Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block
Background In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves. We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation in a patient undergoing a caudal block...
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| Veröffentlicht in: | Canadian journal of anesthesia 2011-06, Vol.58 (6), p.551-554 |
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| creator | Dugani, Shubada Tran, De Q. H. Finlayson, Roderick J. |
| description | Background
In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves. We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation in a patient undergoing a caudal block.
Clinical features
A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she had undergone a partial coccygectomy. A trial caudal block was planned. Fluoroscopy of the lower sacral area revealed the presence of a gas bubble inferoposteriorly to the coccygeal remnant. A confirmatory ultrasound scan revealed a hollow structure compatible with bowel. The procedure was abandoned. Subsequently, a non-enhanced computed tomographic scan of the pelvis confirmed the diagnosis of large bowel herniation. The patient was referred to a colorectal surgeon, and she subsequently underwent successful laparoscopic repair of the coccygeal hernia.
Conclusion
Ultrasonography can be a valuable adjunct in identifying non-neural pathologies in patients undergoing interventional procedures in chronic pain management. This case report highlights the importance of being vigilant for unanticipated pathologies during ultrasound examinations while performing chronic pain block procedures. |
| doi_str_mv | 10.1007/s12630-011-9489-3 |
| format | Article |
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In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves. We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation in a patient undergoing a caudal block.
Clinical features
A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she had undergone a partial coccygectomy. A trial caudal block was planned. Fluoroscopy of the lower sacral area revealed the presence of a gas bubble inferoposteriorly to the coccygeal remnant. A confirmatory ultrasound scan revealed a hollow structure compatible with bowel. The procedure was abandoned. Subsequently, a non-enhanced computed tomographic scan of the pelvis confirmed the diagnosis of large bowel herniation. The patient was referred to a colorectal surgeon, and she subsequently underwent successful laparoscopic repair of the coccygeal hernia.
Conclusion
Ultrasonography can be a valuable adjunct in identifying non-neural pathologies in patients undergoing interventional procedures in chronic pain management. This case report highlights the importance of being vigilant for unanticipated pathologies during ultrasound examinations while performing chronic pain block procedures.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/s12630-011-9489-3</identifier><identifier>PMID: 21432004</identifier><identifier>CODEN: CJOAEP</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Cardiology ; Case reports ; Case Reports/Case Series ; Chronic pain ; Critical Care Medicine ; Female ; Fluoroscopy - methods ; Hernia - diagnosis ; Hernia - diagnostic imaging ; Hernias ; Humans ; Intensive ; Intestinal Diseases - diagnosis ; Intestinal Diseases - diagnostic imaging ; Laparoscopy ; Medical sciences ; Medicine ; Medicine & Public Health ; Nerve Block ; Pain Management ; Pain Medicine ; Pediatrics ; Pelvis ; Pneumology/Respiratory System ; Surgeons ; Tendons ; Ultrasonic imaging ; Ultrasonography</subject><ispartof>Canadian journal of anesthesia, 2011-06, Vol.58 (6), p.551-554</ispartof><rights>Canadian Anesthesiologists' Society 2011</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-6764e2841412610487ede959b1b579124477c5241436b468027a7da0be42fd003</citedby><cites>FETCH-LOGICAL-c443t-6764e2841412610487ede959b1b579124477c5241436b468027a7da0be42fd003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12630-011-9489-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12630-011-9489-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24305792$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21432004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dugani, Shubada</creatorcontrib><creatorcontrib>Tran, De Q. H.</creatorcontrib><creatorcontrib>Finlayson, Roderick J.</creatorcontrib><title>Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anesth/J Can Anesth</addtitle><addtitle>Can J Anaesth</addtitle><description>Background
In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves. We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation in a patient undergoing a caudal block.
Clinical features
A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she had undergone a partial coccygectomy. A trial caudal block was planned. Fluoroscopy of the lower sacral area revealed the presence of a gas bubble inferoposteriorly to the coccygeal remnant. A confirmatory ultrasound scan revealed a hollow structure compatible with bowel. The procedure was abandoned. Subsequently, a non-enhanced computed tomographic scan of the pelvis confirmed the diagnosis of large bowel herniation. The patient was referred to a colorectal surgeon, and she subsequently underwent successful laparoscopic repair of the coccygeal hernia.
