Magnetic sphincter augmentation (MSA) is an anti-reflux procedure with comparable outcomes to fundoplication, yet its use in patients with larger hiatal or paraesophageal hernias has not been widely reported. This review discusses the history of MSA and how its utilization has evolved from initial Food and Drug Administration (FDA) approval in 2012 for patients with small hernias to its contemporary use in patients with paraesophageal hernias and beyond.
Pneumococcal meningitis is the most severe bacterial meningitis rarely complicated by acute myelitis. We report a case of a 54-year-old female who presented with pneumococcal meningoencephalitis. After eight days of hospitalization, the patient presented a sudden onset of bilateral lower leg weakness and bladder and bowel sphincter dysfunction.
The most accurately described causes of alcohol-related myelopathy are cases of hepatic myelopathy, which is myelopathy in the setting of either liver cell failure or portosystemic failure resulting in toxic myelopathy in the absence of liver failure. One of the few descriptions of myelopathy completely attributed to toxic effects of alcohol or its metabolites alone is by Sage et al., who reported five patients with the condition who had no evidence of hepatic involvement, portal hypertension, or nutritional deficiency.
General Surgery, Cancer Center, Department of Hernia Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, China.
Background: The management of Type III sphincter of Oddi dysfunction or functional biliary pain (FBP) is challenging. A strategy of intermittent intrasphincteric botulinum toxin (Botox) injections into the sphincter of Oddi can alleviate pancreaticobiliary pain. In patients who lose response to intermittent Botox injections, endoscopic biliary sphincterotomy (ES) could potentially reset pain facilitating ongoing management of symptoms.
Background Vertebral hemangiomas (VHs) are benign vascular tumors commonly found within the vertebral bodies of the spine. While most VHs remain asymptomatic and are often discovered incidentally during imaging studies, a subset can become symptomatic, leading to clinical challenges. The optimal treatment approach for symptomatic VHs remains a topic of debate.
