Subtalar Arthrodesis in Patients With Prior Tibiotalar Arthrodesis for Posttraumatic Osteoarthritis.

Background: The tibiotalar arthrodesis for end-stage ankle osteoarthritis is a surgical procedure that leads to a modification of the kinematics of the adjacent joints and may result in the development of secondary osteoarthritic degeneration of the subtalar joint. It has previously been observed that subtalar arthrodesis in this context shows a lower fusion rate than isolated subtalar arthrodesis. This retrospective study reports the results of subtalar joint arthrodesis with previous ipsilateral tibiotalar arthrodesis and suggests some factors that may compromise the fusion of the joint.

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study.

Background: Although considerable literature can be found on the outcome of total ankle replacement (TAR), only a few studies have reported the results of the fixed-bearing Cadence prosthesis. This noninventor study reports a consecutive series of 60 Cadence TAR systems with a mean of 2.9 years' follow-up, focusing on clinical and radiographic outcomes and early complications.

A double-blind randomized, multicenter, placebo-controlled study of itopride in functional dyspepsia postprandial distress syndrome.

Background: Itopride, a mixed D2 antagonist and cholinesterase inhibitor, has prokinetic effects on gastric motility. The Leuven Postprandial Distress Scale is a validated patient-reported outcome instrument for functional dyspepsia (FD) postprandial distress syndrome (PDS). We aimed to use the LPDS to assess treatment outcome in PDS and PDS/EPS (epigastric pain syndrome).

Effects of Rome IV Definitions of Functional Dyspepsia Subgroups in Secondary Care.

Background & Aims: Functional dyspepsia (FD) is subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) according to the Rome III consensus. In clinical practice, there is a major overlap between these subgroups. The Rome IV criteria included postprandially occurring symptoms in the PDS subgroup.

Short Occult Retractile Fibrous Scar Causing Exclusive Retrograde Stenosis of the Sigmoid Colon: An Incidental Diagnosis Nineteen Years After a Single Episode of Colonic Diverticulitis.

We report a rare case of purely retrograde stenosing stricture of the sigmoid descending colonic junction fortuitously diagnosed during the waning of a failed virtual colonoscopy in a 69-year-old patient. The rather asymptomatic patient was addressed to investigate a positive fecal occult blood test. He had suffered a single acute colonic diverticulitis episode 19 years before.

Acute massive congestive ischaemic colitis related to inferior mesenteric arteriovenous malformation.

We report a very rare case of acute congestive ischaemic colitis of the left colon caused by brutal decompensation of an uncommon arteriovenous malformation (AVM) in the territory of the inferior mesenteric artery (IMA) in a 45-year-old male patient. The patient presented with severe abdominal pain in the left iliac fossa and abundant mucoid stools. The diagnosis of congestive colitis was made by optical colonoscopy but the full diagnosis of the responsible AVM in the IMA territory was made by contrast-enhanced multidetector CT scan combined with colour Doppler ultrasound.

Pancreaticobronchial Fistula Diagnosed by MDCT.

Pancreatic duct disruption is a serious complication of acute or chronic pancreatitis. These ruptures may cause collections of pancreatic secretion leading to ascites but also to pleural or mediastinal effusions. Rupture into the bronchial tree, resulting in a pancreaticobronchial fistula, is also possible, but it is a rare complication.

Posterior Arthroscopic Subtalar Arthrodesis.

Introduction: Although subtalar joint arthrodesis may be achieved through open or arthroscopic approaches, we have found that posterior arthroscopic subtalar arthrodesis has technical advantages compared with other approaches.

Step 1 Preoperative Assessment And Planning: Clinically assess the foot and ankle with regard to remaining motion, previous scarring, and associated deformities, ensuring that no concomitant procedure will be needed in the supine position.

Step 2 Positioning Of The Patient: Use spinal or general anesthesia.

Arthroscopic Debridement After Total Ankle Arthroplasty.

Background: Residual pain due to impingement after ankle arthroplasty can be addressed with arthroscopic debridement. Literature focusing on the effectiveness of arthroscopic debridement after total ankle arthroplasty (TAA) is scarce. The authors report a case series of 12 patients complaining of anterior or posterior impingement pain, 11 of which were in the absence of malalignment which were treated by arthroscopy.

Anatomical characteristics of the flexor digitorum accessorius longus muscle and their relevance to tarsal tunnel syndrome a systematic review.

Background: Clinical and cadaver studies have reported that supernumerary muscles could be the etiology of a variety of pathologic disorders, such as posterior impingement syndrome, tarsal tunnel syndrome (TTS), and flexor hallucis longus tenosynovitis. We describe a unique variant of the flexor digitorum accessorius longus (FDAL) muscle as an apparent cause of TTS, functioning as an independent flexor of the second toe, which has not been described in the literature. In addition to this case report, a systematic review was performed of TTS caused by the FDAL muscle.

Mass-forming intrahepatic cholangiocarcinoma presenting with painful obstructive hemobilia.

We report a very rare case of acute obstructive hemobilia caused by bleeding of a mass-forming intrahepatic cholangiocarcinoma in a 75-year old man. The prompt complete emergency diagnosis was made by ultrasound and confirmed by MDCT. The features of hemobilia and intrahepatic cholangiocarcinoma are briefly reviewed.

Hepatic angiosarcoma occurring 65 years after thorium dioxide (Thorotrast) exposure: imaging, surgical and histo- pathologic findings of a historical case.

