Ochsner Journal最新文献

Thigh Compartment Syndrome Following Physician-Modified Fenestrated Endograft Aneurysm Repair. 医师改良开窗腔内动脉瘤修复术后大腿腔室综合征。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0026

Alexander Crowley, W Reed Bigham, Mila Scheinberg Hurley, Godfrey Ross Parkerson, Ross Dunbar

{"title":"Thigh Compartment Syndrome Following Physician-Modified Fenestrated Endograft Aneurysm Repair.","authors":"Alexander Crowley, W Reed Bigham, Mila Scheinberg Hurley, Godfrey Ross Parkerson, Ross Dunbar","doi":"10.31486/toj.25.0026","DOIUrl":"https://doi.org/10.31486/toj.25.0026","url":null,"abstract":"Background: Thigh compartment syndrome (TCS), a rare but serious complication of vascular procedures, often leads to severe morbidity. Unlike leg compartment syndrome, TCS can present insidiously, delaying diagnosis and treatment. While most cases of TCS are trauma-related, vascular causes such as ischemia-reperfusion injury have been reported.Case report: A 67-year-old male with coronary artery disease, chronic obstructive pulmonary disease, and a 50 pack-year smoking history underwent physician-modified fenestrated endograft repair of an unruptured thoracoabdominal aortic aneurysm. The procedure, performed via bilateral common femoral artery access, required upsizing the right femoral sheath to 26 French from the original 22 French because of delivery challenges. Postoperatively, the patient developed severe right lower extremity pain and loss of sensation, prompting emergent 4-compartment fasciotomy for leg compartment syndrome. Hours later, he developed new-onset thigh pain, paresthesia, and restricted movement, leading to the diagnosis of TCS. Emergent 3-compartment thigh fasciotomy was performed. The patient's postoperative course was complicated by anterior cord syndrome, paraplegia, and end-stage renal disease resulting from severe rhabdomyolysis. One year later, the patient remained on dialysis with chronic fasciotomy wounds.Conclusion: This case highlights the rare occurrence of TCS following physician-modified fenestrated endograft and the potential for serious complications. Given the increased risk associated with prolonged procedures and large-diameter sheaths (≥20 French), close postoperative monitoring is crucial. Early recognition and timely intervention are key to improving patient outcomes.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"23-26"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Soft Tissue Surgical Technique for Obligate Dislocation of the Patella. 髌骨专性脱位的软组织手术技术。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0061

Barbara Minkowitz, Nitish R Kasarla, Colleen M Spingarn, Julia A Matalon, Nicholas J Avallone, Michael T Busch

{"title":"Soft Tissue Surgical Technique for Obligate Dislocation of the Patella.","authors":"Barbara Minkowitz, Nitish R Kasarla, Colleen M Spingarn, Julia A Matalon, Nicholas J Avallone, Michael T Busch","doi":"10.31486/toj.25.0061","DOIUrl":"https://doi.org/10.31486/toj.25.0061","url":null,"abstract":"Background: Obligate dislocation of the patella (ODP) is a subtype of congenital disorders and dislocations of the patella. Severity of the condition varies; symptoms range from minor disabilities to impaired ambulation. Definitive treatment for ODP is surgery, with the choice of surgical procedure determined by skeletal maturity.Case series: This report documents a soft tissue surgical correction for 2 patients with ODP using (1) lateral release of the retinaculum, (2) Z-lengthening of the quadriceps tendon, (3) patellar tendon split transfer (medial side only), and (4) vastus medialis oblique muscle advancement. Patient 1 is a 7-year-old skeletally immature male who experienced complete lateral dislocation of the right patella with flexion. The patient was unable to play sports without falling and without constant patellar dislocation. Patient 2 is a 7-year-old skeletally immature male with Down syndrome who presented with a right laterally dislocating patella with flexion and a 15° flexion contracture of the knee. The patient was unable to ambulate and-according to his parent-would \"hit the side of his patella\" to center it on his knee to provide stability and permit weight-bearing in a standing frame. After surgery and recovery, both patients reached full weight-bearing without dislocation. Patient 1 plays sports for the first time and has a range of motion of 165°. Patient 2 can stand with stability, continues to work on gait training, and has a range of motion of 160°.Conclusion: This combined surgical approach mitigates patellar tilt, knee flexion contracture, and recurrent instability, offering a reproducible option for improving stability, tracking, and long-term function in complex patellofemoral pathology.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"27-36"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Stener-Like Lesion of the Radial Collateral Ligament of the Thumb Metacarpophalangeal Joint. 拇指掌指关节桡侧副韧带张氏样病变。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0076

