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Confirmation of an internal hydatid bladder fistula using postoperative methylene blue retrograde injection via urinary catheter: a case report.

ABSTRACT: Abdominal hydatidosis resulting in an internal hydatid bladder fistula postoperatively is quite rare and might have serious consequences without timely treatment. A 74-year-old Tibetan woman presented with abdominal distension and was diagnosed with hydatid disease. Cyst contents were removed, and the pericyst was partially resected without contraindication. Furthermore, no internal urinary fistula was found before or during the operation, and the presence of an internal fistula was indicated by methylene blue retrograde injection via urinary catheter after the operation. The use of postoperative methylene blue retrograde injection via urinary catheter is recommended to identify internal hydatid bladder fistula formation.

SUBMITTER: Wang Q

PROVIDER: S-EPMC8647256 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Confirmation of an internal hydatid bladder fistula using postoperative methylene blue retrograde injection via urinary catheter: a case report.

Wang Qiang Q Zhao Shunyun S Sami Malik Waseem MW Gao Wei W

The Journal of international medical research 20211101 11

Abdominal hydatidosis resulting in an internal hydatid bladder fistula postoperatively is quite rare and might have serious consequences without timely treatment. A 74-year-old Tibetan woman presented with abdominal distension and was diagnosed with hydatid disease. Cyst contents were removed, and the pericyst was partially resected without contraindication. Furthermore, no internal urinary fistula was found before or during the operation, and the presence of an internal fistula was indicated by ...[more]

PMID: 34851755

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Project description:BackgroundIn Dupuytren's surgery, limited fasciectomy is still the gold-standard treatment. A relatively high risk of iatrogenic nerve injury has been observed especially when the spiral cords of the Dupuytren's tissue pull digital nerves away from their normal anatomical location. Intraoperative neural marking could facilitate locating the potentially displaced nerves. Hence, surgery could be undertaken more quickly with a lower risk of iatrogenic nerve injury.ObjectivesWe hypothesize that digital nerves may be stained with methylene blue (MB) in vivo providing a visual aid to distinguish them from Dupuytren's tissue. We aim to (a) test an in vivo nerve staining technique using MB in a rat sciatic nerve model and to (b) assess the safety of epineural MB injection.MethodsThree experiments were performed: first, the effects of (a) sham surgery, (b) epineural needle insertion, and (c) 40 μL epineural saline injection were tested in the rat sciatic nerve. Second, we determined the (a) histoanatomical localization of the epineurally injected 40 µL 1 m/m% MB stock solution and (b) we tested which saline dilution (i.e., 1:40, 1:80, and 1:160) of the stock solution does provide optimal blue color upon 40 µL epineural injection. Third, the functional and morphological effect of 40 µL 1:80 diluted MB injection was compared with that of saline, injected into the contralateral sciatic nerve. The functional effects were tested by assessing the pain threshold by using a dynamic plantar esthesiometer (DPA) and by examination of the animal's gate and paw posture. Sciatic nerves were subjected to histological examination and morphometry to test structural damage.ResultsNeither epineural needle insertion nor saline injection caused any functional or morphological changes. Histological examination revealed that the MB stained the epineural compartment. Epineural injection of 40 μL 1:80 diluted MB into the sciatic nerve stained an 18.18-mm segment of the nerve distal to the puncture point. DPA revealed unchanged pain threshold values on the plantar surface of the limbs. Normal gait and foot posture suggested normal motor functions in all groups. No histological changes were seen in the stained nerves, and the nerve fiber density remained unchanged.ConclusionWe demonstrated that in vivo nerve staining with MB is a suitable method to mark nerves without causing detectable negative effect to the stained nerve. Human trials are required to prove the efficacy of the technique in Dupuytren's disease.

Project description:A promising alternative to antibiotics for treatment of Staphylococcus aureus infections is photodynamic inactivation (PDI), which employs a photosensitizer (PS) that produces cytotoxic reactive oxygen species (ROS) when exposed to molecular oxygen and antimicrobial blue light in the spectrum of 400-470 nm. Although the precise mechanistic basis of PDI has not been defined, the formation of ROS and free radicals that oxidize a number of cellular targets, including membrane lipids, damage to proteins and nucleic acids result in inactivation of essential cellular functions and subsequent cell death. Because PDI is non-selective and affects multiple cellular targets, development of resistance or tolerance to PDI has been considered to be unlikely and attempts to induce S. aureus resistance or tolerance upon repeated sub-lethal doses of PDI have not succeeded. However, multiple aspects of PDI suggest that development of tolerance is highly probable, in particular when PDI is used for treatment of infections where the environment at the infection site prevents penetration of PDI at a level sufficient to cause death of all bacteria and with tolerant phenotypes emerging from the surviving bacteria. In this study, we sought to identify the mechanisms that contribute to PDI tolerance in S. aureus. S. aureus HG003 and the isogenic HG003DmutSL strain with defects in DNA mismatch repair were used to evaluate the response of S. aureus and the roles of DNA mismatch repair and gene regulatory networks to repeated sublethal doses of PDI. Global transcriptome and genome analyses were used in an agnostic approach to identify the underlying transcriptional responses and genetic adaptations that occur as a result of repeated PDI and contribute to PDI tolerance. Our results reveal multiple metabolic, transport and cell wall biogenesis pathways that contribute to PDI tolerance, and a S. aureus regulatory gene likely responsible for the adaptive transcriptional response to PDI.

Dataset Information

Confirmation of an internal hydatid bladder fistula using postoperative methylene blue retrograde injection via urinary catheter: a case report.

Publications

Confirmation of an internal hydatid bladder fistula using postoperative methylene blue retrograde injection via urinary catheter: a case report.

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