scholarly journals A rare cause of acute compartment syndrome in the thigh: a case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Henry J T Slade ◽  
Koen De Ridder
Keyword(s):  
Compartment Syndrome ◽  
Case Reports ◽  
Clinical Suspicion ◽  
Acute Compartment Syndrome ◽  
Low Energy ◽  
Crush Injury ◽  
Posterior Compartment ◽  
Literature Research ◽  
High Clinical Suspicion ◽  
History Of

Abstract Acute compartment syndrome (ACS) is an orthopaedic emergency that requires urgent fasciotomy and decompression to avoid significant morbidity. It is most commonly caused by a fracture or crush injury. We present a case of a patient who developed ACS of the posterior compartment of the thigh secondary to a low energy fall and avulsion of sclerotic arterioles. There was no fracture and the patient was not anti-coagulated. They had fasciotomy and embolization of responsible vessels. This case demonstrates the need for high clinical suspicion needed for ACS and the morbidity associated with a delayed fasciotomy. A literature research demonstrated no case reports of a patient developing ACS with no fracture, no crush injury and no history of anti-coagulation.

scholarly journals Infections of the hand: an overview

2019 ◽  
Vol 4 (5) ◽  
pp. 183-193 ◽  
Author(s):  
Dimitrios A. Flevas ◽  
Sophia Syngouna ◽  
Emmanouel Fandridis ◽  
Sotirios Tsiodras ◽  
Andreas F. Mavrogenis
Keyword(s):  
Primary Care Physicians ◽  
Clinical Suspicion ◽  
Correct Identification ◽  
Orthopaedic Surgeons ◽  
Appropriate Treatment ◽  
High Clinical Suspicion ◽  
Inappropriate Treatment ◽  
The Social ◽  
History Of ◽  
Common Infections

Infections of the hand are common entities that are frequently encountered by orthopaedic surgeons and primary care physicians. A high clinical suspicion and a thorough medical history with information about the social and working history of the patients, correct identification of the type and cause of the infection, and prompt initiation of appropriate treatment by the infectious diseases physicians and orthopaedic surgeons are required. Late diagnosis and inappropriate treatment may be a significant cause of morbidity for the hand and mortality for the patients. This article reviews the clinical spectrum and microbiology of the most common infections of the hand, and discusses the current concepts for their treatment. The aim is to increase the awareness of the treating physicians of the diagnosis and management of infections in the hand. Cite this article: EFORT Open Rev 2019;4:183-193. DOI: 10.1302/2058-5241.4.180082

Postauricular swelling secondary to salmonella extradural abscess in a toddler: a near miss condition

2021 ◽  
Vol 14 (7) ◽  
pp. e243412
Author(s):  
Chee Chean Lim ◽  
Jeyasakthy Saniasiaya ◽  
Jeyanthi Kulasegarah
Keyword(s):  
Infectious Disease ◽  
Rare Case ◽  
Clinical Suspicion ◽  
Near Miss ◽  
Emergency Setting ◽  
History Taking ◽  
Suppurative Otitis Media ◽  
High Clinical Suspicion ◽  
Life Threatening ◽  
History Of

Postauricular swelling is usually encountered in an emergency setting in otorhinolaryngology, resulting from complication of acute or chronic suppurative otitis media. Besides that, postauricular swelling may occur secondary to various other conditions including infectious disease, tumour, vascular malformation, granulomatous condition and even trauma. Children less than 2 years old are prone to fall and up to 10% sustain traumatic brain injury without any obvious signs of neurological deficit. We describe a rare case of a postauricular swelling in a toddler which turned out to be salmonella extradural abscess from an infected traumatic haematoma. The importance of high clinical suspicion especially in a child with a history of fall cannot be emphasised more because a missed brain abscess could lead to potentially life-threatening problems. We would like to highlight that meticulous history taking along with prompt assessment and intervention is prudent for a better prognosis and recovery.

Suction injuries in children leading to acute compartment syndrome of the interosseous muscle of the hand: case reports

1996 ◽  
Vol 21 (4) ◽  
pp. 675-678 ◽  
Author(s):  
LCDR Alexander Y. Shin ◽  
Henry Chambers ◽  
Kaye E. Wilkins ◽  
Col. Allan Bucknell
Keyword(s):  
Compartment Syndrome ◽  
Case Reports ◽  
Acute Compartment Syndrome

scholarly journals 974 Paget-Schroetter Syndrome in A Young Fitness Enthusiast with A Negative D-Dimer. Highlighting the Balance Between Clinical Suspicion and Diagnostic Modalities

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Gani ◽  
G Lucas ◽  
C Ellis ◽  
A El-Karim ◽  
J Refson
Keyword(s):  
Great Saphenous Vein ◽  
Clinical Suspicion ◽  
Venous Obstruction ◽  
Risk Profiling ◽  
High Clinical Suspicion ◽  
Rare Manifestation ◽  
History Of ◽  
Diagnostic Modalities ◽  
D Dimer ◽  
Collateral Formation

