SB 203580 hydrochloride The elbow joint was immobilized

The elbow joint was immobilized using a splint postoperatively. Intravenous prostaglandin E1 was administered for 3 days to prevent thrombosis recurrence. Moreover, ultrasonography conducted on Postoperative Day 5 showed a patent flow in the left brachial, proximal radial, and ulnar arteries, without residual thrombi. No postoperative complication was observed. The preoperative bilateral hand skin temperatures remained nearly identical to the postoperative skin temperatures (Table 1).
Discussion Previous studies have reported that arterial occlusions, particularly occlusion of the axillary artery, in throwing athletes mainly occurs in the shoulder region. The axillary artery can be compressed by the humeral head and at the thoracic outlet when the arm is in the pitching position. Rohrer et al postulated that thrombosis of the axillary artery could be caused by a repetitive mechanical trauma of the humeral head during throwing. Thoracic outlet syndrome (TOS) has been reported as the leading cause of arterial occlusion in throwers, and is described as a SB 203580 hydrochloride at the superior thoracic outlet caused by external pressure on the neurovascular bundle. Duwayri et al conducted a retrospective study and reported that 8.2% of TOS was arterial occlusion involving the subclavian artery (81%) and axillary artery (19%). Duwayri et al examined arterial occlusion in their patients with TOS and reported that a spectrum of pathology could be found in overhead athletes. TOS is caused by a repetitive positional compression of the axillary artery during throwing. The pathology of vascular occlusion includes focal intimal hyperplasia, aneurysm formation, segmental dissection, and branch vessel aneurysms. Other causes of arterial occlusion in the shoulder region include structural abnormalities such as a congenital first rib, trauma, coagulopathy, connective tissue disease, arrhythmia, and iatrogenic factors. The cause of arterial occlusion in this patient remains obscure. Nuber et al examined upper extremity ischemia in athletes, and reported that soft tissue hypertrophy and hyperactivity played unique and predominant roles in the pathogenesis of an arterial injury. In our patient, one possible mechanism was temporary vascular compression of the adjacent swollen muscles and soft tissues induced by repetitive pitching. Stasis of the blood stream caused the formation of thrombi and complete occlusion of the arteries.
Introduction A small bowel intussusception is rare and can be caused by infection, polyp, lymphoma, vasculitis, Meckel\'s diverticulum, intestinal duplication, cystic fibrosis, and intramural hematoma. Multiple simultaneous small bowel intussusceptions are rarer. Rapunzel syndrome is an extremely rare intestinal condition resulting from a trichobezoar with a tail-like extension from the stomach to the small bowel. Rapunzel syndrome may present as chronic abdominal pain, malabsorption, gastrointestinal tract obstruction, gastrointestinal bleeding, and intussusceptions. Few cases of Rapunzel syndrome in patients presenting with intussusceptions have been reported. We report a case of a 5-year-old girl with Rapunzel syndrome causing intussusceptions and bowel obstruction.
Case Report A 5-year-old girl presented with severe abdominal pain and nausea that started 2 days before presentation. She experienced cramping pain in the left abdomen for three weeks without other gastrointestinal symptoms. On physical examination, a left palpable abdominal mass was noted. Abdominal echo revealed typical imaging findings but an unusual location for intussusceptions. Abdominal computerized tomography (CT) revealed multiple target signs (Figure 1) over the jejunum. Radiological reduction was unsuitable for the multiple jejunal intussusceptions; therefore, laparoscopic exploration was performed. During operation, 8 segmental jejunal intussusceptions ranging from 2 cm to 8 cm in length were observed at a distance of 20–100 cm from the ligament of Treitz. All intussusceptions were laparoscopically reduced. A mass or diverticulum was not observed. The patient had a smooth recovery and was discharged on the 5th day after operation.