scholarly journals Pararectal angiomyxoma: a diagnostic dilemma

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Abhay N Dalvi ◽  
Mahadeo N Garale ◽  
Jayati J Churiwala ◽  
Avinash Landge ◽  
Sakina Husain ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Supine Position ◽  
Diagnostic Laparoscopy ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Advanced Imaging ◽  
Diagnostic Dilemma ◽  
Spontaneous Reduction ◽  
Ischiorectal Abscess ◽  
Pelvic Floor Hernia

Abstract Clinical diagnosis of pararectal masses remains a challenge to this day. Despite the availability of advanced imaging facilities, we often fail to reach a definitive diagnosis and have to resort to surgery. We describe a case of a 60-year-old female with a painless perianal swelling gradually increasing in size for 6 months with spontaneous reduction on assuming a supine position. Clinical examination of this patient was suggestive of a pelvic floor hernia. However, radiological investigations were suggestive of an ischiorectal abscess. In view of lack of radiological corroboration of clinical findings, patient underwent diagnostic laparoscopy which ruled out a hernia. A wide local excision of the mass was performed, which on histopathology with immunohistochemistry examination revealed an aggressive pararectal angiomyxoma.

scholarly journals A case report: ruptured primary ovarian abscess in pregnancy

2021 ◽  
Vol 10 (9) ◽  
pp. 3627
Author(s):  
Dinesh D. Pratapwar ◽  
Namdev M. Bhure ◽  
Sarika P. Zunjare
Keyword(s):  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Definitive Diagnosis ◽  
Rare Entity ◽  
Diagnostic Dilemma ◽  
Minimally Invasive Surgical Procedure ◽  
Delay In Diagnosis ◽  
Minimally Invasive Surgical ◽  
Ovarian Abscess ◽  
In Pregnancy

Primary ovarian abscess during pregnancy is a very rare entity.  The clinical presentation is very vague and hence can be a diagnostic dilemma. Diagnostic laparoscopy gives a definitive diagnosis and an opportunity to treat the entity in same settings. Herein we discussed a case of a ruptured primary ovarian abscess in pregnancy which was successfully managed by laparoscopy. Ovarian abscess is different from tubo-ovarian abscess. A delay in diagnosis may be associated with risk of maternal death and can be detrimental to the fetus also. Surgical drainage of ovarian abscess and conservative and minimally invasive surgical procedure under antibiotics are recommended during pregnancy.

scholarly journals Appendicular Mucocele—A Diagnostic Dilemma: Managed Laparoscopically

2017 ◽  
Vol 1 (1) ◽  
pp. 38-39
Author(s):  
Bhangu Gurpreet ◽  
Sachdeva Kamal
Keyword(s):  
Histological Examination ◽  
Laparoscopic Appendectomy ◽  
Diagnostic Laparoscopy ◽  
Clinical Presentation ◽  
Mucinous Cystadenoma ◽  
Definitive Diagnosis ◽  
Rare Disorder ◽  
Diagnostic Dilemma ◽  
Risk Of Malignancy ◽  
Colicky Pain

ABSTRACT Appendicular mucocele is obstructive dilatation of the appendicular lumen by mucinous secretions. In most of the cases, it is caused by Mucinous cystadenoma and rarely by Mucinous cystadenocarcinoma. This rare disorder has a varied clinical presentation, with more than half of the patients being asymptomatic. We report the case of a 65-year-old man who presented with intermittent abdominal colicky pain and altered bowel habits. In spite of extensive preoperative investigations, no definitive diagnosis was made. On diagnostic laparoscopy it was found to be appendicular mucocele. We electively performed a laparoscopic appendectomy. As there is a risk of malignancy in the mucocele, we used an endobag to retrieve the specimen. Histological examination confirmed it as a Mucinous cystadenoma. How to cite this article Darpan B, Gurpreet B, Kamal S. Appendicular Mucocele—A Diagnostic Dilemma: Managed Laparoscopically. Curr Trends Diagn Treat 2017;1(1):38-39.

Diagnosis and management of hook of hamate fractures

2017 ◽  
Vol 43 (5) ◽  
pp. 539-545 ◽  
Author(s):  
Assaf Kadar ◽  
Allen T. Bishop ◽  
Marissa A. Suchyta ◽  
Steven L. Moran
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Clinical Findings ◽  
Advanced Imaging ◽  
Level Of Evidence ◽  
Historical Case ◽  
Treatment Groups ◽  
Diagnosis And Management ◽  
Time To Diagnosis ◽  
Hook Of Hamate

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively. Level of evidence: IV

scholarly journals Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 14-17
Author(s):  
Md Saiful Islam ◽  
Md Masudar Rahman ◽  
M Fardil Hossain Faisal ◽  
Md Alamgir Jalil Pramanik ◽  
Muhammad Abdur Rouf
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Correct Diagnosis ◽  
Abdominal Tuberculosis ◽  
Diagnostic Dilemma ◽  
Peritoneal Tissue ◽  
Appropriate Treatment ◽  
Liver Surface ◽  
Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

Polyarticular disease

2016 ◽  
Author(s):  
Ade Adebajo ◽  
Lisa Dunkley
Keyword(s):  
Lupus Erythematosus ◽  
Definitive Diagnosis ◽  
Systemic Lupus ◽  
Musculoskeletal Problem ◽  
Diagnostic Dilemma ◽  
General Management ◽  
Wide Range ◽  
Seronegative Spondyloarthropathies ◽  
Polyarticular Disease ◽  
Made In

