Management of recurrent post-traumatic seroma of thigh (Morel-Lavallée lesion) by percutaneous aspiration and sclerotherapy using tetracyclines (PAST)

2021 ◽  
Vol 14 (1) ◽  
pp. e238804
Author(s):  
Arunesh Gupta ◽  
Vineet Kumar ◽  
Apurva Agarwal ◽  
Aneesh Suresh
Keyword(s):  
Early Diagnosis ◽  
Conservative Management ◽  
Bacterial Contamination ◽  
Soft Tissues ◽  
Successful Outcome ◽  
Serous Fluid ◽  
Percutaneous Aspiration ◽  
Post Traumatic ◽  
Open Debridement ◽  
Definitive Management

Morel-Lavallée lesion is a chronic, recurrent collection of serous fluid in the soft tissues and usually occurs following injury. The most common sites are thigh, hip and pelvic region. This presents as a local or diffuse swelling and may cause discomfort to the patient besides being a potential site for bacterial contamination. So, early diagnosis and timely management is crucial for an early and successful outcome. The investigation modality of choice for diagnosis of these lesions is MRI. Definitive management ranges from percutaneous aspiration with or without sclerotherapy to open debridement and irrigation. Although recurrences are common with conservative management, it can be minimised with judicious use of sclerotherapy.

scholarly journals An unusual presentation of morel- lavallee lesion in the arm: a case report

2020 ◽  
Vol 6 (6) ◽  
pp. 1332
Author(s):  
Yogesh Kumar Balasubramanian ◽  
Raghavendran Balasubramanian
Keyword(s):  
Early Diagnosis ◽  
Subcutaneous Tissue ◽  
Skin Grafting ◽  
Lower Extremity Trauma ◽  
Left Elbow ◽  
Extremity Trauma ◽  
Previous Trauma ◽  
Post Traumatic ◽  
Proximal Forearm ◽  
Open Debridement

<p class="abstract">Morel-lavallee lesions (MLL) are post traumatic closed internal de-gloving injury with abrupt separation of skin and subcutaneous tissue from the underlying fascia. The shearing force damages the blood vessels and lymphatics, resulting in collection of the serosanguinous fluid and necrotized fat. Early diagnosis and management minimize complications like infections or extensive skin necrosis. MLLs commonly described in pelvic and lower extremity trauma, and there are limited reports in other locations. A 28-year-old male presented with pain and swelling over the left elbow for 6 days with multiple deep bruises over the skin extending from mid arm to proximal forearm.  Ultrasound of the arm revealed a large encapsulated collection consistent with MLL. An open debridement with excision of all necrotic skin and necrotic tissue was performed followed by skin grafting. Intra-operative cultures were negative and pathology was consistent with MLL. Morel-lavallee lesions should always be considered as early diagnosis of previous trauma regardless the location. The key to recognize this injury depends on suspicious mechanism involving significant shear forces. Aggressive surgical debridement remains the key to prevent significant morbidity and mortality.</p>

The Central Slip Tenodesis Test for Early Diagnosis of Potential Boutonnière Deformities

1994 ◽  
Vol 19 (1) ◽  
pp. 88-90 ◽  
Author(s):  
P. J. SMITH ◽  
D. A. ROSS
Keyword(s):  
Early Diagnosis ◽  
Conservative Management ◽  
Primary Defect ◽  
Non Invasive ◽  
Boutonniere Deformity ◽  
Invasive Method ◽  
Central Slip ◽  
Boutonnière Deformity

Disruption of the central slip is the primary defect leading to boutonnière deformity. In the closed injury early diagnosis of this lesion is rarely achieved due to the limitations of current methods and difficulties encountered in assessing a painful finger. We describe a simple, non-invasive method of diagnosis which can be carried out on all patients and with minimal discomfort. This test is also beneficial in monitoring the progress of conservative management of central slip disruption.

scholarly journals The management of stress urinary incontinence: A case report

2015 ◽  
Vol 71 (1) ◽  
Author(s):  
Preshani Reddy
Keyword(s):  
Urinary Incontinence ◽  
Case Report ◽  
Stress Urinary Incontinence ◽  
Conservative Management ◽  
Treatment Plan ◽  
Exercise Programme ◽  
Successful Outcome ◽  
Successful Management ◽  
Tailored Treatment ◽  
Programme Improvement

