokinase and ozone(group III).Group I,group II and group III had success rates of 62%,83% and 95% respectively(P drainage,urokinase and ozone is a safe and effective therapeutic modality in thoracic empyema.

关键词： Computed tomography-guided catheter drainage Urokinase Ozone Empyema

Ultrasound guided percutaneous treatment for splenic abscesses: The signifi cance in treatment of critically ill patients

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World Journal of Gastroenterology 2006年第45期12卷 7341-7345页

作者： Enver Zerem Jacob Bergsland Interventional Ultrasonography Department University Clinical Centar Tuzla Bosnia and Herzegovina

AIM: To analyze the results of ultrasound guided percu- taneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess. METHODS: Thirty-six patients (14 females and 22 males, with an average age of 54.1 ± 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess catheter drainage. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, and mortality rates were analyzed. RESULTS: Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was defi nitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%) underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%). Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure. CONCLUSION: Percutaneous treatmnet of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those ≥ 50 mm in diameter and for bilocular abscesses.

关键词： Interventional ultrasound Needle aspiration catheter drainage Spleen preservation

Amebic liver abscess:Clinico-radiological findings and interventional management

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World Journal of Radiology 2022年第8期14卷 272-285页

作者： Rajeev Nayan Priyadarshi Ramesh Kumar Utpal Anand Department of Radiodiagnosis All India Institute of Medical SciencesPatnaPatna 801507BiharIndia Department of Gastroenterology All India Institute of Medical SciencesPatnaPatna 801507BiharIndia Department of Surgical Gastroenterology All India Institute of Medical SciencesPatnaPatna 801507BiharIndia

In its classic form,amebic liver abscess(ALA)is a mild disease,which responds dramatically to antibiotics and rarely requires ***,the two other forms of the disease,i.e.,acute aggressive and chronic indolent usually require *** forms of ALA are frequently reported in endemic *** acute aggressive disease is particularly associated with serious complications,such as ruptures,secondary infections,and biliary *** parameters are deranged,with signs of organ failure often *** form of disease is also associated with a high mortality rate,and early drainage is often required to control the disease *** the chronic form,the disease is characterized by low-grade symptoms,mainly pain in the right upper *** and computed tomography(CT)play an important role not only in the diagnosis but also in the assessment of disease severity and identification of the associated ***,it has been shown that CT imaging morphology can be classified into three patterns,which seem to correlate with the clinical *** pattern depicts its own set of distinctive imaging *** this review,we briefly outline the clinical and imaging features of the three distinct forms of ALA,and discuss the role of percutaneous drainage in the management of ALA.

关键词： Amebic liver abscess Complicated liver abscess Refractory liver abscess Ruptured amebic liver abscess Pleuropulmonary complication Biliary communication Needle aspiration catheter drainage