Alexander Crowley, Jakob Oury, Katherine Fisher, Carol Meyer

{"title":"Stener-Like Lesion of the Radial Collateral Ligament of the Thumb Metacarpophalangeal Joint.","authors":"Alexander Crowley, Jakob Oury, Katherine Fisher, Carol Meyer","doi":"10.31486/toj.25.0076","DOIUrl":"https://doi.org/10.31486/toj.25.0076","url":null,"abstract":"Background: Stener lesions involve rupture of the ulnar collateral ligament of the thumb metacarpophalangeal joint with displacement of the ligament superficial to the adductor aponeurosis, preventing healing. Rarely, however, entrapment of the ligament by the overlying abductor pollicis brevis aponeurosis can lead to a Stener-like lesion. Few Stener-like lesions have been described, and surgical repair is recommended.Case report: A 27-year-old female fell while skiing and hyperextended her right thumb. She presented with thumb pain, swelling, ecchymosis, and laxity. X-ray showed subluxation of the metacarpophalangeal joint. Magnetic resonance imaging demonstrated a complete radial collateral ligament tear with the proximal end displaced superficial to the abductor pollicis brevis aponeurosis (Stener-like), blocking reduction. An incision was made over the metacarpophalangeal joint. The radial collateral ligament fibers were interposed in the abductor pollicis brevis aponeurosis. Metacarpophalangeal joint arthrotomy revealed volar plate interposition that was removed to restore metacarpophalangeal joint reduction. The radial collateral ligament was repaired with a modified Kessler technique and augmented using an internal suture brace involving a suture anchor reinforced with suture tape for collateral metacarpophalangeal joint support. The abductor pollicis brevis aponeurosis was repaired, the joint was confirmed stable, and the wound was closed and dressed in a thumb spica splint.Conclusion: This case describes a rare Stener-like lesion of the thumb radial collateral ligament, adding to the limited literature on this injury pattern. Such lesions are far less common than the classic Stener lesion. Early recognition is critical because interposed tissue will block reduction and healing.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"50-53"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Achieving the Impossible. 完成不可能的事。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.26.5059

Ronald G Amedee

引用次数: 0

Management and Outcomes of Complications Related to BioZorb Use in Breast-Conserving Surgery: A Retrospective Single-Center Case Series Analysis. 保乳手术中使用BioZorb相关并发症的处理和结果：回顾性单中心病例系列分析。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0104

Carolina Baz, Eve Paxton, Justin Turcotte, Meghan Milburn, Steven Woodward, Rubie Sue Jackson

