Biomedical subjects

Devrim Akinci

Publications and source records attributed to Devrim Akinci.

25 records · Page 2Linked to original sources

PubMed2002

Guglielmi detachable coil erosion into the common bile duct after embolization of iatrogenic hepatic artery pseudoaneurysm.

Intermittent hemobilia with a hepatic artery pseudoaneurysm can be seen after open or laparoscopic cholecystectomy. Transcatheter treatment of this complication is widely accepted. Although some authors suggest packing the pseudoaneurysm with coils as the treatment of choice, occluding the parent artery is the standard treatment. The authors present an unusual complication of Guglielmi detachable coil erosion into the common bile duct in a patient who presented with pancreatitis 2 years after undergoing packing of the hepatic artery pseudoaneurysm with coils. The probable causes of this rare outcome and alternative treatment options are discussed.

Aneurysm, False↗

PubMedDate not supplied

Percutaneous drainage of 300 intraperitoneal abscesses with long-term follow-up.

The purpose of the study was to evaluate the efficacy of percutaneous drainage of intraperitoneal abscesses with attention to recurrence and failure rates. A retrospective analysis of percutaneous treatment of 300 intraperitoneal abscesses in 255 patients (147 male, 108 female; average age: 38 years; range: 40 days to 90 years) for whom at least 1-year follow-up data were available was performed. Abscesses were drained with fluoroscopic, sonographic, or computed tomographic guidance. Nine abscesses were drained by simple aspiration; catheter drainage either by Seldinger or trocar technique was used in the remaining 291 abscesses with 6F to 14 F catheters. Initial cure and failure rates were 68% (203/300) and 12% (36/300), respectively. Sixty-one abscesses (20%) were either palliated or temporized. The recurrence rate was 4% (12/300) and nine of them were cured by recatheterization, whereas three of them were treated by medication or surgery. The overall success and failure rates were 91% (273/300) and 9% (27/300), respectively, with temporized, palliated, and recatheterized recurred abscesses. The 30-day mortality rate was 3.1% (8/255). The mean duration of catheterization was 13 days. Intraperitoneal abscesses with safe access routes should be drained percutaneously because of high success and low morbidity, mortality, and recurrence rates.

Abscess↗

PubMedDate not supplied

Percutaneous placement of peritoneal port-catheter in patients with malignant ascites.

We report our experience with a radiologically placed peritoneal port-catheter in palliation of malignant ascites. Port-catheters were successfully placed under ultrasonographic and fluoroscopic guidance in seven patients (five women, two men) who had symptomatic malignant ascites. The long-term primary patency rate was 100%. The mean duration of catheter function was 148 days. Seven patients had a total of 1040 port-days. Two patients received intraperitoneal chemotherapy via the port-catheter. There were no procedure-related mortality and major complications. Minor complications such as ascitic fluid leakage from the peritoneal entry site, migration of the catheter tip to the right upper quadrant, and reversal of the port reservoir occurred in four patients. None of these complications affected the drainage and required port explantation. In patients with symptomatic malignant ascites, a peritoneal port-catheter can provide palliation and eliminate multiple hospital visits for repeated paracentesis with high patency and low complication rates.

Adult↗

PubMedDate not supplied

Percutaneous transcatheter ethanol sclerotherapy and catheter drainage of postoperative pelvic lymphoceles.