Abstract This case illustrates an athletic 22-year-old, who presented to the hospital with a 3-week history of spontaneous right arm ache, discolouration and swelling. His blood tests were normal, with a negative D-dimer (<150ng/ml). He underwent a CT venogram for suspicion of venous obstruction which was unremarkable. However due to a high clinical suspicion, an ultrasound doppler was performed. This identified the presence of axillary-subclavian thrombosis which in conjunction with other clinical and radiological parameters confirmed the diagnosis of Paget-Schroetter Syndrome (PSS). Our patient was commenced on anticoagulation as the venous obstruction was suspected to be sub-acute with clinical suggestion of collateral formation. Unfortunately, his symptoms failed to resolve over a 6-month period, and he underwent an elective right rib resection with right subclavian bypass using the great saphenous vein with good outcome post-operatively. PSS is a rare manifestation of venous thoracic outlet syndrome (TOS) commonly seen in young, healthy, athletic individuals. Despite the high effectiveness of D-Dimers in ruling out acute thrombotic process and the accuracy of dedicated CT angiography in excluding vascular thrombotic events, both tests proved inconclusive in this particular case. This latter observation highlights the importance of the clinical context, and risk profiling in guiding results interpretation.

scholarly journals Complications of refractory juvenile dermatomyositis: a case report and literature review

2021 ◽  
Vol 11 (1) ◽  
pp. 8-12
Author(s):  
Rhett Orgeron
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Juvenile Dermatomyositis ◽  
Disease Process ◽  
Interdisciplinary Approach ◽  
Underlying Disease ◽  
Clinical Suspicion ◽  
Treatment Resistant ◽  
High Clinical Suspicion ◽  
History Of

We present a 29-year-old male with a history of treatment resistant juvenile dermatomyositis (JDM). The patient was admitted for complaints of nausea, diarrhea and abdominal pain and was subsequently found to have intestinal perforation on imaging. The patient had also exhibited classic dermatologic findings alongside rare dermato-pathological manifestations of JDM on examination; likely consequences of his underlying disease process. This case serves to present these rare findings and analyze the similarities of JDM and adult dermatomyositis (DM). In addition, overall diagnosis and treatment of resistant/severe JDM is explored. High clinical suspicion alongside an interdisciplinary approach is warranted for such patients given their extensive risk factors for future complications.

scholarly journals Primary Aortoenteric Fistulae: What Every Surgeon Should Know About Its Diagnosis and Treatment

2021 ◽  
Author(s):  
Mohammad Hassani ◽  
Sina Zarrintan ◽  
Mohamad Moradmand ◽  
Peyman Bakhshaei Shahrbabaki
Keyword(s):  
Clinical Suspicion ◽  
The Other ◽  
Aortoenteric Fistula ◽  
Gi Bleeding ◽  
Aortic Graft ◽  
Rare Finding ◽  
The Third ◽  
High Clinical Suspicion ◽  
Artificial Graft ◽  
History Of

Aortoenteric fistula is a rare finding that is potentially fatal and is usually seen as a fistula between the aorta or an aortic graft and the third part of the duodenum. The type without the presence of an artificial graft is considered as primary and the other type as secondary. The patients usually present with the heralding symptom of minor hematemesis, which later leads to massive and mortal GI bleeding. The most important factor in the diagnosis of an aortoenteric fistula is to have a high clinical suspicion after taking an appropriate and accurate history. In hemodynamically stable patients with clinical suspicion, performing an intravenouscontrast-CT scan of the abdomen and pelvis is of assistance in diagnosis. In general, stable hemodynamics greatly reduces the suspicion for diagnosis. Treatment is often surgical, and in regard to the severity of abdominal contamination or the level of visible infection, the extra anatomical or insitu graft repair is considered as the method of choice. This article tries to transfer our experiences in two patients, each of whom presented with hematemesis and melena without a history of underlying aortic aneurysm.

scholarly journals Apendicitis aguda de presentación atípica, un reto diagnóstico. Reporte de caso y revisión de la literatura

2021 ◽  
Vol 13 (1) ◽  
pp. 61-65
Author(s):  
Karla del Cisne Martínez Gaona ◽  
David Esteban Barzallo Sánchez ◽  
Mónica Eulalia Galarza Armijos
Keyword(s):  
Surgical Intervention ◽  
Case Reports ◽  
Iliac Fossa ◽  
Exploratory Laparotomy ◽  
Poor Quality ◽  
High Clinical Suspicion ◽  
History Of ◽  
The Right ◽  
Prolonged Hospital ◽  
Health Care Associated Pneumonia

