Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal inju...Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal injury,each with their usefulness and limitations.Currently,plain radiographs and intravenous urography have no role in the evaluation of patients with suspected renal injury.Ultrasonography(USG) has a limited role in evaluating patients with suspected retroperitoneal injury;however,it plays an important role during follow up in patients with urinoma formation.USG helps to monitor the size of a urinoma and also for the drainage procedure.The role of selective renal arteriography is mainly limited to an interventional purpose rather than for diagnostic utility.Retrograde pyelography is useful in assessing ureteral and renal pelvis integrity in suspected ureteropelvic junction injury and for an interventional purpose,like placing a stent across the site of ureteric injury.Magnetic resonance imaging has no role in acute renal injuries.Multidetector computed tomography is the modality of choice in the evaluation of renal injuries.It is also useful in evaluating traumatic injuries to kidneys with preexisting abnormalities and can help to define the extent of penetrating injuries in patients with stab wounds in the flank region.The combination of imaging findings along with clinical information is important in the management of the individual patient.This article will describe a spectrum of renal injuries encountered in a trauma setting.展开更多
BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical f...BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical field extension of soft tissue sarcomas.METHODS Grading system:CD-grading is a description system consisting of C and D values in the surgical field extension,which are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.C1/D1 are positive values and C0/D0 are negative.With a known location,1/0 values can be"p"(proximal),"d"(distal),and"b"(in the tumor bed),and the description method is as follows:flap type,CxDx[x=0,1,p,d or b].RESULTS Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.The cases involved a distal upper arm(elbow)synovial sarcoma reconstructed using a pedicled latissimus dorsi(pedicled flap:CpDp);a distal upper arm(elbow)pleomorphic rhabdomyosarcoma reconstructed using a transpositional flap from the forearm(transpositional flap:CdD0);an undifferentiated pleomorphic sarcoma in the buttocks reconstructed using a transpositional flap(transpositional flap:C0D0);and a myxofibrosarcoma in the buttocks reconstructed using a propeller flap from the thigh(pedicled flap:CdDd).CONCLUSION The reconstruction method is chosen by the surgeon based on size,location,and other tumor characteristics;however,the final surgical field cannot be determined based on preoperative images alone.CD-grading is a description system consisting of C and D values in the surgical field extension that are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.The CD-grading system gives a new perspective to the flap reconstruction classification.The CD-grading system also provides important information for follow-up imaging of a possible recurrence.展开更多
Background: Ventral hernia is a complex and progressive condition that may lead to serious complications. However, no specified grading or classifying system is found to categorize the hernia, which leads to clinical ...Background: Ventral hernia is a complex and progressive condition that may lead to serious complications. However, no specified grading or classifying system is found to categorize the hernia, which leads to clinical complexities and may affect the patient outcome. Aim: The general aim of this paper is to build up an easy and comprehensive grading system to categorize ventral hernia. Methodology: By carrying out a secondary search over clinical presentation, physical examination, and imaging studies of ventral hernia, a valid grading system is developed. Results: Hanoon’s grading system is composed of seven grades, grades 1, 2A, 2B, 3A, 3B, 3C, and 4. Each grade entailed different clinical presentations, imaging characteristics, and progressivity of ventral hernia. Conclusion: Hanoon’s grading system for ventral hernia can be used to solve the clinical complexities of ventral hernia. Also, it can be a step forward in hernia research to build upon.展开更多
文摘Renal injuries are classified,based on the American Association for the Surgery of Trauma classification,in to five grades of injury.Several imaging modalities have been available for assessing the grade of renal injury,each with their usefulness and limitations.Currently,plain radiographs and intravenous urography have no role in the evaluation of patients with suspected renal injury.Ultrasonography(USG) has a limited role in evaluating patients with suspected retroperitoneal injury;however,it plays an important role during follow up in patients with urinoma formation.USG helps to monitor the size of a urinoma and also for the drainage procedure.The role of selective renal arteriography is mainly limited to an interventional purpose rather than for diagnostic utility.Retrograde pyelography is useful in assessing ureteral and renal pelvis integrity in suspected ureteropelvic junction injury and for an interventional purpose,like placing a stent across the site of ureteric injury.Magnetic resonance imaging has no role in acute renal injuries.Multidetector computed tomography is the modality of choice in the evaluation of renal injuries.It is also useful in evaluating traumatic injuries to kidneys with preexisting abnormalities and can help to define the extent of penetrating injuries in patients with stab wounds in the flank region.The combination of imaging findings along with clinical information is important in the management of the individual patient.This article will describe a spectrum of renal injuries encountered in a trauma setting.
文摘BACKGROUND Flap reconstruction after resection of a superficial malignant soft tissue tumor extends the surgical field and is an indicator for potential recurrence sites.AIM To describe a grading system for surgical field extension of soft tissue sarcomas.METHODS Grading system:CD-grading is a description system consisting of C and D values in the surgical field extension,which are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.C1/D1 are positive values and C0/D0 are negative.With a known location,1/0 values can be"p"(proximal),"d"(distal),and"b"(in the tumor bed),and the description method is as follows:flap type,CxDx[x=0,1,p,d or b].RESULTS Four representative patients with subcutaneous sarcomas who underwent reconstruction using fasciocutaneous flaps are presented.The cases involved a distal upper arm(elbow)synovial sarcoma reconstructed using a pedicled latissimus dorsi(pedicled flap:CpDp);a distal upper arm(elbow)pleomorphic rhabdomyosarcoma reconstructed using a transpositional flap from the forearm(transpositional flap:CdD0);an undifferentiated pleomorphic sarcoma in the buttocks reconstructed using a transpositional flap(transpositional flap:C0D0);and a myxofibrosarcoma in the buttocks reconstructed using a propeller flap from the thigh(pedicled flap:CdDd).CONCLUSION The reconstruction method is chosen by the surgeon based on size,location,and other tumor characteristics;however,the final surgical field cannot be determined based on preoperative images alone.CD-grading is a description system consisting of C and D values in the surgical field extension that are related to the compartmental position of the flap beyond the nearby large joint and deeper extension for the pedicle,respectively.The CD-grading system gives a new perspective to the flap reconstruction classification.The CD-grading system also provides important information for follow-up imaging of a possible recurrence.
文摘Background: Ventral hernia is a complex and progressive condition that may lead to serious complications. However, no specified grading or classifying system is found to categorize the hernia, which leads to clinical complexities and may affect the patient outcome. Aim: The general aim of this paper is to build up an easy and comprehensive grading system to categorize ventral hernia. Methodology: By carrying out a secondary search over clinical presentation, physical examination, and imaging studies of ventral hernia, a valid grading system is developed. Results: Hanoon’s grading system is composed of seven grades, grades 1, 2A, 2B, 3A, 3B, 3C, and 4. Each grade entailed different clinical presentations, imaging characteristics, and progressivity of ventral hernia. Conclusion: Hanoon’s grading system for ventral hernia can be used to solve the clinical complexities of ventral hernia. Also, it can be a step forward in hernia research to build upon.