We report the CT, surgical and histopathologic findings of a rare case of Hepatic Angiosarcoma (HAS) diagnosed in a 85-year old women 65 years afterThorotrast (Th232) exposure for angiography. At the early arterial phase of dynamic MDCT, peripheral curvilinear and central nodular puddling of contrast produced in the 8 cm tumor.Then progressive contrast filling of the tumor was observed on the delayed scans.

Intermediate-term Results of Mobile-bearing Total Ankle Replacement.

Background: The literature analyzing total ankle replacement (TAR) results should be critically interpreted because studies made by the design surgeons are potentially subject to bias. European nondesigner surgeon studies reviewing the HINTEGRA TAR system are scarce in the literature. The present study is a European nondesigner surgeon study reviewing a consecutive series of 50 HINTEGRA TAR systems with a minimum follow-up of 2 years, focusing on clinical and radiographic outcomes.

Arthrodesis After Failed Total Ankle Replacement.

Background: The literature on salvage procedures for failed total ankle replacement (TAR) is sparse. We report a series of 17 patients who had a failed TAR converted to a tibiotalar or a tibiotalocalcaneal arthrodesis.

Methods: Between 2003 and 2012, a total of 17 patients with a failed TAR underwent an arthrodesis.

Perforation of the gastrointestinal tract caused by inadvertent ingestion of blister pill packs: report of two cases diagnosed by MDCT with emphasis on maximal intensity and volume rendering reformations.

We report two cases of elderly patients presenting with life-threatening complications due to inadvertent accidental ingestion of blister pill packs (BPPs). The first patient presented with obstruction followed by anemia and finally perforation of the small bowel. The second presented with rapidly lethal mediastinitis due to a large perforation of the lower esophagus.

Acute liver failure secondary to metastatic liver infiltration: case report and review of the literature.

We present the case of a patient who died from multiple organ failure due to acute liver failure as a result of malignant hepatic infiltration by an adenocarcinoma. A review of the literature revealed that the clinical picture, laboratory examination, and imaging studies do not contribute to the diagnosis of this rare cause of liver failure. Therefore, liver biopsy should be considered early in the process, as this diagnosis is a contraindication for orthotopic liver transplantation.

Control of AA amyloidosis complicating Crohn's disease: a clinico-pathological study.

Background: Immunosuppressive drugs may prevent or partially reverse progression of renal AA-amyloidosis, a rare complication of Crohn's disease, often fatal due to renal failure.

Materials And Methods: The clinical, biological and pathological data of 16 patients treated since 1976 were reviewed. Serum amyloid A was determined in surviving patients.

Extensive propagation of a pancreatic pseudocyst along the lower limb through the sciatic foramen.

The extremely rare extensive propagation of a giant retroperitoneal pancreatic pseudocyst into the posterior compartment of the lower limb as far as the knee is reported. The extension was found producing through the sciatic foramen and the full diagnosis was made by MDCT. A complete healing was progressively obtained in the 78-year old female after a six months period of sequential multidisciplinary therapeutic approach comprising combined medical and surgical intra-abdominal and external drainage.

Focal parietal necrosis of the sigmoid due to atypical neuroleptics: a case report.

We present the case of a 26-year-old man with schizoid personality disorder who suffered from a very focal and transparietal necrosis of the sigmoid after an overdose of atypical neuroleptics. This is a singular, rather unknown and potentially lethal side effect of these drugs. The physiopathology of this complication is multifactorial.

Spontaneous transhepatic rupture of the gallbladder with massive hemoperitoneum.

Perforation of the gallbladder has an incidence of 1.6 to 2.8% in gallbladder disease.

Pylephlebitis complicating peridiverticulitis without hepatic abscess: early detection with contrast-enhanced CT of the abdomen.

Pylephlebitis is a very rare and dangerous complication of inflammatory abdominal processes, mainly appendicitis (1) and diverticulitis (2).We describe a case of peridiverticular inflammation leading to a extensive phlebitis of the adjacent sigmoid vein, extending to the inferior mesenteric vein up to the proximal portal vein, with distal embolus into the left portal vein. Contrast CT and multiplanar reconstructions allowed early diagnosis, and with antibiotic and anticoagulation therapy, no liver abscess developed.

Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up.

Background: Isolated subtalar arthrodesis is the treatment of choice for several conditions -mostly subtalar arthritis, tarsal coalition and posterior tibial tendon dysfunction- unresponsive to conservative treatment. Arthroscopic procedures are an interesting recent alternative, less invasive than conventional open techniques. Posterior arthroscopy, in prone position, could be more advantageous than the conventional lateral and/or anterior approach.

Plantar pressure relief using a forefoot offloading shoe.

Aim: To assess the effectiveness of the Barouk(®) second-generation postoperative forefoot relief shoes during appropriate use of the shoe on healthy subjects.

Materials And Methods: A convenience sample of 35 volunteer subjects (17 women, 18 men) was recruited to participate in this study. Dynamic foot loading was evaluated with inshoe plantar pressure measurements.

Tarsal tunnel syndrome and flexor hallucis longus tendon hypertrophy.

Tarsal tunnel syndrome (TTS) defines an entrapment neuropathy of the posterior tibial nerve or one of its branches, within the tarsal tunnel. Numerous etiologies have been described explaining this entrapment, including trauma, space-occupying lesions, foot deformities, etc. We present an unreported cause of a space-occupying lesion in the etiology of TTS, namely the combination of a hypertrophic long distally extended muscle belly of the flexor hallucis longus and repetitive ankle motion.