{"title":"Management and Outcomes of Complications Related to BioZorb Use in Breast-Conserving Surgery: A Retrospective Single-Center Case Series Analysis.","authors":"Carolina Baz, Eve Paxton, Justin Turcotte, Meghan Milburn, Steven Woodward, Rubie Sue Jackson","doi":"10.31486/toj.25.0104","DOIUrl":"https://doi.org/10.31486/toj.25.0104","url":null,"abstract":"Background: BioZorb (Hologic, Inc) is an implantable fiducial marker used in breast-conserving surgery. Since the US Food and Drug Administration (FDA) approved BioZorb in 2012, numerous adverse effects have been reported, prompting the FDA to issue a warning about potential risks on February 27, 2024. BioZorb was subsequently recalled, and on October 25, 2024, the FDA classified the recall as a Class 1, the most serious category, because of the risk of severe injury or death associated with the device. Limited research is available on the management of BioZorb-related complications.Methods: In a retrospective medical records review of 296 patients who had BioZorb placed and had more than 30 days of follow-up in the electronic medical record, we identified the patients who were treated for BioZorb complications from January 2012 to February 2025.Results: With an average follow-up of 38.4 months, 13 patients (4%) experienced device-related complications, identified at a median of 6.2 months. Most affected patients had multiple complications, with the most common being chronic pain (54%), surgical site infection (39%), and wound dehiscence (31%). BioZorb was removed in 62% of patients; the remainder of the patients were managed nonoperatively.Conclusion: We identified several complications associated with the use of BioZorb in our patient population, and most of the patients who experienced complications required device removal. Because complications can develop many years after the initial surgery, surgeons should be aware of the existence of complications and the varied presentations. To our knowledge, this study is the first report on the management of BioZorb complications and subsequent outcomes, providing valuable insights for surgeons.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"5-8"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining New Mothers' Access to Zuranolone. 检查新妈妈获得舒诺酮的途径。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0120

Turner J O Simmers, David W Galarneau

引用次数: 0

Phlegmasia Cerulea Dolens Secondary to Iliac Vein Compression From Posttransplant Hematoma Despite Anticoagulation. 移植后抗凝血肿继发于髂静脉压迫的淡蓝色痰肿。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0097

Tiffany Xiu Zhen Lim, Godfrey R Parkerson, Justin Barr

{"title":"Phlegmasia Cerulea Dolens Secondary to Iliac Vein Compression From Posttransplant Hematoma Despite Anticoagulation.","authors":"Tiffany Xiu Zhen Lim, Godfrey R Parkerson, Justin Barr","doi":"10.31486/toj.25.0097","DOIUrl":"https://doi.org/10.31486/toj.25.0097","url":null,"abstract":"Background: Phlegmasia cerulea dolens is a rare, life- and limb-threatening form of venous thrombosis that is often seen in the setting of hypercoagulable states or mechanical obstruction.Case report: We report the case of a 49-year-old female with a history of multiple thromboembolic events and a methylenetetrahydrofolate reductase mutation who, despite therapeutic anticoagulation, developed phlegmasia cerulea dolens following renal transplantation. Her postoperative course was marked by recurrent hemorrhage with rapidly reaccumulating subincision and perinephric hematomas, requiring 4 exploratory laparotomies for hematoma evacuation and graft evaluation. In addition, the patient underwent urgent endovascular suction thrombectomy for extensive iliofemoral thrombosis caused by extrinsic iliac vein compression.Conclusion: This case highlights the complex interplay between bleeding and clotting in high-risk transplant recipients and the need for nuanced anticoagulation management. Although phlegmasia cerulea dolens is rare, clinicians must keep a high index of suspicion for the pathology, as early recognition and timely intervention can be both life- and limb-saving.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"54-57"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Deceptive Nature of Pneumatosis Intestinalis: From Spontaneous Resolution to Bowel Ischemia. 肠性肺肿的欺骗性：从自发消退到肠缺血。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0075