The aim of this study is to investigate the efficacy and long-term results of percutaneous transcatheter ethanol sclerotherapy (PTES) for postoperative pelvic lymphocele treatment. Fifty-two patients who were referred for lymphocele treatment were included in this study. Sixty lymphoceles of 52 patients were treated by percutaneous treatment with or without ethanol sclerotherapy. Lymphoceles developed in 47 and 5 patients, who underwent gynecologic malignancy operation (31 ovarian cancer, 6 cervix cancer, 10 endometrial cancer) and renal transplantation, respectively. Lymphoceles were catheterized by ultrasonography and fluoroscopy guidance using the Seldinger technique. Lymphoceles smaller than 150 mL underwent single-session ethanol sclerotherapy and the others were treated by multiple-session ethanol sclerotherapy. In 10 patients, percutaneous ethanol sclerotherapy could not be performed and they were treated only by percutaneous catheter drainage. The mean lymphocele volume was 329 mL (15-2900 mL). The mean catheterization duration was 11.8 days (1-60 days). The mean follow up time was 25.8 months (2-64 months). The initial treatment was successful in 46 out of 50 (91%) lymphoceles treated with PTES and 7 out of 10 (70%) lymphoceles treated with percutaneous catheter drainage. Minor complications (secondary infection and catheter dislodgement) were noted in seven (11.6%) patients. Recurrence developed in four and three patients who were treated by PTES and percutaneous catheter drainage, respectively. Five of these patients were treated with PTES without further recurrence. Percutaneous transcatheter ethanol sclerotherapy is an effective and reliable method for the treatment of postoperative lymphoceles.

Adolescent↗

PubMedDate not supplied

Combination of extremity computed tomography angiography and abdominal imaging in patients with musculoskeletal tumors.

PURPOSE: To introduce a comprehensive computed tomography (CT) protocol for the evaluation of patients with musculoskeletal tumors by combining extremity CT angiography and abdomen CT in a dynamic multidetector CT study. METHODS: Single contrast bolus was used for each study in 4 patients with musculoskeletal tumors involving the lower extremities. Extremity CT angiography and abdominal CT were acquired sequentially by 4-channel multidetector CT. Technical parameters for extremity CT angiography were as follows: detector collimation, 4 mm x 1 mm; pitch, 1.75; slice thickness, 1.25 mm; reconstruction interval, 1 mm; coverage, 42 cm; and table speed, 14 mm/s. Thick and thin maximum intensity projections, volume renderings, and multiplanar reformats with or without bone subtraction were used to display vascular supply of the extremity mass and adjacent vascular structures. RESULTS: Satisfactory images of the extremity arterial system and abdomen were obtained in all patients. The mean delay time for CT angiography was 25 seconds. Extremity CT angiography demonstrated feeding arteries of a fibular giant cell tumor and a large lymphomatous mass. The same protocol was used for the evaluation of a distal tibial osteosarcoma and a fibular chondrosarcoma. In 2 patients, early venous return was noted, indicating vascularity of the tumors. In all patients, the relation of osseus masses to adjacent vascular structures was visualized as well as the bony anatomy. CONCLUSION: Extremity CT angiography and abdominal staging CT can be combined in a single dynamic multidetector CT protocol in patients with musculoskeletal tumors, resulting in a reduction of costs, acquisition time, and contrast dose as well as an improvement in patient management. The same protocol can also be used in trauma patients.

Adult↗

PubMedDate not supplied

Unilateral perirenal fibrosis.

A case of multifocal fibrosclerosis with an extremely unusual unilateral perirenal involvement is reported. Computed tomography and magnetic resonance imaging findings of unilateral perirenal fibrosis are discussed.

Humans↗

PubMedDate not supplied

Acute Budd-Chiari syndrome resulting from a pyogenic liver abscess.

Budd-Chiari syndrome is a rare condition resulting from outflow obstruction of the liver. This syndrome due to a pyogenic abscess is rarely documented in the English literature. Here a male patient with acute Budd Chiari syndrome is presented. A 21-year-old male patient was admitted to the hospital because of severe right upper quadrant pain, jaundice, hepatomegaly and fever. The examination of liver by computerized tomography and ultrasound revealed a large lesion 120 x l00 mm in size located in the right lobe of liver, which was compressing the inferior vena cava, the right and middle hepatic veins. Twenty-three days after percutaneous catheter drainage and medical treatment, the patient was discharged with complete healing. Although many disorders including malignant diseases can cause Budd-Chiari Syndrome, a pyogenic liver abscess compressing the inferior vena cava, and hepatic veins leading to acute Budd-Chiari syndrome has been rarely reported in English medical literature. Patients presenting with abdominal pain, hepatomegaly, and ascites should be carefully evaluated from this point of view.

Adult↗