Conclusion
Ultrasonography can be a valuable adjunct in identifying non-neural pathologies in patients undergoing interventional procedures in chronic pain management. This case report highlights the importance of being vigilant for unanticipated pathologies during ultrasound examinations while performing chronic pain block procedures.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Cardiology</subject><subject>Case reports</subject><subject>Case Reports/Case Series</subject><subject>Chronic pain</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Fluoroscopy - methods</subject><subject>Hernia - diagnosis</subject><subject>Hernia - diagnostic imaging</subject><subject>Hernias</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intestinal Diseases - diagnosis</subject><subject>Intestinal Diseases - diagnostic imaging</subject><subject>Laparoscopy</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nerve Block</subject><subject>Pain Management</subject><subject>Pain Medicine</subject><subject>Pediatrics</subject><subject>Pelvis</subject><subject>Pneumology/Respiratory System</subject><subject>Surgeons</subject><subject>Tendons</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1kF1rHCEUhqW0NJukPyA3RQolV9MeP0adyxLSJBDoTQu5E0ed7CSuTnWGsP--bnebQCFXgj7n9bwPQmcEvhAA-bUQKhg0QEjTcdU17A1aEd6JRnWyfYtWoBhtBIG7I3RcygMAKNGq9-iIEs4oAF8hexPt6HycTcDOz97OY4o4DbhPTz7gtc9xNH_vnsZ5jZcwZ1NSTPfZTOstNtHhISwpp2LTtMVuyWO8xwZbs7ga2YdkH0_Ru8GE4j8czhP06_vlz4vr5vbH1c3Ft9vGcs7mRkjBPVWc8FqLAFfSO9-1XU_6VnaEci6lbWl9Z6LnQgGVRjoDved0cADsBJ3vc6ecfi--zHozFutDMNGnpWglWxCqVbSSn_4jH9KSY12uQlJ1THBSIbKHbG1Xsh_0lMeNyVtNQO_8671_Xf3rnX_N6szHQ_DSb7x7nvgnvAKfD4Ap1oQhm-q_vHCcQS2725DuuTLtjPr8suHrv_8BjrScVg</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Dugani, Shubada</creator><creator>Tran, De Q. H.</creator><creator>Finlayson, Roderick J.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block</title><author>Dugani, Shubada ; Tran, De Q. H. ; Finlayson, Roderick J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-6764e2841412610487ede959b1b579124477c5241436b468027a7da0be42fd003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Cardiology</topic><topic>Case reports</topic><topic>Case Reports/Case Series</topic><topic>Chronic pain</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Fluoroscopy - methods</topic><topic>Hernia - diagnosis</topic><topic>Hernia - diagnostic imaging</topic><topic>Hernias</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intestinal Diseases - diagnosis</topic><topic>Intestinal Diseases - diagnostic imaging</topic><topic>Laparoscopy</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nerve Block</topic><topic>Pain Management</topic><topic>Pain Medicine</topic><topic>Pediatrics</topic><topic>Pelvis</topic><topic>Pneumology/Respiratory System</topic><topic>Surgeons</topic><topic>Tendons</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dugani, Shubada</creatorcontrib><creatorcontrib>Tran, De Q. H.</creatorcontrib><creatorcontrib>Finlayson, Roderick J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dugani, Shubada</au><au>Tran, De Q. H.</au><au>Finlayson, Roderick J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block</atitle><jtitle>Canadian journal of anesthesia</jtitle><stitle>Can J Anesth/J Can Anesth</stitle><addtitle>Can J Anaesth</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>58</volume><issue>6</issue><spage>551</spage><epage>554</epage><pages>551-554</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><coden>CJOAEP</coden><abstract>Background
In contrast to fluoroscopy, ultrasonography allows visualization of structures such as muscles, tendons, vessels, and nerves. We describe a case where ultrasonography in conjunction with fluoroscopy led to the incidental diagnosis of bowel herniation in a patient undergoing a caudal block.
Clinical features
A 71-yr-old woman presented to our chronic pain clinic with a long-standing history of coccydynia for which she had undergone a partial coccygectomy. A trial caudal block was planned. Fluoroscopy of the lower sacral area revealed the presence of a gas bubble inferoposteriorly to the coccygeal remnant. A confirmatory ultrasound scan revealed a hollow structure compatible with bowel. The procedure was abandoned. Subsequently, a non-enhanced computed tomographic scan of the pelvis confirmed the diagnosis of large bowel herniation. The patient was referred to a colorectal surgeon, and she subsequently underwent successful laparoscopic repair of the coccygeal hernia.
Conclusion
Ultrasonography can be a valuable adjunct in identifying non-neural pathologies in patients undergoing interventional procedures in chronic pain management. This case report highlights the importance of being vigilant for unanticipated pathologies during ultrasound examinations while performing chronic pain block procedures.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21432004</pmid><doi>10.1007/s12630-011-9489-3</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Cardiology Case reports Case Reports/Case Series Chronic pain Critical Care Medicine Female Fluoroscopy - methods Hernia - diagnosis Hernia - diagnostic imaging Hernias Humans Intensive Intestinal Diseases - diagnosis Intestinal Diseases - diagnostic imaging Laparoscopy Medical sciences Medicine Medicine & Public Health Nerve Block Pain Management Pain Medicine Pediatrics Pelvis Pneumology/Respiratory System Surgeons Tendons Ultrasonic imaging Ultrasonography |
| title | Incidental detection of bowel herniation with ultrasonography and fluoroscopy during a caudal block |
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