Surgical Treatment of a Symptomatic Diaphyseal Tibiofibular Synostosis in a Professional Rugby Player: A Case Report and Literature Review

Context: Diaphyseal tibiofibular synostosis (DTS) is a rare pathology with unknown origin especially occurring in intensive sport athletes. No therapeutic guideline has been well established in the literature. Case Presentation: A rare case of DTS in a 26-year-old professional rugby player has been described. A 5-month exhaustive conservative treatment including physiotherapy and oral medication has been achieved but failed. Management and Outcomes: Following the conservative treatment failure, the DTS has been widely removed including the adjacent interosseous membrane, and the patient could return to competition at the same level after 5 months of convalescence. No recurrence has been revealed at a 35-month follow-up at least. Conclusion: In accordance with the literature data and even if the pathophysiology remains obscure, resection of DTS seems to be the adapted treatment to allow and to reduce professional athletes’ recovery time at the same sport level. The resection including a part of the tibiofibular interosseous membrane could avoid the occurrence of recurrence. Conservative treatment should be reserved for senior patients with a low sport activity.

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Incidental Findings of Brugada Syndrome Type-1 and Epsilon-Like Pattern in Otherwise Healthy Man: a Case Report

10.21203/rs.3.rs-1247914/v1 ◽

2022 ◽

Author(s):

Brian Mendel ◽

Valerie Dirjayanto ◽

Radityo Prakoso ◽

Sisca Siagian

Keyword(s):

Brugada Syndrome ◽

Unknown Origin ◽

Initial Assessment ◽

Structural Abnormality ◽

Bundle Branch Block ◽

Case Presentation ◽

Electrophysiology Study ◽

Esc Guidelines

Abstract Background: Brugada Syndrome (BrS) and arrhythmogenic right ventricle dysplasia (ARVD) are rare cardiomyopathies predisposing to sudden cardiac death (SCD). Comprehending the electrocardiographic features of these cardiomyopathies are crucial especially in emergency settings.Case presentation: A 25-year old medical student presented with no complaints, but had episodes of syncope, chest pain, and palpitations of unknown origin 10 years ago. The initial assessment showed stable hemodynamics. During examination, the ECG demonstrated incomplete right bundle branch block, Brugada-type 1 pattern, with signs of Epsilon wave. The following year, assessment of the ECG was repeated and findings were found suggestive of Brugada syndrome, although his echocardiography showed no structural abnormality. According to ESC guidelines, asymptomatic Brugada patients should undergo electrophysiology study.Conclusion: Careful follow-up with electrophysiology study is recommended for this patient in order to identify the likelihood of true Brugada and suitability for radiofrequency ablation or implantation of implantable cardioverter defibrillator (ICD).

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Forestier´s Syndrome, Diffuse idiopathic skeletal hiperostosis: Report of a case of oropharyngeal dysphagia with conservative treatment and literature review

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.v8i4.1708 ◽

2021 ◽

pp. 1-14

Author(s):

Marta Elizabeth Osorio Fleitas ◽

Blas Antonio Medina Ruíz ◽

Blás Agustín Medina Izcurdia ◽

Joaquín Julián Medina Izcurdia

Keyword(s):

Conservative Treatment ◽

Oropharyngeal Dysphagia ◽

Unknown Origin ◽

Posterior Wall ◽

Neck Surgery ◽

The Body ◽

Common Symptom ◽

Variable Intensity ◽

Rheumatological Disease

Forestier Syndrome is a rheumatological disease of unknown origin, which consist in calcification of different areas of the body, predominantly at the level of the anterior common vertebral ligament, where osteophytes capable of producing varied symptoms of variable intensity are formed. Normally asymptomatic, although, when it affects the cervical spine, the most common symptom is dysphagia. A case of Forestier syndrome is presented who consulted for dysphagia in the Head and Neck Surgery Unit of the Otolaryngology Service of the Institute of Social Prevision, Asuncion, Paraguay. The semiology allowed to observe a submucosal bulge in the posterior wall of the oropharynx of 1,5 cm in diameter, which could be evaluated and confirmed by tomography. Due to the low intensity of the symptoms and little impact on the general state, it was decided to carry out a conservative treatment with good results, after two years of clinical follow-up. In these cases, surgery occupies a secondary place, either before the failure of this conservative behavior or the progression of the symptoms.