Polyarticular disease is a commonly encountered musculoskeletal problem which regularly confronts clinicians as a diagnostic dilemma. Polyarticular disease is a musculoskeletal presentation in which more than four joints are affected by the disease. The classical rheumatological condition which presents as polyarticular disease is rheumatoid arthritis, although even this condition can very occasionally present with a mono- or oligoarticular onset. Polyarticular disease includes a wide range of musculoskeletal conditions including such disorders as polyarticular gout, the seronegative spondyloarthropathies, rheumatic fever, and systemic lupus erythematosus. This chapter emphasizes how through a careful history, thorough clinical examination and appropriate investigations, a definitive diagnosis can be made in a patient presenting clinically with polyarticular disease. General management principles for patients with polyarticular disease are also provided.

Nasopalatine Cyst or Apical Pathology? A Diagnostic Dilemma and How to Manage It

Dental Update ◽  
2020 ◽  
Vol 47 (2) ◽  
pp. 165-169
Author(s):  
Marialena Cresta ◽  
Robert Philpott ◽  
Eleni Besi
Keyword(s):  
Clinical Examination ◽  
Clinical Relevance ◽  
Definitive Diagnosis ◽  
Histopathological Analysis ◽  
Apical Region ◽  
Diagnostic Dilemma ◽  
Anterior Teeth ◽  
Appropriate Treatment ◽  
Odontogenic Origin ◽  
Careful Assessment

Nasopalatine cysts (NPCs) present as maxillary midline radiolucencies and are the most common radiolucency of non-odontogenic origin. The proximity of these radiolucencies to the apical region of the maxillary anterior teeth may complicate diagnosis. We are presenting two cases of maxillary midline radiolucencies with a similar presentation but different diagnoses. Reaching a definitive diagnosis may be complicated, even when a detailed clinical examination has been carried out. The use of CBCT has been a valuable addition to the diagnostic armamentarium which can help clinicians reach more accurate diagnoses in such cases. A definitive diagnosis may be established following histopathological analysis, which is indicated in symptomatic cases. CPD/Clinical Relevance: This article highlights the importance of careful assessment of apical radiolucencies associated with the maxillary midline, leading to the correct diagnoses and appropriate treatment planning.

scholarly journals Recurrent pneumonia-H type Tracheoesophageal fistula, diagnostic dilemma.

2014 ◽  
Vol 34 (1) ◽  
pp. 71-73
Author(s):  
S Adhikari ◽  
K Malla ◽  
P Poudyal
Keyword(s):  
Congenital Anomaly ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Definitive Diagnosis ◽  
Diagnostic Dilemma ◽  
Recurrent Pneumonia ◽  
Rare Congenital Anomaly

Tracheoesophageal fistula (TEF) without associated esophageal atresia (EA) is a rare congenital anomaly.  Most of the children are treated for episodes of pneumonia prior to definitive diagnosis.  A 5 months infant presented with recurrent pneumonia and diagnosis of H type TEF was made with contrast esophagram.DOI: http://dx.doi.org/10.3126/jnps.v34i1.8517   J Nepal Paediatr Soc 2014;34(1):71-73

scholarly journals Subperiosteal Osteoid Osteoma of the Neck of Talus

2009 ◽  
Vol 48 (173) ◽  
Author(s):  
Javed Ahmad Khan ◽  
S Vaidya ◽  
P Devkota ◽  
BM Acharya ◽  
NMS Pradhan ◽  
...  
Keyword(s):  
Osteoid Osteoma ◽  
Ankle Sprain ◽  
Definitive Diagnosis ◽  
High Index ◽  
Review Of Literature ◽  
Ankle Pain ◽  
Diagnostic Dilemma ◽  
High Index Of Suspicion

Juxta-articular, subperiosteal osteoid osteomas arising around the ankle are unusual. Tumors arising on the neck of the talus commonly produce symptoms mimicking monoarticular arthritis. Patients are usually treated for arthritis or ankle sprain, which often leads to a delay in definitive diagnosis. Here we present a case of osteoid osteoma of neck of talus which was presented as ankle pain. It puzzled us until MRI was done. Diagnostic dilemma and delay can be avoided by high index of suspicion. The patient was treated with open removal of the tumor. We also present brief review of literature about juxta-articular, subperiosteal osteoid osteoma which is uncommon from the typical osteoid osteoma occurring elsewhere in the body.Keywords: juxta-articular, subperiosteal, osteoid osteoma, talus neck

scholarly journals Y Shaped Colonic Duplication Mimicking Intestinal Volvulus: A Case Report and Review of Literature

2021 ◽  
Author(s):  
Volkan Sarper Erikçi
Keyword(s):  
Abdominal Pain ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Chronic Abdominal Pain ◽  
Review Of Literature ◽  
Colonic Duplication ◽  
Intestinal Volvulus

Enteric duplications are rare congenital anomalies found anywhere from mouth to anus. Colonic duplications constitute about 13% of all enteric duplications. In this report a 6-year-old boy with chronic abdominal pain for a duration of last 2 years requiring intermittent hospital admissions was diagnosed as colonic duplication mimicking intestinal volvulus. Clinical findings are nonspecific and definitive diagnosis can only be made during surgical intervention and surgical treatment is advocated for all duplications. The topic is discussed under the light of relevant literature with a brief a brief literature review.

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