Bilateral isolated mylohyoid groove fracture progressing as submandibular abscess: an usual fracture pattern of mandible

The mylohyoid ridges or lines are pairs of anatomical bony structures located on the internal or lingual surface of mandible. They are the origin for the mylohyoid muscle. These bony structures are distinct in the mandibular molar region, well protected and gradually become undiscernible towards anterior mandible. Bilateral, isolated fracture of the mylohyoid ridges without concomitant mandibular fracture is rare and, to the best of the authors knowledge, was never previously described. This case report describes an isolated bilateral mylohyoid groove fracture, where one side of a necrotic bone fragment at the fracture site progress to became a nidus of infection, which later caused submandibular space abscess requiring emergency surgical intervention. Diagnosis, possible theory to explain the occurrence of isolated mylohyoid groove fracture and management of these condition are explained in this report.

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Fascicular torsions of the anterior and posterior interosseous nerve in 4 cases: neuroimaging methods to improve diagnosis

Journal of Neurosurgery ◽

10.3171/2019.3.jns183302 ◽

2020 ◽

Vol 132 (6) ◽

pp. 1925-1929 ◽

Cited By ~ 3

Author(s):

Jennifer Kollmer ◽

Paul Preisser ◽

Martin Bendszus ◽

Henrich Kele

Keyword(s):

Magnetic Resonance ◽

Surgical Intervention ◽

Case Series ◽

Diagnostic Methods ◽

Posterior Interosseous Nerve ◽

Nerve Ultrasound ◽

Magnetic Resonance Neurography ◽

Surgical Exploration ◽

Hyperintense Signal ◽

Emergency Surgical Intervention

Diagnosis of spontaneous fascicular nerve torsions is difficult and often delayed until surgical exploration is performed. This case series raises awareness of peripheral nerve torsions and will facilitate an earlier diagnosis by using nerve ultrasound (NUS) and magnetic resonance neurography (MRN). Four patients with previously ambiguous upper-extremity mononeuropathies underwent NUS and 3T MRN. Neuroimaging detected proximal torsions of the anterior and posterior interosseous nerve fascicles within median or radial nerve trunks in all patients. In NUS, most cases presented with a thickening of affected nerve fascicles, followed by an abrupt caliber decrease, leading to the pathognomonic sausage-like configuration. MRN showed T2-weighted hyperintense signal alterations of fascicles at and distal to the torsion site, and directly visualized the distorted nerves. Three patients had favorable outcomes after being transferred to emergency surgical intervention, while 1 patient with existing chronic muscle atrophy was no longer eligible for surgery. NUS and MRN are complementary diagnostic methods, and both can detect nerve torsions on a fascicular level. Neuroimaging is indispensable for diagnosing fascicular nerve torsions, and should be applied in all unclear cases of mononeuropathy to determine the diagnosis and if necessary, to guide surgical therapies, as only timely interventions enable favorable outcomes.

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EMERGENCY SURGERY DURING COVID 19 AT K.A.P.V GOVERNMENT MEDICAL COLLEGE AND MGMGH , TRICHY

10.36106/ijar/8200303 ◽

2021 ◽

pp. 6-9

Author(s):

Sumathi Ravikumar ◽

Yeganathan Rajappan ◽

Durairajan Vaithiyanathan ◽

Catherine Sindhuja

Keyword(s):

Surgical Intervention ◽

District General Hospital ◽

Favourable Outcome ◽

Emergency General Surgery ◽

Emergency Admissions ◽

Medical College ◽

Prolonged Duration ◽

Current Impact ◽

Emergency Surgical Intervention ◽

The Impact

COVID 19 pandemic was declared by WHO as public health emergency on January 30,2020. Health system was reorganised with the aim to cope with the new disease and maintain essential health service. Many patients suffered from ARDS which lead to the modication of clinical and surgical activity. Current impact of COVID 19 outbreak on emergency surgical practice is still not developed. Varied presentation, diagnostic uncertainity, lack of guidelines present challenges to surgeons. AIM: The aim of our study was to evaluate the impact of the COVID-19 pandemic on emergency general surgery admissions and operations in our institution METHODS: We conducted a retrospective study in K.A.P.V.G.M.C. and M.G.M.G.H., Trichy from march 2020 to December 2020. All general surgical emergency admissions to KAPVGMC and MGMGH, district general hospital were included from march to December 2020.The details of diagnosis and subsequent management were retrieved from records. CONCLUSION: It was observed thatclinical decisions were made based on urgency of each case while simultaneously evaluating their COVID 19 status. The number of surgicalcases during COVID 19 period were signicantly reduced. Recognising asymptomatic carriers and need of emergency surgical intervention were the challenges faced by the surgeons. Effective communication between microbiologist, radiologist, anaesthetist and surgeon was necessary to attain a favourable outcome. .Inspite of challenges faced 80% had postoperative uneventful period other than prolonged duration of stay and were discharged and followed up. Covid 19 pneumonia and ARDS attributed to majority of death among the 20 % of deceased , other than septicemia