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Spontaneous regression of lumbar herniated disc Case presentation

Romanian Neurosurgery ◽

10.1515/romneu-2015-0053 ◽

2015 ◽

Vol 29 (4) ◽

pp. 381-384 ◽

Cited By ~ 1

Author(s):

A. Chiriac ◽

Giorgiana Ion ◽

Z. Faiyad ◽

I. Poeata

Keyword(s):

Conservative Treatment ◽

Intervertebral Disc ◽

Clinical Improvement ◽

Spontaneous Regression ◽

Surgical Intervention ◽

Herniated Disc ◽

Common Disease ◽

Intervertebral Disc Herniation ◽

Case Presentation

Abstract Intervertebral disc herniation is a common disease that usually requires surgical intervention. However, in some cases, neurological symptoms may improve with conservative treatment. In this article, we present a case with spontaneous regression of extruded lumbar herniated disc correlated with clinical improvement and documented with follow up MRI studies.

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Abdominal pain as first manifestation of lyme neuroborreliosis in children, case report and review of literature

Italian Journal of Pediatrics ◽

10.1186/s13052-020-00936-y ◽

2020 ◽

Vol 46 (1) ◽

Author(s):

Salvatore Savasta ◽

Ivan Fiorito ◽

Thomas Foiadelli ◽

Anna Pichiecchio ◽

Patrizia Cambieri ◽

...

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Unknown Origin ◽

Lyme Neuroborreliosis ◽

Review Of Literature ◽

Case Presentation ◽

Neurological Sequelae ◽

Cranial Nerve Palsies ◽

Radiological Images

Abstract Background Lyme neuroborreliosis can cause a variety of neurological manifestations. European children usually present facial nerve palsy, other cranial nerve palsies and aseptic meningitis. Case presentation We hereby report a case of Lyme neuroborreliosis in a 9-year-old boy with abdominal pain as first symptom and subsequent onset of attention deficit and ataxia. Diagnosis was made by detection of specific antibody in both serum and cerebrospinal fluid with neuro-radiological images suggestive for this infectious disease. A 12-months follow-up was performed during which no relevant neurological sequelae were revealed. Conclusion This case report shows that abdominal radiculitis, although extremely rare, could be the first manifestation of early Lyme neuroborreliosis in pediatric patients. Pediatricians must consider Lyme disease in the differential diagnosis of abdominal pain of unknown origin in children, especially in countries where the infection is endemic.

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Clinical Analysis of Pyocele of Tunica Vaginalis in 56 Newborns

Urologia Internationalis ◽

10.1159/000519096 ◽

2021 ◽

pp. 1-6

Author(s):

Tian-Qu He ◽

Li-Hui Zhu ◽

Chuang-Ye Li ◽

Qian-Long Peng ◽

Jian-Cheng Zu ◽

...

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Recovery Time ◽

Pathogenic Bacteria ◽

Color Doppler ◽

Tunica Vaginalis ◽

Term Infants ◽

Surgical Exploration ◽

Clinical Recovery

Objective: This study aimed to explore the clinical characteristics, treatment methods, and prognosis of neonatal pyocele of tunica vaginalis and to provide a reference for the clinical treatment. Methods: A total of 56 newborns with pyocele of tunica vaginalis were admitted to our hospital due to the scrotal emergency from January 2015 to January 2020. Our study retrospectively analyzed these 56 cases. Of the 56 cases, including 32 full-term infants and 24 premature infants, age ranged from 1 to 27 days. Initially, conservative treatment (intravenous antibiotic treatment) was applied to 42 cases, and surgery to 14 cases. Then, 7 underwent surgical exploration during the conservative treatment, and 2 cases with initial surgical treatment experienced orchiectomy because of complete necrosis. For 56 cases, the average follow-up time was 18 months. Results: The clinical recovery time of cases with conservative treatment ranged from 8 to 17 days, with an average of 11.02 ± 2.31 days. The clinical recovery time of cases with surgery ranged from 6 to 15 days, with an average of 9.28 ± 2.78 days. During the follow-up, for 56 cases, except for the 2 cases with orchiectomy, the testicular position and Doppler flow both went back to normal, of the 42 cases with initial conservative treatment, 1 case experienced testicular retardation, of the 14 cases with initial surgical treatment, 2 cases experienced testicular retardation, and hydrocele of 42 cases were self-healed. Conclusions: Neonatal pyocele of tunica vaginalis is mostly secondary to intra-abdominal infection. Color Doppler ultrasound is helpful for the diagnosis. The percutaneous aspiration is a way of collecting pathogenic bacteria during the conservative treatment. If the color Doppler suggests testicular involvement, surgical exploration should be performed.