Introduction: Conservative management is the first option for patients with stress urinary incontinence (SUI). However, successful management of women diagnosed with SUI is dependent on a proper assessment and a tailored treatment plan. This case report aims to show the effectiveness of physiotherapy management in a 42-year-old patient diagnosed with SUI.Patient presentation: The patient’s main complaints were involuntary loss of urine on coughing, sneezing and lifting of heavy objects, which started following the birth of her third child.Management and outcome: The patient was taught the ‘Knack’ manoeuvre and provided with a tailored pelvic floor exercise programme. Improvement was noted at the third visit and the patient no longer had involuntary episodes.Conclusion: This case report shows the successful outcome of conservative management in a patient with stress urinary incontinence.

scholarly journals Management of fracture of neck talus and clinical evaluation of results

2016 ◽  
Vol 2 (3) ◽  
pp. 80
Author(s):  
Satish Raghunath Gawali ◽  
Gajanan Madhav Kathar ◽  
Pramod Vilas Niravane ◽  
Mansoor Iqbal Bhosage
Keyword(s):  
Soft Tissues ◽  
Late Complications ◽  
Successful Outcome ◽  
Excessive Pressure ◽  
Lower Extremity Injuries ◽  
Non Union ◽  
Type Iv ◽  
Subtalar Arthritis ◽  
Neck Fracture ◽  
Extremity Injuries

<p class="abstract"><strong>Background:</strong> Fracture of neck of talus is rare and serious injury with significant complication rate. The talus is involved in about 2% of all lower extremity injuries and about 5-7% of foot injuries. Talus neck fixation is associated with serious complications such as stiffness at ankle and subtler joint, AVN of body of talus, ankle arthritis and later on subtalar arthritis. The objective was to study and evaluate the operative treatment for talus neck fracture.</p><p class="abstract"><strong>Methods:</strong> All adult patients with talus neck fracture admitted in government medical college and hospital, Latur, Maharashtra, India from January 2006 to December 2015 were involved. There were 15 patients with 10 males and 05 females. Fractures were classified as per Hawkins classification and were treated with closed/open reduction and internal fixation with CC screws.</p><p class="abstract"><strong>Results:</strong> All patients were followed prospectively post operatively and clinical and radiological evaluation was done. Results were analyzed. We noted skin complications in 02 patients and rate of consolidation was 60-70%. The final follow-up examination included determination of the AHS score (ankle–hind foot scale) from the American orthopaedic foot and ankle society (AOFAS), range of motion evaluation and radiological analysis.</p><strong>Conclusions:</strong> Displaced talar neck fractures are a therapeutic challenge which has significant early and late complications. Despite of all excellent management, non-union rate in type III, and type IV Hawkins fracture is 85%; and AVN of body of talus is 90-95% due to inherent complications of cut off of blood supply which comes from talar neck. Types II, III, IV were associated with talar body dislocation which caused excessive pressure on soft tissues having significant soft tissue complications. Early anatomical reduction and stable fixation is of vital importance to achieve successful outcome.

scholarly journals ENT trauma in children: causes, frequency and characteristics in different periods of childhood

2020 ◽  
Vol 19 (6) ◽  
pp. 94-101
Author(s):  
E. Yu. Radtsig ◽  
◽  
M. M. Evsikova ◽  
M. A. Varavina ◽  
◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Soft Tissues ◽  
Traumatic Events ◽  
Frequency Of Occurrence ◽  
External Nose ◽  
Post Traumatic

Numerous injuries (and their treatment) have been encountered since the very beginning of the development of human civilization and remain one of the most significant problems in our time, since the frequency of injuries in general (and of ENT organs in particular) does not tend to decrease either in children or adults. ENT injuries are in fourth place in terms of emergency appeal rates. The most common injury to the maxillofacial area is a fracture of the skeleton of the nose. The article presents data on the frequency of occurrence of this pathology and describes the features of the causes that caused it in different periods of childhood, presents an algorithm for managing patients. The role of homeopathic arnica-containing remedies (Arnigel®) in the conservative treatment of reactive post-traumatic events from the soft tissues of the external nose is shown.

scholarly journals Successful Outcome of Pregnancy with Addison’s Disease & Hypothyroidism

2017 ◽  
Vol 13 (1) ◽  
pp. 134-137
Author(s):  
Nargis Nahar ◽  
Iffat Ara
Keyword(s):  
Early Diagnosis ◽  
Addison’S Disease ◽  
Armed Forces ◽  
Successful Outcome ◽  
Addison's Disease ◽  
Endocrine Disorder ◽  
Medical College ◽  
Fetal Surveillance ◽  
In Pregnancy