Carolina Baz, Ian Bussey, Jennifer Wormuth

{"title":"The Deceptive Nature of Pneumatosis Intestinalis: From Spontaneous Resolution to Bowel Ischemia.","authors":"Carolina Baz, Ian Bussey, Jennifer Wormuth","doi":"10.31486/toj.25.0075","DOIUrl":"https://doi.org/10.31486/toj.25.0075","url":null,"abstract":"Background: Pneumatosis intestinalis, a rare condition characterized by the presence of gas within the bowel wall, has an estimated incidence of 0.03% in the general population. Although the exact etiology of the condition remains uncertain, pneumatosis intestinalis is broadly classified as primary (idiopathic) or secondary (associated with an underlying condition), and the secondary form accounts for approximately 85% of cases. Secondary pneumatosis intestinalis has been associated with up to 60 potential causes and presents with a wide range of clinical manifestations, making thorough physical examination and imaging essential for appropriate management. Diagnosis is typically based on characteristic computed tomography (CT) findings.Case report: An 89-year-old female presented with shortness of breath, abdominal pain, nausea, vomiting, and diarrhea. CT imaging revealed extensive pneumatosis intestinalis in the small intestine. Despite the patient's stable hemodynamics and a mostly unremarkable physical examination, focal abdominal tenderness raised concern for bowel ischemia. The patient underwent an exploratory laparotomy that revealed patchy areas of pneumatosis intestinalis in an otherwise normal-appearing small bowel, with no evidence of ischemia or necrosis.Conclusion: Because of the deceptive nature of pneumatosis intestinalis, the mere presence of the condition is not enough to justify surgery. Cases with benign causes can often be managed conservatively and resolve spontaneously, whereas concerning findings that may indicate a surgically treatable cause may require urgent intervention to reduce mortality.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"45-49"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Isolated Herniation of Gallbladder Through Diaphragmatic Defect Following Hepatic Microwave Ablation. 肝微波消融术后隔膈缺损孤立性胆囊疝。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0071

Ivan Buitrago, Jordan Spring, William C Conway

引用次数: 0

Immune Checkpoint Inhibitor-Induced Myocarditis: A Late Presentation. 免疫检查点抑制剂诱导的心肌炎：一种晚期表现。

IF 1.2

Ochsner Journal Pub Date : 2026-01-01 DOI: 10.31486/toj.25.0063

Adrienne Koos, Farnoosh Shariati, Senthil Anand

{"title":"Immune Checkpoint Inhibitor-Induced Myocarditis: A Late Presentation.","authors":"Adrienne Koos, Farnoosh Shariati, Senthil Anand","doi":"10.31486/toj.25.0063","DOIUrl":"https://doi.org/10.31486/toj.25.0063","url":null,"abstract":"Background: Immune checkpoint inhibitors (ICIs) have revolutionized oncology by providing a new treatment modality for a wide range of malignancies. ICIs have been shown to aid in remission of cancers with poor prognosis, including stage IV malignancies. The first ICI was approved for metastatic melanoma, but now ICI indications range from melanoma to small cell lung cancer and triple-negative breast cancer. While this drug class has revolutionized cancer treatment, ICIs can also cause a broad range of immune-related adverse events, including myocarditis. ICI myocarditis has a broad clinical presentation, from fulminant heart failure to cardiac arrhythmia, and is confirmed with a histopathology finding of myocardial infiltration by T lymphocytes and macrophages and cell death. We present a case of cardiogenic shock secondary to ICI-associated myocarditis with onset 13 months after administration of pembrolizumab for triple-negative breast cancer.Case report: A 30-year-old female with history of triple-negative breast cancer presented to the emergency department with a 1-month history of progressive chest tightness, dyspnea on exertion, and dry cough. The patient was diagnosed with acute decompensated heart failure (stage C cardiogenic shock), started on milrinone and vasopressin, and transferred to our institution for a higher level of care. At that time, she progressed to stage D cardiogenic shock. A presumptive diagnosis of ICI-associated myocarditis was made within 12 hours, and treatment with high-dose intravenous methylprednisolone was initiated. Despite the high mortality associated with ICI-associated myocarditis, the patient improved and was discharged 9 weeks after admission.Conclusion: This case highlights the importance of considering ICI myocarditis in the differential diagnosis of cardiogenic symptoms, even in delayed presentations, and supports the lifesaving potential of early recognition and treatment.","PeriodicalId":47600,"journal":{"name":"Ochsner Journal","volume":"26 1","pages":"37-40"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0