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A case report of intestinal obstruction caused by cryptogenic multifocal ulcerous stenosing enteritis

BMC Gastroenterology ◽

10.1186/s12876-020-01450-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cheng Chang ◽

Chen Jiang ◽

Yaoyao Miao ◽

Bin Fang ◽

Lili Zhang

Keyword(s):

Small Intestine ◽

Case Report ◽

Surgical Treatment ◽

Intestinal Obstruction ◽

Rare Disease ◽

Male Patient ◽

Unknown Origin ◽

Case Presentation ◽

The Future

Abstract Background Cryptogenic multifocal ulcer stenosing enteritis (CMUSE) is a rare disease characterized by multiple superficial ulcers, stenosis, and obstruction of the small intestine of unknown origin, and the course can recur. Case presentation We encountered a 62-year-old male patient with intestinal obstruction. The patient was admitted to the hospital for surgical treatment due to intestinal obstruction, and was diagnosed with cryptogenic multifocal ulcer stenosis enteritis due to comprehensive surgery and postoperative pathological considerations. Conclusion In the future, we will continue to follow up the patient. The present study aims to remind clinicians of this disease, and reduce the incidence of misdiagnosis.

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Spontaneous Subarachnoid Hemorrhage Caused by Ruptured Aneurysm of Basilar Trunk Perforator

10.21203/rs.3.rs-32783/v1 ◽

2020 ◽

Author(s):

Tao Wu ◽

Yao Wu ◽

Ailin Chen ◽

Chungang Dai ◽

Qing Zhu

Keyword(s):

Subarachnoid Hemorrhage ◽

Conservative Treatment ◽

Surgical Intervention ◽

Endovascular Embolization ◽

Good Choice ◽

Ruptured Aneurysm ◽

Case Presentation ◽

Spontaneous Subarachnoid Hemorrhage ◽

Sudden Headache

Abstract Background: The morbidity of BAPA is very low. Up to now, the pathogenesis and treatment of BAPA are not uniform. Conventional endovascular embolization and craniotomy seem not to be a good choice. We report a case of spontaneous subarachnoid hemorrhage caused by rupture of perforator aneurysm of basal trunk and successfully discharged after conservative treatment, suggesting that conservative treatment may be superior to surgical intervention.Case presentation: A 65-year-old male patient with sudden headache and dizziness for five days was admitted to our hospital for emergency treatment. Spontaneous subarachnoid hemorrhage was diagnosed by DSA. We finally found that hemorrhage Caused by ruptured aneurysm of basilar Trunk perforator.After conservative treatment for two months,DSA showed that the aneurysm disappeared completely.Conclusions: Aneurysm located at perforator artery of basilar trunk was rare and difficult to treat.Conservative treatment for certain cases with periodic angiography follow-up was recommended in order to prevent from potential iatrogenic effects.

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Conservative Treatment of Vestibular Schwannomas: A Follow-Up Study on Clinical Outcomes

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0032-1314176 ◽

2012 ◽

Vol 73 (S 02) ◽

Author(s):

M. Sadadcharam ◽

R. Wormald ◽

M. Javadpour ◽

D. Rawluk ◽

R. McConn-Walsh

Keyword(s):

Conservative Treatment ◽

Clinical Outcomes ◽

Vestibular Schwannomas ◽

Follow Up Study

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A combined lateral-crestal approach of sinus floor elevation: A report on three cases

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-20-00061 ◽

2020 ◽

Author(s):

Xin Zhang ◽

Yuting Zhang ◽

Jian Wang ◽

Qianbing Wan ◽

Lei Li

Keyword(s):

Clinical Study ◽

Conservative Treatment ◽

Lateral Approach ◽

Clinical Report ◽

Sinus Lift ◽

Sinus Floor Elevation ◽

Long Term Follow Up ◽

Sinus Floor

This clinical report describes a combined lateral-crestal approach to elevate the sinus floor when placing implants on a wide maxillary posterior ridge. The buccally enlarged osteotomy broadens vision of practitioners and facilitates access of instruments in the sinus. Compared to the traditional lateral approach of sinus lift, the proposed technique may offer a more conservative treatment modality. And a clinical study with sufficient subjects and long term follow up is needed to validate the potential and limitations of the proposed technique.

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