Hypocortisolism or hypoadrenalism is well known as Addison’s disease which is a long term endocrine disorder. In pregnancy it requires much awareness and attention of treating physicians. Early diagnosis, adequate supplement of glucocorticoid and mineralocorticoid and fetal surveillance through regular antenatal checkup is essential for pregnant ladies with Addison’s disease. Patients should be counselled appropriately regarding medication, life-style and precautions to be taken in case of infection, operational exposure or any other stress. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 134-137

scholarly journals Assisted Reproductive Technology as a Transcutaneous Route for Bacterial Contamination of Ovarian Endometrioma with Coagulase-Negative Staphylococcus: Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Shimon Edelstein ◽  
Inbar Ben Shachar ◽  
Hila Ben-Amram ◽  
Seema Biswas ◽  
Naama Marcus
Keyword(s):  
Assisted Reproductive Technology ◽  
Bacterial Contamination ◽  
Soft Tissues ◽  
Group B Streptococcus ◽  
Rare Condition ◽  
Oocyte Retrieval ◽  
Reproductive Technology ◽  
Causative Organism ◽  
Coagulase Negative Staphylococcus ◽  
Group B

Tubo-ovarian abscess may develop in women with endometrioma following assisted reproductive technology (ART). The infection, though rare, is typically late in onset and may present several months after the procedure, and in pregnancy—with the risks of abortion and premature labor. It is thought that transcutaneous oocyte retrieval during ART is the route for bacterial contamination resulting in infection of the endometrioma. Pathogens reported in the literature include Escherichia coli (E. coli) and Group B streptococcus (GBS) but Staphylococcus lugdunensis (S. lugdunensis), a coagulase-negative staphylococcus (CoNS), and groin and perineal skin commensal was isolated from the endometrioma in this case. We discuss the challenges in diagnosis and treatment of this rare condition and the implications of the discovery that an organism previously dismissed as a contaminant has emerged as a causative organism in severe, deep-seated infections of soft tissues in recent literature.

scholarly journals Post-traumatic bronchobiliary fistula

2019 ◽  
Vol 12 (4) ◽  
pp. e228294 ◽  
Author(s):  
Niladri Banerjee ◽  
Amulya Rattan ◽  
Pratyusha Priyadarshini ◽  
Subodh Kumar
Keyword(s):  
Early Diagnosis ◽  
Surgical Management ◽  
Gold Standard ◽  
Complete Recovery ◽  
Rare Entity ◽  
Bronchobiliary Fistula ◽  
Confirmatory Tests ◽  
Post Traumatic ◽  
Torso Trauma ◽  
Individualised Treatment

Post-traumatic bronchobiliary fistula (BBF) is a rare entity, with only a few cases reported worldwide. Bilioptysis is pathognomonic of the condition, however, bronchoscopy and bronchoalveolar lavage along with CT are used for confirmation. We describe this condition in a young woman who presented to us with bilioptysis following a laparotomy for blunt torso trauma. Diagnosis was made of BBF, followed by surgical management and complete recovery. We emphasise the signs of early diagnosis, confirmatory tests, individualised treatment and advocate surgical management as the gold standard of treatment.

SCREENING FOR NEONATAL HIP INSTABILITY IN AN ASIAN POPULATION: AN EVALUATION OF THE FIRST 5 YEARS

1999 ◽  
Vol 03 (01) ◽  
pp. 33-37
Author(s):  
K. C. Ang ◽  
E. H. Lee
Keyword(s):  
Early Diagnosis ◽  
Screening Program ◽  
Adult Life ◽  
Hip Dislocation ◽  
Successful Outcome ◽  
Prolonged Treatment ◽  
X Rays ◽  
Screening Programs ◽  
Live Births ◽  
Neonatal Hip

Developmental dysplasia of the hip can result in significant morbidity both in childhood and later in adult life. Early diagnosis enables better results to be obtained with fewer complications, while delayed diagnosis can lead to prolonged treatment with less satisfactory outcome. A Neonatal Hip Screening program for DDH has been in place in the National University Hospital, Singapore since December 1989. Our program is run by consultant neonatologists and consultant paediatric orthopaedic surgeons. All neonates seen with DDH are followed up for a minimum of 1 year with ultrasonography and X-rays. Our results show an incidence of dislocated hips of 4.7 per 1000 live births. The incidence of neonates with acetabular dysplasia as defined by an Acetabular Index of > 30° is 16.8 per 1000 live births. The early diagnosis and treatment of hip dislocation is important for the development of a normal acetabulum. Neonatal Hip Screening programs have been shown to be effective in the early diagnosis, resulting in successful outcome of treatment and reduction of economic costs in the management of DDH. The finding of a significant incidence of DDH in our population and the successful management after early diagnosis in our study have vindicated the establishment of our hip screening program.

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