BACKGROUND: Atypical appendicitis corresponds to approximately 39.3% of all appendicitis cases. Typically located appendicitis begins with acute pain around the belly button, which will later migrate to the right iliac fossa; however, the patient’s condition must be oriented in details that arise from a meticulous anamnesis, considering the patients history and the development of the symptoms. CASE REPORTS: 17-year-old male patient with history of right hepatectomy 15 years ago. He presented with five day evolution continuous abdominal pain, located in the right upper quadrant, nausea, vomiting and fever. Complementary laboratory tests evidenced: leukocytosis, neutrophilia, elevated procalcitonin and CRP. Tomography was suggestive of an inflammatory process in the lower right thoracic region and the right upper quadrant. A diagnostic laparoscopy was performed, it was converted into an exploratory laparotomy, showing purulent fluid in the right parietocolic gutter, adhesions, appendicular plastron in the right sub and retrohepatic region formed by the cecum, distal ileum, omentum and appendix. Retrohepatic appendix with perforation in the middle third, appendicular base and poor quality cecum. An appendectomy, cavity lavage was performed, with placement of a drain. EVOLUTION: During the postoperative period, the patient had a poor clinical evolution, with health care associated pneumonia, in addition to the need for a second surgical intervention due to the formation of a sub-hepatic collection. After 13 days of hospital care, after the second surgical intervention, he presented an adequate recovery and was discharged from the hospital. CONCLUSION: Physicians must have a high clinical suspicion of atypical location appendicitis in the presence of acute abdomen; since a late diagnosis of this cases increases the risk of complications, with perforation and peritonitis and prolonged hospital stay. The first-line treatment for complicated appendicitis is surgical intervention.

scholarly journals Crimean-Congo haemorrhagic fever presenting with acute compartment syndrome of the extremities (think beyond normal infections)

2020 ◽  
Vol 13 (2) ◽  
pp. e232323
Author(s):  
Ishma Aijazi ◽  
Fadhil Mustafa Abdulla Al Shama ◽  
Yaseen Shandala ◽  
Rupa Murthy Varghese
Keyword(s):  
Hospital Admission ◽  
Compartment Syndrome ◽  
Disseminated Intravascular Coagulation ◽  
Direct Contact ◽  
Acute Compartment Syndrome ◽  
Haemorrhagic Fever ◽  
Cchf Virus ◽  
History Of ◽  
Crimean Congo Haemorrhagic Fever ◽  
The Right

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonosis transmitted to humans and animals (which act as a reservoir) through the bite of a ‘Hyalomma’ tick. CCHF virus belongs to the genus Nairovirus. Humans are infected when they come in direct contact with the blood or secretions of infected livestock or other infected humans. This disease initially presents with non-specific febrile symptoms common to many viral illnesses and later progresses to disseminated intravascular coagulation (DIC) with haemorrhagic manifestations.We present the case of a middle-aged man with CCHF. He presented to the hospital with DIC and acute compartment syndrome in the right forearm, requiring urgent orthopaedic intervention. The diagnosis was delayed because there was no clear history of contact. The patient was started taking ribavirin on the fifth day of hospital admission. He recovered fully.

Management of external jugular vein aneurysm: a systematic review

Vascular ◽  
2021 ◽  
pp. 170853812110139
Author(s):  
Petroula Nana ◽  
Eleni Gkrinia ◽  
Chara Maiou ◽  
Ourania Karyda ◽  
Christos Korais ◽  
...  
Keyword(s):  
Systematic Review ◽  
Jugular Vein ◽  
Valsalva Maneuver ◽  
Case Reports ◽  
Case Series ◽  
External Jugular Vein ◽  
Clinical Suspicion ◽  
Histological Evaluation ◽  
Primary Indication ◽  
High Clinical Suspicion

Introduction Aneurysms of the jugular vein system are rare and high clinical suspicion is needed for diagnosis. External jugular vein aneurysms (EJVA) are considered innocent lesions that need treatment mainly for aesthetic reasons. The aim of this systematic review was to present current literature regarding diagnosis and management of EJVAs. Methods A literature review was conducted through the Pubmed/Medline and Scopus regarding articles referring on EJVA from 2000 to 2020. Using the PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses), 30 articles were identified, according to inclusion criteria. Demographics, clinical characteristics, etiology, diagnostic imaging, complications, treatment, and histopathological findings were recorded and analyzed. Results Twenty-seven case reports and one case series were identified, including 30 patients and 31 EJVAs. One-third of patients (30.3%) were < 18 years old (mean age 32 years, range 1–72 years) and 54% of them were females. In 51% of the cases, the lesion was characterized as a true aneurysm after histological evaluation. The presence of a soft cervical mass was the most common clinical symptom, while Valsalva maneuver pointed out the presence of an EJVA in 66.7% of patients. Diagnosis was achieved using ultrasonography, computed tomography, or magnetic resonance imaging. Forty-three percent of the patients underwent more than one radiological examination. Twenty patients underwent surgical management. The primary indication of surgical treatment was aesthetic reasons (11/20, 55%). Thrombosis was the most common EJVA complication (11/30, 36.3%). Conclusions Differential diagnosis of neck mass should include EJVA. High clinical suspicion and adequate imaging are important for diagnosis. Open surgical approach is the more commonly applied therapeutic strategy.

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