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Emergency Surgical Intervention by Mobile Surgical Team in the NICU

Open Journal of Pediatrics ◽

10.4236/ojped.2014.42022 ◽

2014 ◽

Vol 04 (02) ◽

pp. 162-168

Author(s):

R.-B. Trobs ◽

A. Stein ◽

U. Felderhoff ◽

L. Hanssler

Keyword(s):

Surgical Intervention ◽

Surgical Team ◽

Emergency Surgical Intervention

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Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

South Sudan Medical Journal ◽

10.4314/ssmj.v14i3.4 ◽

2021 ◽

Vol 14 (3) ◽

pp. 85-88

Author(s):

Jok Thikuiy Gang ◽

Sisay Kirba Kea ◽

Samson Gebremedhin

Keyword(s):

Ectopic Pregnancy ◽

Medical Records ◽

Selection Criteria ◽

Surgical Intervention ◽

Addis Ababa ◽

Safe Alternative ◽

Medical College ◽

Endometrial Cavity ◽

Emergency Surgical Intervention ◽

Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

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Meconium peritonitis in a preterm infant: a surgical emergency

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20211090 ◽

2021 ◽

Vol 8 (4) ◽

pp. 753

Author(s):

Priyanka Yadav ◽

Ankit Agarwal

Keyword(s):

Intestinal Perforation ◽

Surgical Intervention ◽

Bowel Resection ◽

Postnatal Period ◽

Meconium Peritonitis ◽

Clinical Presentations ◽

Good Clinical Condition ◽

Severe Peritonitis ◽

Emergency Surgical Intervention ◽

Chemical Peritonitis

Meconium peritonitis is sterile chemical peritonitis that occurs after intestinal perforation resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The clinical presentations after birth can range from completely sealed-off peritonitis without any symptoms, to severe peritonitis requiring emergency surgical intervention. We describe a case of meconium peritonitis in a premature infant following intestinal perforation. In the immediate postnatal period, the patient was intubated and a peritoneal drain was placed. Laparotomy with bowel resection was performed the following day. The postoperative course was uneventful and the patient was discharged home in good clinical condition.

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Accuracy of Diagnostic Peritoneal Paracentesis in Acute Abdominal Condition Requiring Emergency Surgical Intervention

New Indian Journal of Surgery ◽

10.21088/nijs.0976.4747.7116.12 ◽

2016 ◽

Vol 7 (1) ◽

pp. 53-58

Author(s):

Shrikant Channadasar ◽

◽

Shankar Lal J. ◽

Keyword(s):

Surgical Intervention ◽

Emergency Surgical Intervention ◽

Acute Abdominal Condition

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Clinical Implications of the Submental and Sublingual Arteries in Relation to the Mylohyoid Boutonnière

Otolaryngology ◽

10.1177/0194599820939852 ◽

2020 ◽

pp. 019459982093985

Author(s):

Matthew J. Zdilla ◽

Adam N. Bender-Heine ◽

H. Wayne Lambert ◽

Dawn D. Hunter

Keyword(s):

Blood Vessels ◽

West Virginia University ◽

Mylohyoid Muscle ◽

Cross Sectional ◽

Submental Artery ◽

School Of Medicine ◽

Sublingual Artery ◽

Pass Through ◽

Anterior Mandible ◽

Submental Island Flap

Objective Mylohyoid musculature may be included in the submental artery flap to protect perforators. However, blood vessels may pass through the mylohyoid muscle and therefore cause bleeding and risk to pedicle or perforator injury when a mylohyoid-containing flap is lifted. The objectives of this study were to identify the prevalence of the submental and sublingual arteries that traverse the mylohyoid and to assess relationships between vasculature transmitted through mylohyoid muscles and mylohyoid boutonnières. Study Design Cross-sectional human cadaveric study. Setting The West Virginia University School of Medicine human gross anatomic laboratories. Subjects and Methods A total of 43 intact mylohyoid muscles from 22 cadavers were dissected. The prevalence of submental vasculature perforating the mylohyoid was recorded in addition to the prevalence and contents of mylohyoid boutonnières. Results Of 43 mylohyoid muscles, 21 (48.8%) transmitted the submental or sublingual arteries, and 30 (69.1%) possessed boutonnières. One muscle had 2 boutonnières. Of 31 mylohyoid boutonnières, 21 transmitted blood vessels (67.7%). Specifically, 9 transmitted an artery and a vein (29.0%), and 12 transmitted an artery (38.7%). Ten boutonnières (32.3%) were exclusively occupied by fascia. Conclusion This report identifies the importance of identifying and carefully ligating branches of the submental artery that pierce the mylohyoid during elevation of the submental island flap. This report also identifies that a boutonnière is often present where a submental or sublingual artery is traversing the mylohyoid to supply sublingual glands, tongue, and anterior mandible.

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